Today, Australia is navigating a mental health, suicidality, and social and emotional wellbeing crisis. Exacerbated by successive natural disasters and the COVID-19 pandemic, this crisis has amplified social disadvantage, increased service demand and presentations of mental illness, and exposed the limitations of our mental health and suicide prevention and aftercare service systems.
There is growing evidence linking mental health and climate change. The compounding trauma of living through extreme weather events – bushfires, floods, droughts – along with increasing levels of anxiety about the future cannot be ignored. It is past time for a whole-of-government, whole-of-parliament approach to mental health and suicide prevention that takes into account wider environmental considerations.
The Productivity Commission Inquiry Report on Mental Health (Productivity Commission Report) quantified the significant annual cost of mental ill health and suicide – approximately $70 billion per year, based on 2018-19 estimates. If the Australian Government wishes to improve services and minimise future costs, it must act decisively on the recommendations raised in this and across other relevant reports and shift the focus to implementation.
The 2021-22 Budget responding to the findings of the Productivity Commission Report and a range of other major reports, along with initiating the National Mental Health and Suicide Prevention Agreement and the National Mental Health Workforce Strategy, were positive steps towards improving services and outcomes for individuals.
Over the course of the last year, the Committee conducted its inquiry into mental health and suicide prevention to assess the current landscape, review the recommendations already before the Australian Government, and examine the gaps that are resulting in far too many people still unable to access the right care at the right time and place.
The Committee found several barriers and identified priority reforms across the mental health and suicide prevention sectors that must be addressed. Workforce shortages and inadequate training are underpinning service gaps, especially for our most vulnerable populations. Many of these issues stem from governance and funding structures that, once reformed, would enable improvements across workforce management, multi-jurisdictional collaboration, and referral processes.
This inquiry highlighted that a broad definition of the mental health workforce is required to provide a person-centred, stepped care approach that incorporates the physical and social determinants of health. There is also an urgent need to further embed training around culture, suicide prevention and lived experience across public, private and non-government services and agencies, to ensure the safe provision of services. This will be crucial for delivering the efficient, consumer-oriented, and accessible mental health and suicide prevention services and systems of the future.
The Committee was pleased to hear the success of some of the federally funded initiatives, such as telehealth as a part of virtual mental health care, which is helping to mitigate barriers to access as a result of distance, stigma or lack of specialist workforces. An increased focus and funding for digital health service systems, service evaluation, and research are now required to rapidly increase access to assessment, service coordination and to track outcomes of care and data collection.
Evidence was clear that the key points for intervention are early in life and early in illness – supporting parents through pregnancy, providing scaffolding for children throughout school, and helping adults transition through life stages with ready access to reliable information and clear pathways to appropriate services. Underpinning this is ensuring that there is a common mental health language shared across the community and a diverse, coordinated workforce that incorporates lived experience and a wide range of specialist skills.
The Committee’s recommendations support the safety, quality, and evidence-based delivery of mental health care by improving our regulation systems of health professionals to recognise both the value and risks associated with the full range of mental health-interacting professions.
The Committee recommended further work for the Australian Government, to advance the cultural competencies of workforces, the commissioning pathways for culture, and the funding available for community infrastructure. These investments are critical for building community connectedness and the social and emotional wellbeing of all Australians across-the-lifespan, noting specifically the needs of Aboriginal and Torres Strait Islander, culturally and linguistically diverse, LGBTIQ+, and rural and remote populations.
The recommendations of the Committee have focussed on consolidating the evidence base for reform and ensuring that the Australian Government is responsive to the current demands of the mental health and suicide prevention sectors. Looking forward, the Committee would like to see mental health and suicide prevention given the same recognition as physical health both within the health sector and by policy makers. On this basis, the Committee has recommended the appointment of a Standing Committee on Mental Health, Suicide Prevention, and Social and Emotional Wellbeing in the next Parliament.
The Committee would like to express its appreciation to all who have contributed their time, knowledge and lived experience throughout the course of the inquiry.
Dr Fiona Martin MP