PC’s holistic approach to mental health reform charts a positive new direction

31 October 2019

The Australian Council of Social Service welcomes the call by the Productivity Commission for a fundamental change to the way we treat and support people experiencing mental ill health and support their inclusion in our society.

“We welcome the Productivity Commission’s holistic approach which examines mental health in the context of the broader system of health, employment, housing and community services. The Commission has heeded the calls from community and mental health experts for a much greater focus on prevention and early intervention, finding that we have underinvested in this part of the system. We welcome its direct focus on the role of affordable, secure, stable housing and of financial stressors in mental ill health. This is a clarion call to governments to do things very differently.”, said ACOSS CEO Dr. Cassandra Goldie.

“Housing is a critical factor in people’s mental and physical health. Despite this, nearly 200,000 people are on public housing waiting lists, many waiting a decade, 116,000 are homeless and many, many more in rental stress.  We particularly welcome the Commission’s recommendations to prevent discharges from hospital into homelessness and address persistent homelessness. This must be coupled with a significant investment in social and affordable housing more generally, as an important measure to prevent and address homelessness and mental ill health. ACOSS proposes an immediate boost to social housing funding to deliver an absolute minimum additional 20,000 dwellings, which would start to address the urgent need for more affordable homes. Rapidly accelerating the supply of social and affordable housing would have a transformative social impact and a strong economic multiplier effect.

“We also welcome the recognition by the PC that the employment services system is not meeting the needs of people with mental ill health. There are 170 000 people with either a self-reported or diagnosed mental illness who participate in an employment support service. We welcome the focus on improving the appropriateness of job plans for people with mental ill health, and the responsiveness of the system more generally. This should be a priority in the reform of the Jobactive system, and must be resourced. For far too many people, engaging with Centrelink and JobActive has become a toxic, debilitating experience, and cause of serious mental illness. Aggressive breaching, pursuit of overpayments, and onerous job search, coupled with severe financial deprivation has become a pervasive experience which needs to end. Employment services need to be tailored to individuals, supporting them to address sometimes significant barriers to work. Major problems with JobActive also include high case-loads, ‘tick a box’ case management meetings and insufficient funding to obtain the necessary additional support people need.

“There are also some strong recommendations in this report around how mental health services are funded and commissioned. We welcome the proposal for longer funding cycles for community mental health services along with the acknowledgment that consumers and carers should be included in all mental health program development. We also welcome the proposal that Aboriginal and Torres Strait Islander community controlled organisations are given preference in funding decisions for Aboriginal and Torres Strait Islander peoples and communities. The proposal to pool Commonwealth and state mental health funding and for decisions about the allocation of that funding to be made at the local level by regional commissioning authorities has the potential to increase funding transparency and service coverage and we would be keen to discuss this further with governments.

“We know that the links and associations between poverty, low income and mental ill health are well documented. That’s why it was so important that the Productivity Commission reported that people experiencing financial stressors such as low income or poverty, are at increased risk of developing a mental illness. Noting that, it was disappointing that the Productivity Commission did not address one of the biggest contributors to poverty in Australia – the inadequacy of the Newstart and Youth Allowance payments. Newstart is not working – $40 a day is not enough to get people through tough times and into suitable paid work.

“People can’t afford rent, food, energy, clothing, transport, haircuts, dental care or internet access, which severely hampers their chances of getting a job, especially as there is only one job available for every eight people looking. An urgent increase of $75 a week is the absolute minimum we need after 25 years without a real increase.”