Sebastian Rosenberg, a senior lecturer at the Brain and Mind Institute (for those playing at home, the same Institute that Ian Hickie heads), has written a piece for the Canberra Times. It would be sweet to see friends sticking together as such, if it weren't reministant of playground bullies gathering together in order to take our lunches away. For our own good of course *insert sarcasm*.
As part of his piece, Rosenberg writes "Mark Butler has travelled widely and has proven himself a willing
listener. There is never a shortage of complaints in mental health so
this is no small thing. Butler is now, as I understand it, formally
the Minister Assisting the Prime Minister for Mental Health. This moves
him and his portfolio responsibilities clearly out of the realm of
health and gives him licence, indeed obligation, to work with Jenny
Macklin's Department of Family and Community Services, Tanya Plibersek
and Mark Arbib in Housing, and Chris Evans and Kate Ellis in Employment
and Education in relation to mental health."
So let me clear this up for people who may not have had the pleasure of attending the two online "forums" I have; and that Mark Butler has "attended" in order to provide a QandA session... The term ButlerBot has come about for very good reason. Mark Butler has answered very few questions, and only those that could be answered with what has been an obviously predetermined response that puts forth the usual government spin. Both times there were photo's of him sitting at his computer - while I didn't bother wasting my download limit, I suspect they were probably very similar. Indeed the description both times of him being in his PJ's seemed to put forth the idea that the photo's were just for show. Who knows?
I have talked to many people after both events, and am yet to hear anything positive about their experiences. Not surprising really, given how obvious it was to all that Mark Butler couldn't have given a rats arse about anyone there, or anything that was discussed. He had an agenda of selling the latest budget and he stuck to it like glue.
Not impressed. Tell us what we don't want to hear - but don't just ignore us while pretending to give a shit.
While I'm sure that Mark Butler has been making good use of some frequent flier miles (or at least acquiring them), I doubt very much that he's listening to anyone who isn't singing his praises.
As for how well he'll do with his new title of Minister Assisting the Prime Minister for Mental Health - I'm hardly sitting by waiting on the wings of anticipation.
"Butler has stated that the Government's support for a commission is
based heavily on community support for such an entity. In my view, such
support reflects fatigue with the same old debates and the same old
voices and interests."
Based heavily on community support hey? Well, you know what? I think that one of the few things the government and McGorry Crew have done well is unite the country around the issue of mental health. They've done this so well, that few are asking the pertinent question of "Show Me The Money". All the community knows is that there is some, and they're happy as. And who can blame them? Mental health has had a bad rap for - well, ever.
We may have new voices and interests - and yes - wait - we have new interests. The new voices are not the welcome change we've all been hoping for - indeed instead of the apathy of old, what we're finding is greed and conflicts of interest. Lack of full disclosure. And lies that on the one hand are working really well, and on the other hand, to anyone who is actually looking for the money trail, makes my two year old look like a professional.
We may have new voices, but we have the same shit behind them - money and power.
"Consumers and carers are used to being ignored as government departments
and many service providers make arrangements to suit themselves rather
than their clients."
This. Is. Fucking. Rich.
Consumer and carers are STILL being ignored. And a couple of service providers have done well to screw over a majority of mental health consumers this year, suiting themselves nicely, not to mention suiting their bottom line, their current projects, and their end-game.
"Poor services retain their funding while effective services miraculously
lose their funding. New service options struggle to emerge and when
they do, ugly and ill-founded public controversy often arises. Witness
the public vitriol associated with the emergence of a national roll-out
of the Orygen model of early intervention for youth psychosis.
Commentators like Janet Albrechtsen criticise McGorry for his role in
''politicising'' mental health. From its base in a series of
demountable dongas in Carlton, Melbourne, Pat McGorry's service has led
the world in demonstrating the benefit of early intervention in
psychosis in young people. Supporting this new service does not mean we
ignore the mental health of children, adults or the elderly. It simply
means that piece by piece, Australian governments are being poked,
prodded and persuaded into developing a range of mental health services
designed to cover all ages. If this is political then so be it."
We're still talking about mental health right? What effective services? Oh, do you mean Better Access, which just had it's arse handed to it? That one?
McGorry has led the world in jack shit. The Orygen model of early intervention is a joke. It's that much of a joke, that prominent psychiatrists overseas are scratching their heads.
And when you cut programs like Better Access (cuts which affect a hell of a lot of kids with psychosis too, given the very few EPPIC centres around) - you ARE "ignoring the mental health of children, adults and the elderly". Whether it is political or not is up for debate. What isn't up for debate is the fact that it very fucking sad to watch.
"It follows that a key role for the new National Mental Health Commission
must be as an independent arbiter of what works, what should be funded
and, importantly, what should be de-funded."
True that. What a shame it's never going to happen, when the likes of McGorry and Hickie have their claws in everything and our Hon Mark Butler lacks the balls to tell them both to piss off.
"Mental health needs not only more funding but also to make sure it is spent in accordance with the evidence."
