‘We are failing on mental health’: Premier pledges biggest social reform in generation
The use of restraint and seclusion in mental health care would be eliminated within ten years and compulsory treatment would be used only as a last resort under reforms recommended by the Royal Commission.
The Royal Commission into Victoria’s mental health system found it was overwhelmed and cannot keep up with the number of people who seek treatment.
There was an over-reliance on medication, the perspectives of people with mental illness were overlooked, families and carers were left out and services were difficult for many people to afford.
Premier Daniel Andrews has committed to implementing all 65 recommendations in the report, tabled on Tuesday morning in Parliament, which he said would “serve as our blueprint for the biggest social reform in a generation”.
He said the Royal Commission’s final report, which ran to more than 3000 pages, revealed “one inescapable truth: we are failing. And it is costing lives.”
The Royal Commission found the present system was not designed or equipped to support the diverse needs of people living with mental illness or psychological distress.
“Many people who ask for help are turned away unless they are in absolute crisis,” the Royal Commission said.
It recommended between 50 and 60 new adult and older adult local mental health services with extended hours be established across the state, to minimise the need for people to travel far to access services.
Rigid catchments, where people can only receive specialist services based on their place of residence would be dismantled.
“Service providers will never turn people away on the basis of where they live,” the Royal Commission, which was chaired by Penny Armytage, says in its summary.
The Royal Commission said some of its recommendations were a first for Victoria, such as a new agency led by people with lived experience of mental illness, and establishing lived experience leaders throughout the system.
The Royal Commission found consumers still had their human rights breached through compulsory treatment and the use of seclusion – the sole confinement of a person to a space from which they can’t escape – and physical restraint.
Lucy Barker, a witness before the Royal Commission, who has significant trauma from compulsory treatment, said the measures taken were extreme.
“You wouldn’t treat anyone else that way, but because you are perceived to have a mental illness, you can be restrained to a bed for hours or thrown in a seclusion room or chucked in the back of a divvy van or jabbed in the butt, and then knocked unconscious for a day,” Ms Barker said.
“It’s that kind of stuff that makes compulsory treatment terrible.”
The Royal Commission recommended the government act immediately to ensure compulsory treatment was used only as a last resort and set targets to reduce the use and duration of compulsory treatment on a year by year basis.
It said the government should act immediately to reduce the use of seclusion and restraint in mental health, with the aim to eliminate these practices within 10 years.
It also recommended a new Mental Health and Wellbeing Act and an independent Mental Health and Well Being Commission, to hold the government to account.
“During our early consultations, one participant told us: “We don’t want to fill in the potholes, we want an entirely new road,” Ms Armytage said.
“With these final report recommendations, we have designed a system that is an entirely new road. It has been fundamentally reformed – there are no bandaids.”
Each year one in five Victorians will experience mental illness, with about 200,000 meeting the criteria for severe mental illness, such as schizophrenia or bipolar disorder. Last year there were 698 deaths by suicide in Victoria.
Last November the Victorian government pledged $870 million – including 120 mental health beds in Geelong, Epping, Sunshine and Melbourne – acknowledging the “broken” mental health system had been strained even further under the pressures of the COVID-19 pandemic.
It also said the government would invest $2.2 million to begin designing the Victorian Collaborative Centre for Mental Health – a key recommendation of the Royal Commission’s interim report.
“One in five of us will experience a mental illness this year, but five in five of us benefit from a better mental health system,” Premier Daniel Andrews said at the time.
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