Meet the faces failed by broken mental health system amid radical move to fix its issues
From a teen waiting six months for one appointment to a husband left abandoned by its services, meet those failed by Victoria’s fractured mental health system.
Victoria
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Daniel Henderson fell through every crack in Victoria’s fractured mental health system, to his death at just 17.
His mum, Kim Edgar, doesn’t need a report to tell her what’s wrong with “the system”, because she’s experienced every painful part of it, fighting to keep her severely depressed son alive.
Daniel, who had attempted suicide before his death in August 2018, waited six months for an appointment with a psychiatrist. It was too long. He took his life three weeks before the meeting.
“I spoke to teachers, counsellors, doctors, psychologists, government agencies, hospitals,” Ms Edgar said. “I spoke to anyone who would listen … but it wasn’t enough.”
The Bellarine Peninsula teen was failed by the Geelong region’s swamped and under-resourced mental health system, Ms Edgar believes.
“It’s also costly, and I can’t tell you what that does to a mother who just doesn’t have enough money to pay for what her child needs,” she said. “Even if you can afford the services, they are typically so overburdened … people aren’t assessed properly and even when they are referred for help, have to wait too long to get it.”
Ms Edgar said one of the most heartening recommendations in Tuesday’s report was family and carers needed to be heard, recognised and supported. After a suicide, they also needed funded, ongoing support.
Recommendations that standards be developed for services and specialists to share information could also be lifesaving, she said.
“This is so important because often privacy laws are used as a blanket reason to not share information,” Ms Edgar said. “Privacy laws … should never be allowed to contribute to loss of life.”
‘HE WASN’T EATING OR DRINKING’
When Wonga Park schoolteacher Kylie Poppins implored mental health services to hospitalise her suicidal husband, she was asked if she was “trying to get rid of him”.
Shocked, she answered “of course not”, and the family of four battled on.
But Ms Poppins’s husband, Peter, was not his usual self as he faced his young daughter’s diagnosis with a serious genetic illness, a failing business and an insurance battle over flood damage to their home.
“He wasn’t eating or drinking. The things he was saying were deluded, they didn’t make sense,” Ms Poppins said.
“I was saying to them (the mental health workers) ‘I think he needs to be in hospital’. I felt like they thought I was hysterical.”
Shortly afterwards, in 2017, Peter took his life aged just 49.
Ms Poppins said she hoped the government found “the political will” to enact real change and when families like hers called out for help, “that the help will be there for them”.
“I think they owe it to those of us who have suffered through the broken system and who continue to suffer, not just from the terrible loss of our loved ones, but also because of the way that our family were treated at a time when we were pleading for help,” she said.
Former Numurkah dairy farmer Steve Dalitz backed the report’s push for better services in regional areas and for those who can’t afford private treatment.
Traumatised after witnessing a fatal accident and depressed by the toll drought was taking on his herd, he waited five months to see a psychiatrist through the public system. While he survived the experience in 2019, he knows many other farmers did not.
“You can’t get in anywhere for (public) treatment,” Mr Dalitz said.
FARMER’S PAINFUL FIVE-MONTH WAIT
Former Numurkah dairy farmer Steve Dalitz waited five months to see a psychiatrist through the public health system in country Victoria.
While he survived the experience in 2019 – and went on to become a men’s mental health advocate – he knows many other farmers took their own lives over the course of the same, extended dry spell.
Traumatised after witnessing a fatal accident and depressed by the toll drought was taking on his dairy herd, like many other men, the father and local sports coach was worried about money and his ability to pay the bills and care for his family.
The future looked bleak.
But when asked by mental health workers if he was suicidal, Mr Dalitz answered ‘no”, and so went to the back of the very long local queue for help.
He estimates 50 per cent of the dairy farmers he knew were suffering from depression at the height of the drought.
“The truth of it was I had actually thought about how I’d do it (kill myself) … so I probably was suicidal. People in that sort of mind space aren’t the best ones to say whether they need treatment or not,” he said.
“And you can’t get in anywhere for treatment anyway. You’ve got no hope unless you’ve got lots of money for private (treatment). But if you’ve only got Medicare, you’ve got no hope of getting in quick.”
Commission report recommendations for more affordable and accessible mental health services in regional Victoria were welcome news, Mr Dalitz said.
REGIONAL MENTAL HEALTH CENTRES NEEDED
Six new mental health treatment centres will be fast-tracked in Victoria following release of a landmark report into the state’s fractured system.
The new centres will focus on providing a “front door” for people in crisis as well as access to long-term care.
Locations flagged for the new facilities include Benalla, Brimbank, Frankston, Greater Geelong, Latrobe Valley, and Whittlesea.
Daniel Andrew’s said “we are not wasting any time on this”, after unveiling the findings of the landmark Mental Health Royal Commission report handed down on Tuesday.
Mental Health Minister James Merlino said these areas were identified by the department as being “priority locations”.
“These sites will support people from their first to the last contact with mental health services,” Mr Merlino said.
“These six areas identify themselves.
“Here in Frankston, one of the highest per capita suicide attempt presentations to emergency departments, as well as one of the highest per capita, suicide rates in the state.
“Benalla has been identified the highest per capita suicide rate over the last decade in Victoria.
“Places like Whittlesea are one of the highest per capita community mental health presentations.”
It’s the first of 60 new centres after decades of underinvestment, with more sites to be identified.
There has been no amount of funding yet identified for the roll out, or the program to facilitate 60 sites.
