On Monday 13 and Tuesday 14 April, ABC's Australian Story and The 7:30 Report ran stories that highlighted the nation's poor mental health system, resulting too often in people reaching crisis point and taking their own lives. The stories were very human accounts of the dislocation and disorientation wreaked by mental illness.
These stories foreshadowed the release of the National Mental Health Commission's Review of Mental Health Programs and Services, and the addition of mental health as an agenda item for the Council of Australian Governments (COAG). The review highlights waste in the mental health system, ambiguous reports and the inability to determine whether real and substantial change has occurred.
The review provides 25 recommendations across nine strategic directions which guide a detailed implementation framework of activity over the next decade. It includes almost 200 specific actions which provide concrete ways of making these recommendations a reality. The more weighty recommendations of the review are:
for the Government to reallocate a minimum of $1 billion over five years from 2017-18 from hospitals to community-based services;
an aim to reduce suicides and suicide attempts by half over the next decade;
the inclusion of mental health in Close the Gap targets for Aboriginal and Torres Strait Islander health.
The recommendation to reallocate a minimum of $1 billion of mental health funds from hospitals to community-based services is interesting. While the best outcome for people with mental illness and their carers is to ensure adequate funding for both hospital and community sectors, in an increasingly cash strapped economy tough decisions have to be made about where to prioritise funding.
Community based responses to mental health have much to offer — particularly respectful, person-centred, and relational responses.
The importance of respecting people's strengths (recovery) and building strong compassionate relationships has been confirmed by research across cultures for over four decades and has reached its zenith in the work of Scott Miller and Barry Duncan. The key message of this line of research is that, according to the patients' and clients' perceptions, the theories and techniques of professional and clinical therapy have very little to do with therapeutic success.
Psychologist Michael Lambert's seminal findings attribute patients' and clients' perceptions of therapeutic success largely to non-clinical factors in the following proportions:
55 per cent to recovery factors (such as the client's ego strength, resilience, social support, hope and expectancy);
30 per cent to relationship factors (such as the therapist's/case manager's empathy, warmth, respect and encouragement of risk-taking);
15 per cent to clinical