Australia is at the pointy end of a mental health crisis.
Psychological stress is mounting, particularly among younger Australians.
At the same time there's a serious workforce crunch in mental health services.
Now both Labor and the Coalition are promising improvements as part of their federal election campaigning.
Since the budget last month Labor has been under pressure to do more for mental health and today they came out swinging, promising a $1 billion package if they're elected.
The Coalition says Labor is copying their previously announced policies and just playing "catch up".
So let's breakdown what both the major parties are (so far) offering for mental health and then what the experts think of those promises.
The Coalition
A Dutton government would invest $400 million, with a very specific focus on youth mental health.
They made their big announcement more than a week before Labor and had a focus on the "missing middle".
The "missing middle" are a group experts say need more support as they don't have mild mental illness but they also don't require admission to a hospital.
It includes those with personality disorders, eating disorders and early psychosis.
The Coalition has promised to:
- Expand early psychosis youth services so it covers 20 regions (currently they're in eight). These clinics help diagnose and treat people with more chronic or complex conditions and are staffed by a mix of psychiatrists, psychologists and social workers.
- Expand the capacity of existing headspace centres. Headspace offers free mental health support for 12 to 25 year olds.
- Reinstate 20 Medicare-subsidised psychology sessions per year, which was a COVID-era policy that Labor later reduced to the pre-COVID amount of 10 sessions per year.
- Expand the remit of the National Centre for Excellence in Youth Mental Health (created in 2014 when Mr Dutton was health minister) to lead policy advice to the government, commission youth services and train professionals.
Labor
The Albanese government is putting a bigger dollar figure on the table — $1 billion — and is aiming a bit broader than just youth.
They have committed to:
- Opening or upgrading 31 Medicare Mental Health Centres, which are dotted around the country and provide free drop-in care.
- Opening or expanding 58 Headspace services (right now there's 171 operating nationally).
- Opening 20 youth specialist care centres for young people with complex needs (i.e the "missing middle").
- Providing more than 1,200 training places for mental health professionals and peer workers.
There's definitely similarities between the packages but where they differ most is Labor's focus on Medicare Mental Health Centres and training, compared to the Coalition's reinstatement of the 20 subsidised psychology sessions.
What do the experts think?
Dr Astha Tomar is the president of the Royal Australian and New Zealand College of Psychiatrists.
She said investment in youth mental health was wholeheartedly welcome as 75 per cent of mental illnesses present before the age of 25.
But she said support for middle age or older Australians was lacking in both parties' promises.
"It's a whole of life journey … access to specialist care doesn't stop just because you turn 25. It's also about what happens later," she said.
Dr Tomar said Labor's promise to train more professionals was to be applauded and while she urged Mr Dutton to match it, she said both parties were massively under-spending.
The Productivity Commission's report on mental health in 2020 found the cost to Australia of mental-ill health was around $200 billion per year and for every $4.2 billion spent on mental health per year it resulted in almost $20 billion in benefits.
"A commitment of $1 billion is a really good start but we really need $20 billion. We need visionary leaders who would make that commitment and I know it won't happen overnight but it should."
Loading...
Professor Bridianne O'Dea specialises in child mental health at the Flinders Institute for Mental Health and Wellbeing.
She said there needed to be more specifics about how any of this would help with wait times.
She said teens were waiting more than three months for their first session.
"Our research calls for national standards on wait times … we don't have anything in Australia that outlines an acceptable time that a person should wait for mental health treatment."
In the UK, the National Health Service (NHS) has set a standard that 75 per cent of people who need talking therapies — for conditions such as depression — should be treated within six weeks and those who are experiencing psychosis should start treatment within two weeks of referral.
On the Coalition's increase of subsidised psychology sessions, Professor O'Dea said it shouldn't be about dictating the number of appointments but letting the clinician decide what the patient needed.
"The data has shown there's huge variability in the number of sessions people actually use [and] by doubling the sessions the wait times do increase because we have people staying in care with their clinician for longer, and while that may be needed, the unintended consequence is longer wait times."
Professor Paul Fitzgerald is the director of medicine and psychology at the Australian National University.
He said the money would be usefully spent but those with more serious mental health conditions were left out.
"What we never seem to do is put money into services that support the vast majority of people with serious mental health problems, like schizophrenia and severe depression and bipolar disorder, who are managed through the standard public mental health services, which are becoming more and more degraded over time."
Professor Fitzgerald said services like Headspace were great value, but often don't have many psychiatrists on staff so couldn't take on the most unwell patients.
"So they are often pushed to the private system and you know, rebates for private psychiatrists haven't grown over time. So what we need is federal and state funding in this area that is about needs across the spectrum, not just isolated policies."
As for Labor's training promise, Professor Fitzgerald said these kinds of pledges were important but needed to come with more specifics about where in the system newly trained professionals would work.
What do others want?
The Greens have pledged to provide "universal mental health care" through Medicare by removing session limits, increasing rebates and include subsidised access tor registered counsellors and mental health nurses.
They would also employ 1,000 additional peer workers.
Mental Health Australia want all parties to commit to free psychological therapies for those under the age of 25, while Suicide Prevention Australia want commitments to fund the national suicide prevention strategy before we head to the polls.
Loading...
Having trouble seeing this form? Try this link.
