Analysis of the 1992 Australian National Mental Health Policy

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An analysis of the 1992 Australian National Mental Health Policy and other relevant policy documents. This presentation was completed in 2007.

An analysis of the 1992 Australian National Mental Health Policy and other relevant policy documents. This presentation was completed in 2007.

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  • 1. National Mental Health Policy (1992) Amber Stasiuk, Kirsten Giersch & Louise Miller 2007
  • 2. Agenda
    • Policy context:
    • current understandings of mental health
    • current causation beliefs
    • historical context
    • National Mental Health Policy (1992)
    • intro
    • Policy in Action: Strategies and Plans
    • Hidden Arguments and omissions
    • The future
  • 3.
    • While the National Mental Health policy defines neither mental health nor mental illness....there is no common agreement elsewhere either
    • South Australian Mental Health Act 1993 : Any illness of disorder of the mind
    • High Court of Australia : An underlying pathological infirmity of the mind, be it long or short duration and be it permanent or temporary, which can be properly termed as distinct from the reaction of a healthy mind to extraordinary stimuli.
    Some definitions....
  • 4. Definitions cont’.
    • New South Wales Mental Health Act 1993 :
    • … a condition which seriously impairs, either temporarily or permanently, the mental functioning of a person and is characterised by the presence in the person of any one or more of the following symptoms:
    • a) delusions
    • b) Hallucinations
    • c) serious disorder of thought form
    • d) a severe disturbance of mood
    • e) sustained or repeated irrational behaviour indicating any one or more of the above symptoms.
  • 5. Types of mental illnesses
    • Mood disorders : eg. depression, anxiety
    • Psychotic disorders eg: schizophrenia
    • Behaviour disorders eg: conduct disorder
    • Personality disorders
    • Substance Abuse Disorders
    • Dementia / brain injury (??)
    • etc
  • 6. Mental illness definition changes over time
    • Intellectual disability : now funded under disability
    • Dementia: now funded under aged care
    • Homosexuality : until 1990 was still included in the WHO definition of mental illnesses
    • Eating disorder: mental illness or physical habituation?
  • 7. And mental health?
    • Health is also not defined, although the underlying assumption seems to be lack of detectable clinical symptoms.
    • Difficult to define a distinct marker btw eccentric and clinically ill, normal and abnormal. Largely, the clinician decides.
    • No difference is made between remission and cure.
  • 8. Impacts of Mental Health in Australia
    • Highest non-fatal burden of disease (30%)
    • Third highest total burden of disease
    • 20% of Population experience Mental Health Problem each Year
    • Mental Illness affects 14% of Children and Adolescents
    • However.....
    • 7% of Total National Health Expenditure
  • 9. Mental Health Causation Theories
    • Policy recognises: genetic, social/situational stressors, and mentions some high-risk populations.
    • Current thinking includes:
    • - Lifestyle: Social, environmental (“stress”), psychological
    • - Personal Behaviour (eg: marijuana)
    • - Biological (eg: chemical, brain injury, brain disease)
    • - Genetic
    • - Infection (tertiary syphillis, schizophrenia)
    • - Central Nervous System Developmental Theory
    • - multifactorial (problematic to address)
    • - and recognises that many causes still unidentified
  • 10. History of Mental Illness
    • Earliest known mental institutions established in 918AD
    • 1811 – Governor Macquarie announced plans for first purpose built asylum in Australia
    • 1939-45 – WWII
    • 1940’s – electro-convulsive therapy
    • 1950’s – introduction of phenothiazine
    • 1960’s – antidepressants available
    • 1960-70’s – de-institutionalization
  • 11. The National Mental Health Policy 1992
    • Promote the mental health of the Australian community
    • Where possible, prevent the development of mental disorder
    • Reduce the impact of mental health disorder in individuals, families and the community
    • To assure the rights of people with mental disorders
    • De-institutionalisation
  • 12. Burdekin Report 1993
    • Report of the National Inquiry into the Human Rights of People with Mental Illness
    • To increase the understanding, acceptance and observance of human rights in Australia
    • To promote a fairer society by protecting human rights and ensuring that Australia complies with its human rights obligations under international law
  • 13. Australia’s National Mental Health Strategies: Policy in Action
    • First National Mental Health Strategy, 1992-1998
      • Encourage a national approach to mental health policy and service delivery
      • Provide the impetus for reform of mental health services
      • Provide a mechanism for addressing agreed priority issues
  • 14. Australia’s National Mental Health Strategies: Policy in Action
    • Second Mental Health Strategy 1998-2002
      • mental health promotion and illness prevention
      • service reform through development of partnerships
      • quality improvement in service delivery
  • 15. Australia’s National Mental Health Plan: Policy in Action
    • National Mental Health Plan 2003-2008
    • builds on the priorities of both earlier strategies
    • consolidates existing reforms as well as strengthens the focus in areas of particular significance
  • 16. National Mental Health Policy Hidden Arguments
    • 1. Policy ownership
    • 2. Human Rights / Consumer Rights
    • 3. Public Health / Prevention
    • 4. Evidence Based medicine
    • 5. Disease Causation theories
  • 17. What’s missing? What’s happening?
    • 1. Delineation of specific roles
    • 2. GPs
    • 3. Carers
    • 4. Mental Health in detention
    • 5. Workforce
  • 18. The future........
    • “ Nothing in life is completely free, nor should it be.” Prime Minister John Howard
    • “ There needs to be some restraint when it comes to the availability of taxpayer funds for non-essential procedures.”
    • Federal Health Minister Tony Abbott
    • “ Taxpayer funding of health needs to be based on the likelihood of success of medical treatments.” Treasurer Peter Costello