From a health economic rationalist point of view, this minimises the number of acute admissions. There’s a youth health model which in the spectrum of care is probably in the more acute-care end compared to HeadSpace (early intervention program), but we’ve got several examples where these multi-faceted youth mental health teams, often with early psychosis positions attached to them, are working with HeadSpace. Dawn O’Neil: The official Australian Bureau of Statistics for suicide for 2007 was 1,881, but that’s just been revised up to 2,054. The number of deaths by intentional self-harm for both men and women aged 15 to 44 is 1,128, which is double the road-related deaths for that age group. And, a significant number of those deaths on the roads are actually suicides. John Mendoza: The overall burden of mental health disability is the highest of any disorder and accounts for nearly a third of all disability in Australia: years of life, loss, productivity, and so forth.

The system is completely around the wrong way. It’s as if health reform has gone through every other area of health and yet with metal health we’ve stayed stuck in the 1960s. There’s a universal call for us to revamp and reform radically our mental health services, to reorient them to that primary prevention, early prevention focus that we have across all other areas of health. No government in Australia has got that right. The economic burden is going to continue to fall on group insurers and the rest of the country, unless we get in place a more proactive, a more assertive response that’s much more focused on prevention than intervention. Unfortunately, since John Howard’s departure and Morris Iemma’s departure, there’s been a loss of leadership on mental health. Colin Tate: What is the road block with the Federal Government in particular – it looks like Rudd’s been a great supporter of mental health. John Mendoza: The rhetoric’s there, the action’s not.

The platitudes are there, but we are yet to see any investment. All we’ve heard from the Federal Government to date is about hospitals, hospitals, hospitals, and more recently health. Australia has already one of the highest hospitalisation rates in the western world if not the whole world. We don’t need more hospital beds, quite frankly. We need more upstream and downstream investment to prevent hospitalisation, in all areas of health, but particularly in mental health. Pat McGorry: We had an 1890s model until almost yesterday. In the 1990s there was an attempt to start to build a 20th century model and the foundations were laid, but then everyone went on strike. In New South Wales, we had very excellent communitybased services, crisis teams, which have been progressively defunded. These new community facilities were underinvested in. They faced this huge onslaught of unmet need and buckled under pressure.

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