Then why aren't you? Better Access was working well and some bastards convinced the government to cut it in favour of something that may or may not work (and if it doesn't - could do a hell of a lot of long-term harm). And even if EPPIC and headspace DO work - they reach such a small number of people it's ridiculous. One senate inquiry submission put the number of clients seen at a headspace centre to be 17 in a month (Number 483, p. 17). Not one particular month, but as an average. Put that money into Better Access and how many could have been helped?
(Edited 5th October 2011 - I had mistakenly put 17 clients at an EPPIC centre, whereas I should have written "headspace centre". My apologies to all, and thanks to the person who pointed out my error :) ).
"The Government has already committed itself to the task of developing a
10-year road map for mental health, though it is yet to make clear what
if any role the new commission will play in this. A simple re-hash of
the fourth National Mental Health Plan will leave an expectant mental
health sector feeling very let down. This plan has no goals, no targets
and commits no one to anything."
Quite frankly, I'd prefer a plan that has no backbone, to the severe fucking over mental health consumers are seeing at the moment. At least it leaves things open for discussion and debate. Something I'm sure is a new concept to some of our current players.
"The Government has appointed Robyn Kruk as chief executive to the
commission. An experienced and able health administrator, she will have
her work cut out to bring these various threads together but in this,
she will have the strong backing of a mental health sector keen to
ensure that the next 20 years of plans deliver more than the past 20
years. "
I don't know much about Robyn Kruk - however a quick Google search finds that she's been doing a fair bit for the environment lately - not health.
"The capacity of the commission to build strong partnerships with key
organisations in the sector will also be critical. The recent
resignation of Dawn O'Neil as chief executive of Beyond Blue is a
significant blow in this regard. The ex-chief executive of Lifeline and
Deputy Chair of the Mental Health Council of Australia, Dawn had
demonstrated commitment to reform and innovation in mental health over
many years. In an environment characterised by a lack of resources,
Beyond Blue is the largest non-government organisation operating in the
area of mental health promotion and awareness.
Under Dawn's
leadership, it had begun to show a willingness to support a range of new
services and research and from such a huge and influential
organisation, this was both very significant and welcome."
Jeff Kennett shows his bigotry against the LBGTI community, there's some scuffling behind closed doors and Dawn O'Neil quits. My first question was - did she try to out him (and for good bloody reason) and he and his buddies kicked her out?
"In an environment characterised by a lack of resources..." WTF? Beyond Blue is making a profit - quite substantial profits - each year. 2009 - $7 278 315, and 2010 - $1 258 758 (2009/2010 Annual Report, p. 76).
Not that we can be that surprised by anything Beyond Blue does. In the above report, they state:
"During the 2009-10 financial year, more than 4.2 million Better Access Medicare-subsidised mental health services were accessed by Australians living with mental illness... The number of people who have received primary mental health services clearly demonstrates the need for such subsidies" (p. 57).
Yet, in their submission to the Senate Inquiry, they state:
"The rationalisation of GP and allied health services through the Better Access program is justified. It enables the redirection of funds to other mental health programs and services, which focus on prevention, early intervention, and increasing access to services...The majority of people with depression and anxiety seeking treatment through the Better Access program will not be impacted by the reduction to the number of allied health services" (p. 4).
Clearly their opinion is driven by the given mood of whoever is in charge on the day. Either that or they just put forth whatever bullshit they've decided to swallow in order to... well, what exactly I don't know. Not sure about their end-game yet. I'll find out eventually. I suspect it's nothing more than an easy pay cheque.
Sebastian - I hope for damn sure you're getting paid well for your soul.
A few Bupa shares perhaps?
Showing posts with label Prominent Psychiatrists. Show all posts
Showing posts with label Prominent Psychiatrists. Show all posts
Monday, October 3, 2011
Friday, September 23, 2011
Dear Mr Hickie
First of all, you speak of "$2.2 billion to new programs". Let's be honest shall we? It is NOT for new programs, it is for the total mental health budget. And it is the total mental health budget for the next five years - a point that seems lost on some. It is not even the correct figure.
The total spend over the next five years is $1 463 300 000. $316 200 200 was already earmarked from previous budgets, so only $1 147 100 000 is actually new money. $1.1 billion is a far cry from $2.2 billion. I'm not even totally sure where the $2.2 billion figure comes from, other than political spin, because I can't find it anywhere. Even the government here, says the budget spend over the next five years is $1.5 billion. For now, I'll assume that they mean their Ten Year Road Map for mental health or something.
Aside from all this however, is the $580 500 000 that has been cut from Better Access. $580 million CUT from the budget. $580 million that people such as myself will now have to find.
Your article points out that the changes "will greatly increase the number of services provided and, most importantly, access for those with the least capacity to pay privately". I am on the Disability Support Pension, and as my carer, my husband is on the Carer's Payment. I consider us to be about the least capable of paying as you can get. Ideally, I need to see my psychologist every fortnight. Every week would be great, but I don't mind keeping it real. The current eighteen session cut off leaves me with eight fortnights to find the full fee myself. After the changes go through, I will have to find the money for sixteen full fees. Possibly twenty, depending on what the criteria is for the additional four sessions.
