Opinion Politics — 14 January 2015

AM ABC News

ASHLEY HALL: A leading policy adviser says it’s time for the Abbott Government to deliver on its election promises in mental health.

The Government has recently received a report it commissioned from its mental health advisory group, and is expected to release its response before the May budget.

Workers in the sector are watching closely, including John Mendoza, who was the former Prime Minister Kevin Rudd’s top mental health adviser until he quit in frustration.

He’s been speaking to Lexi Metherell.

JOHN MENDOZA: Well, this year is very much a litmus test for Tony Abbott’s Government in relation to mental health.

Tony Abbott made much of the Rudd government’s failure to continue the reforms that were led by Morris Iemma and John Howard in particular, really getting mental health reform on the COAG agenda.

He took a strong stance in opposition, he really put up the proposal of a National Mental Health Commission back in 2011, but since the Abbott Government’s been in power, we’ve seen very little or nothing in relation to, I guess following through on those commitments that were made in opposition.

The second reason it’s a litmus test is that he has two crucial reports on the table from the National Mental Health Commission and from the McClure investigation or inquiry in welfare.

Both of those have profound implications for how the Government really starts to address the continuing crisis in mental health care across the country.

LEXI METHERELL: The review by the National Mental Health Commission has now been handed to the Government.

What do you think its response to that review, which focussed on the efficiency and effectiveness of programs and services, should be?

JOHN MENDOZA: Well, firstly I think the Government should do the right thing and let the community see the report.

I think it’s regrettable at this stage that the Government’s chosen to keep it in Canberra so to speak.

Having said that however, I think there are two very important fundamental sort of areas that the Government can address quickly.

One, it has to sit down with the states and territories and work out who does what.

At the moment it is a dog’s breakfast – to put it positively – as to who delivers what.

We’ve got to get a clear line of sight from the funding authorities through to the providers.

The second area that they need to focus on, Lexi, is in the area of innovation.

It’s pretty clear that, as we go forward into the rest of this decade, our governments, state and federal, are going to have pretty serious constraints in terms of revenue, and that means innovation has to be at the forefront.

We can no longer do business as usual.

We know that people are taking more interest in and more capability in self-care and we need to promote ways of building the capacity of people with mental illnesses to self-care and self-manage and there are already many many easily accessible and affordable approaches that can be supported by government there.

And this extends into the area of e-therapy where, at the moment, if a doctor refers someone with a mental health problem, they generally refer them to face to face counselling with a psychologist or clinical psychologist.

I would recommend that, for many cases, they could be best treated through e-therapy with the possibility of elevating a level of care to a face to face condition.

LEXI METHERELL: And are such e-therapy models in place anywhere else in the world?

JOHN MENDOZA: They are. If I present to a GP in Norway, I will be given access to online therapies before I’m afforded under the national scheme a private psychologist.

Now that’s how it should be here.

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Unless someone is clearly presenting with a high-level of acuity complexity, we should be beginning with proven e-based therapies and we’ve been the world leader in developing these in Australia.

It’s pretty odd that we haven’t really embedded that into our Medicare systems.

LEXI METHERELL: Both the reviews you mentioned earlier – the review into the welfare system and the review into the mental health system – were initiated under different ministers to the health minister and the social services minister who are in place now after the cabinet re-shuffle.

Do you think that the change in the ministry will affect the outcome at all?

JOHN MENDOZA: Changes in ministry – as a bureaucrat I know – they’re never helpful in terms of keeping momentum up on major policy initiatives.

It takes ministers understandably time to get their head around these things.

We’re only four months away from the next budget and this is, as I say, a litmus test budget and a year for the Government on mental health reform and those two ministers are going to have to get their head around, very quickly, quite complex issues which to date, certainly Minister Morrison has had no background in.

Now that makes it very challenging.

Sussan Ley has had some background in her previous roles and in opposition indeed, but nonetheless, this is complex.

There are many ducks to get in line in relation to, not only mental health service reform but those other areas of housing, welfare, employment, education – all of these areas impact upon the ability of people with mental illnesses to participate in the community and the economy.

And the government currently spends well over $10 billion in those support payments – it’s getting a very bad dividend for that.

So this is the challenge that the Government faces over the next few months.

ASHLEY HALL: Sydney University’s John Mendoza, speaking to Lexi Metherell.

This transcript originally appeared on ABC NEWS, 12 January 2015.

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