Four successive state budgets under the McGowan Government have increased the number of mental health inpatient beds in WA, with no corresponding funding for early intervention, prevention, or community support for people with mental health issues.
Despite a record allocation of $1 billion to the Mental Health Commission, the recent budget was another missed opportunity to rebalance the WA mental health system. Rebalancing would help meet people’s needs before they reach crisis, especially at a time when we need to maintain good mental health in response to the impact of COVID-19.
Unless we fund early intervention, reintervention and prevention services in the community, people will become increasingly unwell. Family and friends might not be able to offer the support and safety required so the person ends up at an emergency department.
Hospital beds are expensive at $1,595 a day. What the budget papers do not reveal is the human cost of a system that can be dehumanising, distressing and unable to provide recovery after hospital care.
Provide the front-end support and the likelihood of an emergency department presentation reduces. Family and friends want their loved one and themselves to be safe and would rather find this safety and support in the community, before the situation deteriorates even further.
Hospital bed expenditure is now at 43% of the $1 billion mental health budget. Prevention spending sits at 1.7% of the budget which is $17m of the $1 billion budget. It is a similar story for community support which is only 5.3% of the budget.
It is no wonder then, that when a person reaches out for services which are close to home, person centred and provide early intervention, they are not available.
Mental Health Minister Cook is a kind and compassionate person who is genuinely concerned about mental health. Now is the time for this compassion to be directed towards community solutions because a continued focus on the acute end simply increases costs of health without breaking the cycle of demand.
Earlier this year he released the state priorities for mental health, alcohol and other drugs and suicide prevention. He called for a rebalancing of the system away from increasing beds to increasing support in the community and prevention services, but these are yet to be funded.
Ben Wyatt as Treasurer understands the importance of directing spending in ways that maximise the impact of the dollars spent. There is scope for more efficient spending on mental health. If he wants to see the health budget spending contained, he will see the sense in investing in early intervention and community support as that will help reduce the numbers of people having to be hospitalised.
This state budget had a strong reliance on construction and infrastructure, bricks and mortar and hard hats. There was little that focussed on social infrastructure. In mental health spending it is easier to demonstrate a budget result by counting beds. But ask people if they would rather avoid going to hospital and be supported in the community; their answer would be ‘yes’.
When we feel the first signs of a cold or some other physical health concern, we usually take some preventive action. Otherwise it might progress to a more serious illness, even hospitalisation. When the first signs of emotional distress or mental health problems emerge, we should not wait until we are sick enough to access public mental health services.
According to the 2019 Mental Health Inpatient Snapshot Survey, 178 people were deemed unable to be discharged from hospital because of a lack of suitable community-based accommodation and/or mental health support services.
That’s why we gathered the voices of people with mental health issues, their families and friends to call on the government to urgently and significantly increase funding for prevention and community mental health services under the Prevent Support Heal campaign.
We invited people to join us at midday on November 10 on the front steps of Parliament House. We illustrated what 178 people looks like by marking out people in position.
It takes courage for a person to reach out to get help for their mental health challenge.
Premier McGowan, Deputy Premier Cook and Treasurer Wyatt, please match this courage to ensure the funding and resources are available to enable people to remain in the community and not be hospitalised. It is time to rebalance the mental health system.
Joe Calleja is the former CEO of Richmond Wellbeing and has been involved in several state and commonwealth mental health and suicide prevention committees.
This article first appeared in The West Australian on Friday 23 October 2020.