But the Premier admitted “this is not going to be cheap”.
There was also no update on what form a Mental Health Levy would take with Mr Andrews saying such detail would be revealed closer to the State Budget.
He flagged a final model had not yet been decided on, but also flagged the impacts of the pandemic would need to be considered as part of the process.
RADICAL MOVE TO FIX BROKEN MENTAL HEALTH SYSTEM
Victoria’s mental health system will be torn up and transformed after a two-year Royal Commission found the state has been failed by an “antiquated” system that was driven by crisis.
A new Mental Health Commission will be established, services will be moved and expanded into local communities and a new levy will be introduced to pay for sweeping changes to the state’s patchwork of struggling services.
In a damning 3000 page report tabled to parliament on Tuesday morning, the Royal Commission found the current system was overwhelmed and that more than 95,000 people missed out on needed services during the 2019-20 financial year.
Among these was a “missing middle” of people whose needs were too complex for local primary care services but not severe enough for proper treatment at specialist clinics.
As a result, the system is “driven by crisis” and people receive support too late and after it would make the most difference.
Other key issues included a reliance on medication, significant difficulties in Victorians being able to seek help and very little focus on local needs.
In 2019, 718 people losing their lives to suicide in the state.
Victoria was also understood to spend less per person than most other states, with about $91 spent per capita in 2018-19 compared to $110 in South Australia, $110 in Queensland and $130 in the Northern Territory.
The cost of poor mental health to Victoria was estimated to be about $14.2 billion per year, with more than 200,000 people believed to fall under the category of severe mental illness.
The Commission made 65 recommendations to tear up the current model and establish new structure that would address all these issues and more.
The Andrews Government has committed to implementing all of these changes, including the legislating of an entirely new Mental Health and Wellbeing Act that would oversee these changes.
At the centre of the restructure will be a new Chief Officer for Mental Health and Wellbeing that will oversee a division in the Department of Health.
By mid-2021, there will be eight mental health regions that will become fully operational boards by 2023, that will be in charge of how support services are distributed.
They will be tasked with delivering the Commission’s key goal of having most Victorians receive mental health care within their local community.
The report found this was vital to ensure people with poor mental health were picked up early, did not slip through the cracks of the system and received the right treatment.
To boost this massive local effort, up to 60 new services will need to be set up across the set up with extended hours, with further support hubs to be set up through partnerships with hospitals, non-government organisations.
Each of the eight regions will need to have at least one 24-hour crisis response centre.
Commission chair Penny Armytage AM said the report outlined a system-wide change that was modern and flexible.
“The future system will ensure that people have access to high-quality mental health and wellbeing services that are compassionate, responsive to their needs and are based on their rights and preferences,” she said.
“During our early consultations one participant told us, ‘We don’t want to fill in the potholes, we want a new road.’
“With these final report recommendations we have designed a system that is an entirely new road.
“It has been fundamentally reformed – there are no band aids.”
All of this work will be assisted by a new Mental Health and Wellbeing Commission that has the power to initiate inquiries, handle complaints and make recommendations to the Premier.
As flagged in its interim report, funding for these changes will be secured through a new levy which is likely to be announced by the Andrews Government in its upcoming state budget.
In a statement, Premier Daniel Andrews said the suffering of everyday Victorians had not been taken seriously enough.
“These big gaps in the system mean that people are falling between the cracks,” he said.
“Instead of help early on — we’re leaving people until it’s too late and they need to be treated in our emergency departments.
“These recommendations will serve as our blueprint for delivering the biggest social reform in a generation.”
“The system has catastrophically failed to live up to expectations and is woefully unprepared for current and future challenges,” Ms Armytage told the Victorians parliament on Tuesday.
“We must address the fact that the mental health system is imbalanced.
“Under resourcing is leading to an over reliance on medication.
“We know a collection of discrete reforms to an antiquated system is not enough. We have recommended a fundamental redesign.”
LIVED EXPERIENCE FOCUS
A key finding of the Royal Commission into Mental Health report released on Tuesday is that people who had experienced poor mental health had little to no say in how the system is run.
It called for a new structure that allowed people who had struggled with mental health in their past, known as lived experience, to have a greater influence in the major changes to be undertaken and ongoing maintenance of the program.
A new agency will be set up led by people with lived experience to advise the Department of Health and other organisations.
Additionally, at least one commissioner on the newly formed Mental Health and Wellbeing commission will be required to have lived experience with this problem while another will be required to have experience as a family member or carer.
FEDERAL QUESTIONS REMAIN
The findings of the report have massive implications for the state’s relationship with the federal government, with a significant share of health funding shared with the Commonwealth.
The Victorian Government is expected to consult with the Morrison Government over how it implements these changes and whether there is scope to widen these changes to a national level.
But it is understood they will push on with the recommendations even if the federal government does not come to the table.
The new structure of the mental health system will also need to integrate with private health providers and questions remain about how this will work with current Medicare and health insurance arrangements.
DEALING WITH TRAUMA
In some instances, the Commission found the process of treating those suffering from poor mental health added to their suffering by creating further trauma.
This included instances where people were forcibly restrained as part of the support being provided.
The Commission has recommended that Ambulance Victoria immediately be given the lead on all mental health triple-0 calls, rather than Victoria Police.
This would place a focus on health support and recovery for those struggling with psychological distress.
A new Statewide Trauma Service will be established by the end of 2022 to help deal with this problem.
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