Hi chibam,
Thanks for copying me in on this conversation
I agree with you that this is mostly political BS. In my opinion Butler is just kicking the can down the road on the basis that changes are all going to cost a lot of money and the government is short of money at the moment so guess what, no significant changes. If we are lucky we might see a few deck chairs moved around on the Titanic. I have looked at this situation and spoken to a number of people over the past twelve months and I really can't see any evidence that significant government led change is likely to take place in the foreseeable future. As for setting up a federal consumer voice organization, I see it as a waste of time and money.
In my opinion this as just another political public relations stunt. I have tried getting involved in some of the existing advocacy organizations. They are invariably about people getting payed one way or another to produce impressive looking reports that say what the government wants the public to hear. One CEO of one of the better mental health consumer support groups that I spoke to was honest enough to tell me that they can't advocate for what mental health consumers really want or need because if they did it would jeopardise their government funding.
In any case I don't believe it is just about spending more money. To be sure, money does or will need to be spent but the existing system is well recognized to be in such a mess that spending more money on it will just create a bigger more expensive mess. Since money is seen by government to be such a big problem, the first and obvious thing to do is to stop wasting money and fix some of the serious underlying problems that would cost little or nothing to fix. In some cases it would save the government substantial sums of money which could then be spent on other areas of need with little or no change in net expenditure. The problem with this approach is that government would have to acknowledge and face up to some very large elephants in the room which could perhaps be called the Collective Conservative Interests.
One example of the sort of thing that could be fixed without any significant expenditure would be compliance with United Nations and World Health Organization directives on mental health abusive practices and human rights violations. This might seem like a minor issue for the average Joe who is depressed because he has lost his job or something similar but I would suggest that the average Joe is standing on the tip of a very big underlying and dangerous iceberg. I believe that once some of these issues start to get addressed, benefits will quickly flow through to average Joe because it it these sorts of systemic issues that are, again in my opinion, the cause of most of this systemic mess.
You don't need a PhD in psychology to figure out that if someone has a mental health issue and you subject them to abuse, threats and maltreatment it is not going to help their condition. This however is exactly what is happening in developed countries around the world including Australia. Australia in fact is one of the worst offenders. Based on the state government figures that I was able to get hold of it looks like about 70,000 Australians were subjected to Community Treatment Orders (CTO's) in 2022.
Most of these orders would have been to force people who didn't want to use medication to be injected with long term anti-psychotics. The effect of them typically lasts about 3 months. I'm told that if someone subject to one of these CTO's complains, their dosage is often increased. If they object, state mental health workers accompanied by police come to their place of residence, hold them down, pull down their pants and inject them. Apart from the humiliation and trauma of being treated this way, many people suffer horrifically from the side affects. It is hard to believe that 70,000 Australians or even a small fraction of that number are mad enough or dangerous enough to warrant that sort of degrading treatment. 70,000 is nearly double the number of people in Australian jails.
It should be noted that any move to abolish these medieval practices doesn't mean that thousands of people will suddenly be deprived of their medication. What it means is that people will have a choice of what treatment they want. The claim that thousands of people are too stupid or sick to know what is good for them is itself pretty "sick". In order to make good decisions, people do of course need to be properly informed which often isn't the case at the moment.
I also listened to the podcast with Luke Grant and Dr Marjorie Collins the President of the Institute of Clinical Psychologists. In my opinion Collins is simply making a case to support her position as the head of a professional services union. If this assumption is correct then the agenda is probably more about power bases and money than delivering better mental health services to the public.
The Australian Psychological Society (APS) standard schedule of fees for a nominal fifty minute consultation is currently $280. The Medicare rebate is currently $131.65 or less than half. Collin's bleating about the Medicare rebate being reduced from 20 sessions per year which was introduced as a short term covid measure, back to the original 10 sessions per year is irrelevant for a lot of people who can't even afford the out of pocket cost for one session. Her other gripe about the government not spending more money on tertiary PhD level training for psychologists is another red herring. There is no evidence that higher qualifications produces better or more effective councilors in fact I have seen research evidence suggesting the opposite to be true. One of the biggest criticisms I hear about psychologists and psychiatrists is that they don't listen to their clients. This failure to listen closely associates with a lack of empathy which is probably the most important requirement of a good councilor. You don't learn empathy at university. You are more likely to learn arrogance and in my experience there are some pretty terrible, well educated and often arrogant psychologists around.
It is a pity that Collins doesn't take more of an interest in lifting the professional standards of many of her qualified, well paid but under performing colleagues.
These days medical students are staying away from psychiatry in droves and psychologists seem to have stepped in to fill the gap. Many if not most GP's are now the primary subscribers of psychiatric medication. It is interesting to note that some medical practitioners interested in mental health now seem to be training in psychology rather than psychiatry.
Rather than trying to produce more psychologists that many people can't afford, a better, faster and more viable solution would be to leverage their services. There are a number of approaches to doing this which have been tried in the past and have worked well. Not only do some of these alternative approaches have much better outcomes than traditional methods but they are far more cost affective. This is another reason why you would think governments would be very interested in looking at these approaches. Unfortunately you don't have to look too hard for the answer as to why they don't?
I have recently been looking at a number of these alternative approaches. One of them is known as Soteria. It started in the US in the 1970s but was eventually trampled to death by elephants. It has however seen a revival in recent years mostly in European countries like Finland, Sweden, Switzerland, Hungary etc.
Here is a link to an interesting webinar if anyone is interested
Soteria Past, Present, and Future: The Evidence For This Model of Care.
There are numerous other approaches. All of them are built around peer-to-peer support communities with experienced competent professionals adding value.
Those of us who have experienced mental health issues know from our own experiences that you don't just walk into a psychiatrist or psychologists office, have a few sessions, get fixed up and live happily ever after. More typically it tends to be a long and often lifetime journey with the inevitable back sliding along the way. What my studies of alternative approaches like Soteria etc show is that supportive communities with expert professional support can make this journey a lot faster, easier and much more cost effective compared to traditional approaches.
An organization like the SANE forum could, in theory, become a starting point for such a community with the on-line community extending and reaching out into the real world. I can see the possibility here of creating something new and uniquely Australian.
There is one thing I am certain about. If we wait around for the government to deliver something like this we will wait forever. They are too busy feeding the elephants. We have to do it ourselves. It is most definitely doable but it won't be easy. If history is any indication there will be fierce resistance from the elephant keepers but our best defense is numbers.
There are about 5 million Australians at the moment with mental health problems. If only a small percentage are willing to take on the initial challenge of setting up peer supported mental health communities there will soon be far too many people for the elephants to trample on and the political clout from those of us involved in these communities will be too strong for the government to ignore.
Another bonus is that by reaching out to support and help others, we help ourselves. Some of us would have already discovered this from participating in this forum.
Australia can and should be a global leader in mental health care but it may be necessary to cull a few elephants in order to get there.
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