I have heard of all manner of other alternatives, and I can assure you that I have either tried them to no avail (medication, inpatient services), or been turned away (public mental health outpatient services). ATAPS is not an option as I don't know a GP who is eligible to refer, and other GP's here have totally closed their books to new patients.
Seeing my current psychologist is the first time I have felt "better". And that is about to be ripped away from me because I can't afford to pay the full fee privately. Your argument on behalf of those least able to pay makes no sense at all to the people who are actually living it.
In addition to this, I will have to come up with the same fees for my son, who has Asperger's and needs psychological appointments to help him learn how to regulate his emotions. As he was diagnosed after his sixth birthday, we are not eligible for funding from the Helping Children With Autism Package. This is on top of his speech therapy and occupational therapy - a total out of pocket of $285 a fortnight. We live rurally - there is no other alternative for him here and we are not in a position to move.
Let us step back for a moment, and suppose that these new services WILL cater to our needs. Our sessions run out on November 1st of this year. This mental health reform is a five year plan. At what stage in that five years is our local area going to see some new services that we can utilise? What are we to do in the meantime?
And let us not forget the issue of continuity of care shall we? I've been seeing my psychologist for three years. In that time, I've developed a physical disability. Most of our sessions to date have been dealing with issues that have arisen from that, thus, even after three years, my psychologist is still acquiring my history given I've led quite the eventful life. To change over to another service will mean all that time is lost - wasted - as I will have to start over with someone new.
The second point you raised was the issue of attacks on the evidence of the new approaches, and indeed, exactly what these new approaches consist of. Given that I am not a health care professional, I can not in good conscious debate that point in detail here. I will say however, that I have done enough tertiary study in statistical analysis to be highly sceptical of the studies I have read. The outright lies (such as $2.2 billion of new money), do not help your credibility either. Nor does the fact that yourself, and many of your cohorts, fail to disclose any potential conflicts of interest.
Your third point that "academic voices have expressed concern that expanding services to include early intervention will come at the expense of desperately under-developed services for those with chronic or persistent illness" and that "no such debate characterises similar advances in cancer or heart care" can be rebutted with a simple - in other areas of medicine, early intervention is added to advanced treatment. In the case of the last budget, funding was taken away from the only advanced treatment that some of us have available to us (Better Access).
The fourth and final argument you stated is that "a very peculiar commentary proposes that mental health academics should not engage with the broader public debate". From what I've seen, there seems to be more of a concern that some of those academics have their own agenda's to push at the detriment of consumers; and that consumers themselves need to consulted as well (which is not happening effectively), as they know best what works for them. And usually what works best for us is choice, because we are all individuals and we all need different things, even if our "diagnoses" are the same.
Your final statement that "those governments (including NSW) that are making genuine attempts to develop a mental health system of which we can all be proud need the public's support" is truly a laugh. If the current developments were indeed "genuine", I imagine there wouldn't be such opposition to them.
And so Mr Hickie - your arguments may work at your dinner parties with friends - but down here in the dirt where we struggle every day living this nightmare - your arguments simply smell like bullshit.
Note: In order to keep this blog relatively small enough to read in one sitting, I have left out quite a few finer points - and there are many many finer points. Please don't think that they have escaped me. I simply wanted to keep this as an overview rebuttal of the article Mr Hickie wrote.
Figures from the 2011-2012 budget.
Budget
Delivering National Mental Health Reform
| Total funding | Old funding | New funding | |
| Leadership in mental health reform | $64,100,000.00 | $64,100,000.00 | |
| Coordinated care and flexible funding for people with severe and persistant mental illness | $549,900,000.00 | $206,100,000.00 | $343,800,000.00 |
| National Mental Health Commission | $32,000,000.00 | $19,800,000.00 | $12,200,000.00 |
| Mental Health Online Portal | $14,400,000.00 | $14,400,000.00 | |
| ATAPS | $205,900,000.00 | $205,900,000.00 | |
| Support for day to day living in the community program | $19,300,000.00 | $19,300,000.00 | |
| Expansion youth mental health - headspace | $197,300,000.00 | $197,300,000.00 | |
| Health and well being checks for three year olds | $11,000,000.00 | $11,000,000.00 | |
| National partnership agreement on mental health | $201,300,000.00 | $201,300,000.00 | |
| Research funding | $26,200,000.00 | $26,200,000.00 | |
| Family mental health support services | $61,000,000.00 | $61,000,000.00 | |
| Employment services | $2,400,000.00 | $2,400,000.00 | |
| Four mental health infrastructure projects | $78,500,000.00 | $78,500,000.00 | |
| $1,463,300,000.00 | $316,200,000.00 | $1,147,100,000.00 | |
| Better Access Initiative - rationalisation of allied health treatment sessions | -$174,600,000.00 | ||
| Better Access Initiative - rationalisation of GP mental health services | -$405,900,000.00 | ||
| -$580,500,000.00 | |||
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