Under the Chairmanship of its founding father Jeff Kennett, Beyond Blue, the hitherto respected initiative, has been highly successful in countering the stigma attached to a diagnosis of depression.
Recently the organisation and Kennett seemed to have come to a fork in the road. There was an outcry and calls for Kennett's resignation in the wake of his assertion that only children in the care of heterosexual parents could achieve optimum mental health.
Despite being criticised as alienating and exhibiting bias against the gay community, Kennett was re-elected by the Beyond Blue board.
Nonetheless this controversy should not eclipse more important questions. After ten years of good groundwork, do we need something new from Beyond Blue and other key mental health institutions?
According to the World Health Organisation, depression affects 'about 121 million people worldwide', is 'among the leading causes of disability worldwide', and, although it 'can be reliably diagnosed and treated in primary care', 'fewer than 25 per cent of those affected have access to effective treatment'.
Beyond Blue and the current zeitgeist has largely been identified with the medical disease model. Treatment has favoured a limited number of sessions — six to 18 sessions under Medicare, now reduced to ten. It has promoted a cognitive behavioural approach plus medication.
There are strengths and limitations in this approach.
The promotion of understanding, removal of stigma and encouragement to seek help requires the countering of stereotypical and unhelpful attitudes. In the bad old days those suffering from debilitating depression have been regarded as having character or personality flaws. People in a depressed state often have been judged as lazy, unsociable, and just not willing to make an effort.
It has therefore been necessary for Beyond Blue and similar groups to package a fairly simple message. The disease model is readily understood and has been progressively less imbued with moral condemnation.
However the one-size-fits-all view can foster problematic misconceptions. The notion that mental ill health is a bundle of symptoms and neurological processes can exclude the full range of human distress. Depression is not always readily or lastingly addressed by current approaches, and may remain intractable (in 20 to 40 per cent of cases, according to WHO).
How does this fit