'We can't afford not to act': experts on their hopes for mental health in Australia's budget

www.theguardian.com
5 min read
fairly difficult
Australia needs to start flattening the mental health curve urgently. The coming budget is an opportunity for action
Ian Hickie: Is the government up to the task?

The 2021 federal budget has been heralded as the point at which the Morrison government will respond, at scale, to the many failings of the mental health system. We spend only $10.6bn a year providing mental health services to over 4 million people. Importantly, there is an increasing divide between the federal government's reporting and the independent accounting of what monies are spent on mental health. The responsible ministers claim that federal spending has already substantially increased, up from $3.5bn five years ago to $5.9bn in 2020-21.

By contrast, the Australian Institute of Health and Welfare reports that the commonwealth only expends $3.6bn, with an increase of only 2.1% per annum. AIHW also notes that all governments only increased their spend by 1.5% per capita between 2014-15 and 2018-19 and that the proportion of total health expenditure spent on mental health actually decreased by 1.1%. It remains at 7.5%, and this is largely unchanged since 1992.

If we only see very limited new investments in this budget, then we must stop and ask "why"? Common answers include stigma and structural discrimination. Others note the lack of simple "announceables". After all there is no simple "social vaccine". Governments are now working on new federal-state agreements and "whole of government" responses. So it is likely that real action is postponed (once again) till after the next election.

Australia is not alone in its attempts to build an effective mental health system. Unlike many other countries, however, we have had substantial positive movements in community attitudes. We have also seen real innovations in early intervention, youth mental health, use of new technologies and Medicare support for psychological therapies.

Sadly we have not yet seen the combination of those factors that can transition a crisis-driven response to a stable and responsive system. They are: investments at scale; genuine structural…
Ian Hickie
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