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Mental health review should be about effectiveness, not cost

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AMA President Dr Steve Hambleton has welcomed as “timely” a Federal Government review of mental health services and programs, but has warned it should not be simply a cost-cutting exercise.

The Federal Government has engaged the National Mental Health Commission to undertake a the comprehensive review of all government, non-government and private sector mental health programs and services, and has asked it specifically to identify gaps in the delivery of mental health services, as well as inefficiencies, duplications and excessive red tape.

Announcing the terms of reference for the inquiry, Health Minister Peter Dutton said the Government had commissioned the review as part of its undertaking to ensure the nation had a world-class mental health system.

“To do this, we need to know what really works, and ensure that existing resources in the mental health sector are being targeted as effectively as possible,” the Minster said.

However, with the Government on a vigorous hunt for savings across all portfolios, some groups, such as the Australian Greens, have voiced concerns the review’s primary purpose will be to cut costs.

Greens mental health spokeswoman Senator Penny Wright said the review was “a clear forerunner” for cuts to the sector.

But Dr Hambleton took a more measured view of the inquiry.

The AMA President said a number of problems with the current configuration and provision of mental health services meant that it was a good time for a thorough review.

“We certainly need to look at what has happened in the last couple of years, particularly in general practice, where there has been a decline in investment in this [mental health] area,” he said.

Dr Hambleton said the decision in 2011 to cut the rebate for GP Mental Health Treatment Plans by up to 50 per cent had impeded the ability of GPs to spend sufficient time with patients with mental health problems, and to organise allied health and other support services.

The AMA President said assessing the true state of mental health care was made more complicated by the many varied settings in which it was provided, including in hospitals, through outreach services and in the community, heightening the risk that many patients were “falling through the cracks”.

Dr Hambleton said that although it made sense to look at whether current funds were being used to best effect, there was a case to actually increase investment in mental health care provided by primary providers such as GPs in order to prevent mental illnesses advancing to the stage where patients required hospitalisation, had to take time off work or other costly outcomes.

“This cannot be a cost-cutting exercise,” the AMA President said. “[Greater] efficiency is ok, cutting red tape is ok, but cutting spending is probably not the right thing to do at this time.

“We can increase our spending on primary care and patient-doctor connection services, which should decrease our health spending overall.”

Mental Health Council of Australia Chief Executive Officer Frank Quinlan said the Review was an opportunity to address “significant under-investment” in many areas of mental health in recent years.

“There is no doubt in anyone’s mind that the mental health system in Australia is in need of reform,” Mr Quinlan said. “The Terms of Reference rightly identify the need to review spending in the sector, to reduce duplication and address the gas in services. Btu we also know that many areas have seen significant under-investment for many years.”

Mental Health Commission Chairman Professor Allan Fels said his organisation would complete the Review and report to the Government in late November.

Adrian Rollins