Beyond blue achievements1/14/2023 ![]() The evidence for this relationship-based care is deep, but often services use multiple teams with health professionals who change frequently. People should be able to form close and continuing relationships with clinicians, so their story and needs are known and trust can develop. We need to decide whether every dollar spent on clinical treatment of mild to moderate depression and anxiety could be better spent on housing, trauma therapy, employment or other forms of social careĪlleviate suffering. Provide outcomes that matter to the person receiving the service. The value-based care movement argues there are four elements that create value for people. It’s hard to see the value-add of a narrow mental health response that funds a set of services which can only care for people with mild to moderate distress, while ignoring the people with the greatest disability. How do get the best value for our mental health services? Those who are on the margins of society, and rely on the social safety net or charity, are unlikely to use this model of care. Like Headspace, Better Access risks excluding people with complex conditions or unstable mental illnesses. It also puts considerable strain on the psychology profession, which is already overloaded, especially in rural areas. The budget’s commitment to extend the program to 20 sessions, at a cost of more than A$100 million, is welcome. It’s a useful initiative, but only for those who can afford the co-payments and live in areas where psychologists are available. In theory, this is the basis of the federal government’s Better Access program, which allows people to access ten Medicare-subsided sessions per year with a psychologist or psychiatrist. All tend to have higher rates of mental illness than the general population.Īll people with mental distress and illness should be able to access mental health care. People who commonly don’t receive adequate care include those who are homeless, poor and unemployed, as well as Aboriginal and Torres Strait Islander people, and those on temporary visas. Doubling Medicare-subsidised sessions won’t help those who receive no care Patients describe being too complex or not complex enough for services, and a little like Goldilocks they have difficulty finding a service that is “just right” for their needs. One example, among many, is that in the ACT, public child and adolescent mental health services exclude patients with autism or attention deficit disorder. Many people with disabilities also encounter difficulty in accessing appropriate care for their needs. People with ongoing or serious mental illnesses almost always suffer other physical conditions which compound their mental illness, and die decades earlier than the average Australian. The Headspace model was never set up to deal with more complex presentations, people with impairments already established, those who had complex mixes of anxiety, depression and substance misuse.Īs clinicians with a particular interest in mental health, we are wary of the “single illness fallacy” - one person, one illness - that underpins many of Australia’s current mental health policies. Professor Ian Hickie, who was a founding director of Headspace, says: Others live with disability, homelessness, chronic pain, domestic violence and poverty. Many people have also survived considerable trauma, and this has a deep and lasting impact on their health and well-being. Mental health concerns range from grief and loss, to chronic severe schizophrenia, to depression and anxiety, and many of these conditions overlap. People with mental illnesses aren’t all the same. These services aren’t suited for those with complex needs In fact the people with the deepest need tend to receive the least care. These organisations favour people who are resourced, resourceful, literate in English, urban, and have more easily treated conditions than those with complex or multiple chronic illnesses. ![]() The commitment to mental health is channelled through these services, which provide a narrow spectrum of care. ![]() Look more closely, however, and some concerning patterns emerge. Meanwhile, many people are facing job losses, financial hardship, isolation and some are suffering long-term symptoms of COVID-19 or other chronic illnesses.Īt first glance, it’s fitting the 2020-21 federal budget, unveiled on Tuesday, includes A$7 million for mental health organisations Beyond Blue, Headspace, Kids Helpline and Lifeline. ![]() And we will, devastatingly, lose more Australians to suicide. The COVID-19 pandemic has ushered in more anxiety and depression, raised rates of bipolar disorder and other psychoses, and left many Australians stricken with grief. Louise Stone, Australian National University and Christine Phillips, Australian National University ![]()
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