The closing of mental health facilities by state governments resulting in very ill people living among the wider community is a disgrace (at least in South Australia). SA has quite a history of tragedies, thanks to government incompetence and lack of knowledge of mental health - or lack of interest. The attacks on family by people who should be in secure care, and suicides of people denied any care, are commonplace.

Recently, while a group of dopey Opposition and minor party Senatators were in SA bleating about mental care for illegal immigrants in Baxter detention centre, an elderly Australian man killed himself because he could not get a hospital bed. We don't do anything for our own people, but they want to talk about people who should never have been in Australia in the first place!

The Howard Government cut Health funding to the States last year by nearly $1 billion over 5 years, which is why the States are struggling to keep thier services going, at the same time Howard has a surplus of $13.6 billon and is wondering where to spend it. If there are no services available to you, look no further than your "worker friendly" Howard Government

Mr Woodruff

Thank you for your article. Spot on!

From my experience as a long time psychiatric/mental health nurse I have watched the erosion of effective mental health services since the 1984 Richmond Inquiry.

I was proud of what I did in the "old system" - even though it was fraught with problems. And I have been proud of my community work - and totally frustrated by it! I have assessed dozens of people who clearly required urgent hospitalisation - only to be turned away by the system because of the inexperience of hospital assessors. Then, despite my efforts and intensive home visits, clients got sicker and sicker. Pathetic really. They needed a place of safety and time out from the pressures of society.

We need a combination of both systems. Let's face it - the term asylum - means a place of safety. And that is what some people with protracted mental illness need. They need to feel safe. They need to feel cared about. Some need long term protection. Some simply cannot survive on their own. They want help. They need help.

Last week's "Insight" Program on SBS has been transcribed on the SBS Insight Web Site. A good read.

True psychiatric/mental health nurses are a retiring and dying race. There is no-one to replace us.

I despair for the future of people with mental health problems.

Regards
Kay

Hmmm .... whilst its true we need to look after our own,with regard to mental health services, whether we like it or not there are people in detention whose needs should be addressed equally to ours. Whether they should or shouldn't be here in the first place, is a separate issue. Whilst I do see what you are saying, Leigh a large number of these people are also in dire straits in terms of their mental health and are also deserving of adequate treament.

The politicians in government, opposition, senate, etc seem to be dodging the bare issue of menatl health, or the lack there of, in the community. The police and even the prisions seem to be the main agengies that are now forced to deal with the ever increasing overflow of people with serious mental health issues, from the current mental health system. This is especially true after the normal working hours of mental health professionals. It seems that if you are about to kill someone whilst having a seroiusly major outburst, then maybe you will be considered for a bed. Perhaps some of these people at this stage of illness, may not have deteriated that much if they'd been treated adequately in the first place.

Cheers SM

Our collective failure to address mental illness is cultural one and not one rooted in inept structures.

Our society do not like mental illness or those who suffer from it. It is hard to treat, and there are those who simply do not believe it to be a problem, it presents us with challenging behaviours that upset our neat systems designed to churn the sick through like banged up cars in a panel beaters garage and for many health professionals it is not a sexy issue - and the consumer is often not grateful - they swear, reject treatment and think they are fine; The health profesisonal likes nothing more than a compliant customer.

Where are the ER's or St Elsewhers' or Dr House type programs gloryfying the pschyatric team battling against all odds to alleviate human suffering? - it doesnt sell well.

Institutions were built behind high walls and a long way from CBD's because we shy away from the issue. The main reason most peole now rail against the deinstitutional process is because those turfed out now cluuter our suburbs in a very untidy manner indeed - recent calls for a retun to the instution have there genesis in a desire to reclaim the streets not provide adequate care for those with mental illness.

Movements like Beyond Blue have gome some way in dispelling the myth of mental illness but even articels on these pages haev suggested those suffering with this kind of affliction just need to pull up their socks and get on with it.

Thanks for this article Tim.
We have heard this before though and we all know we can expect little to change. I think if we reaaly want to help mentally ill people we need to start to look at alternative approaches. Governments of all persauasions have failed to provide adequately and the health departments especially the NSW Health Department has failed catastrophically in providing for their mentally ill. There have been mass deaths resulting from withdrawal of services in that State not to mention prisons having become defacto mental hospitals now few services exist.

I'd like to see local government taking a lead and starting to provide shelter and other asistance. We can access our local government members more easily than our State and Federal members of partliament. If we can start to act on a local level we can start to engage the community in providing resources. I would also like to see us thinking about how we can stop paying State and Federal taxes and divert this money into local causes. There must tax schemes businesses use that we can copy to provide care. Any Accountants out there with advice?

It's time to start looking elsewhere for solutions than to our callous parliamentarians and beaurocrats.

Equitable, psychological strategic support in community is an essential question facing Mental Health. With the central focus being almost exclusively on crisis care, Mental Health practitioners annul responsibility to deal with normal day social perplexities, which contribute to the agitation of a majority of presenting clients.

The Mental Health system poorly recognises the value-benefit of psychological support, to its clients. This is having adverse effect on the wellbeing clients, who are implicated by the Mental Health system, as “mentally ill”, in unsettling high numbers, transversely, throughout Australian society.

i.e., More than 80% of clients in Mental Health are unemployed. Here we must ask on what grounds were these people assessed as “mentally ill”, and is the diagnosis factors used to screen these people equitable, given we comprehend the decline in life quality indices, that surrounds issues of a persons unemployment?

In a high number of cases, I suggest Mental Health system perceives a poor understanding of non-medical care treatment strategies which may assist to alleviate human "disturbance", where wider social factors transpire and undermine the existence of "wellbeing" in its socio-economic context of the human experience. This is why Mental Health appears to have little or no capacity to deal with comorbidities associated to substance abuse, particularly among the growing number of dis-connected youth.

The Mental Health system appears to negate the value of a multi-disciplinary human resource approach where interrelated socio-economic and psychological issues affecting a majority of clients, contribute their poor sense of mental wellbeing.

Community-based resource access for example, needs to include strategic socio-economic and cultural-psychological support resources, if it is to enhance its capacity to deal with the strain imposed on clients suffering from socio-economic related disparities.

At present there is no one level of government that recognises the pressing burden of clients entangled in the system of Mental Health, that can be sourced to a social breakdown in life-quality indices. This is adding to a deterioration of general social wellbeing throughout society, and contributes inevitably to social breakdown resulting in a growing bulge of social drift.