Psychiatrists reveal ‘alarming’ issues in youth healthcare

Top psychiatrists have sounded the alarm on Australia’s “ineffective” mental healthcare system as Headspace is overwhelmed by rising cases and staff shortages.

Professor Patrick McGorry was one of three psychiatrists to warn of the ‘public health crisis’. Picture: AAP

Young Australians’ mental health is “rapidly declining” and rising case numbers are “overwhelming” Headspace’s capacity, while fragmented health services offer “non-evidence-based,” “ineffective” “salami slices” care, three leading psychiatrists say.

Headspace founder and Orygen director Professor Patrick McGorry; Melbourne University and Royal Children’s Hospital Developmental Mental Health chair Prof David Coghill and Deakin University and Barwon Health psychiatry chair Professor Michael Berk, called out the “unacceptable situation” in an online piece for the Medical Journal of Australia on Monday.

They wrote, despite an “alarming rise” in youth mental illness rates, public pressure and political will to act on this “public health crisis” did not match the “scale and urgency of the crisis”.

“Suicide is the leading cause of death in young people, and may be rising again post pandemic,” they wrote.

The trio wrote Headspace – which caters to young people with mild to moderate mental health issues – was “overdue” for change.

“The rising tide of new cases is now overwhelming the capacity to provide timely access and the funding model has been exposed as no longer adequate to recruit and retain a workforce,” they wrote.

They wrote “rapid, stigma free access” to early help was no longer possible and called for reform to primary care, echoing the demands of leading GP groups.

“The surge in need, workforce shortages and the collapse of bulk‐billing has created a perfect storm both for GPs and headspace centres,” they said.

They also called out the “missing middle” – referring to those who are well enough to be in the community but need more intensive support beyond extra psychology sessions.

They wrote that while Victoria had commenced reform, more work was needed across Australia.

“Most young people with more severe and persistent illness need expert, multidisciplinary team‐based care to recover,” they wrote.

They wrote this team-based care should replace the current “weak and piecemeal” Youth Enhanced Services initiative that has “little regard” to evidence”.

“Aspects of federally funded health care, especially mental health care, has been outsourced to essentially privatised Private Health Networks (PHNs),” they wrote.

“This ecosystem is diffuse, piecemeal, poorly integrated and regulated, typically non‐evidence‐based, confusing to the public, and, ultimately, ineffective.”

They wrote this lack of integrated care also applied to the NDIS, and called for both a funding rethink and greater access to the system for people in the “early stages of potentially disabling mental illnesses” such as ADHD.

A Federal health department spokeswoman said they were committed to “real reform” of the mental health system — including boosting workforce shortages, tripling the GP bulk-billing incentive and considering recommendations from last year’s Headspace audit.

This reform will not occur overnight – and cannot be done within a single Budget or by a single government,” she said.

“The government has signalled its clear intention for continued reform as funding has been provisioned.”