Mental health needs a great deal of attention. It’s the final taboo and it needs to be faced and dealt with. — Adam Ant
Back in 2010, mental health expert and then Australian of the Year Professor Patrick McGorry lobbied the Federal Government to commit more money to the country’s mental health system. He was reported as saying Labor’s $277 million plan was “simply not enough” and the Coalition’s $1.5 billion proposal “may have a better price tag”, but it excluded children and older people.
In 2015 a lot has changed for older people suffering chronic mental illness, thanks to Disability Services Australia initiatives, but as the peak national non-government organisation representing and promoting the interests of the Australian mental health sector, Mental Health Australia, suggests, “still more is needed to improve services to meet increasing demands and to ensure that those with a mental illness receive high quality and targeted services. Small investments in existing systems and services will not end the crisis in mental health and will continue to offer poorly integrated services that fail to deliver quality care.”
Case in point, a recent article by the executive director of Mental Illness Fellowship of Australia, David Meldrum, questions whether the right people are getting access to Tier 3 National Disability Insurance Scheme funding currently being trialled at different sites.
As a family with a mentally ill sibling who has suffered the illness for now on 30 years, we are one of the lucky few grateful for NDIS funding that has found its way to a sister and daughter who has been crying out for “quality care” for way too long. And it couldn’t have come at a better time. At age 53, she’s been diagnosed with stage 4 cancer. The prognosis isn’t good and the specialist help she requires is protracted and expensive.
The journey to this outcome has been long and stressful on all sides. Thirty years ago psych patients were given treatment and then thrown out to the elements. If they were lucky, they had family or charities who could pick up the pieces; if they weren’t, they roamed the streets aimlessly or jumped from boarding house to public housing depending on how quickly they were evicted due to the way they lived. To get a case worker meant the patient had to agree to it, or families had to take out court orders.
To understand the difficulty of securing help, it takes a team of health-care professionals [see list below], including a wide range of dedicated professionals, in getting treatment to someone such as our sibling, who suffered paranoid schizophrenia.
- Case worker
- GP (general practitioner/family doctor)
- Psychiatrist, psychotherapist and psychiatric nurse
- Social worker
- Members of the patient’s family
Getting long-term help is hit or miss due to the very nature of the disease. Psych patients distrust the system and reject suggestions that ongoing psych medication can assist them to lead “normal” lives. A revolving door of hospitalisation therefore ensues.
For 20 years our sibling spent more time trying to buck the system than work with it. When in her words she was “finally cornered and institutionalised”, the outcome still proved poor. After five years of “help” under Mental Health she was described as being “treatment resistant” and discharged on that basis.
During her internment she repeatedly failed the mental institution’s staged system of learning how to live independently yet was still discharged and placed in an apartment with no outlook where she proceeded to trash it as her mental health deteriorated rapidly. It was decided a different style of community accommodation was required, but again she was able to refuse medication, or help being offered to a psych patient “living in the community”. That deterioration was so sever that within six months she had to be hospitalised and could not return to her flat due to its state. It required a “forensic clean” because it was that filthy and festered.
Not having the funds to pay for the $2000 clean-up, she was ushered in to a short-stay mental health facility that ended up nursing her back to mental health for a period of 12 months. But even so, as in the previous institution, there were few health checks as psych patients can refuse it. After 30 years it seems there is still no such thing as a holistic approach to mental health.
A year on from that situation, under a brave new mental health regime in Australia, our sibling finally has “quality” assisted help, but it’s come too late for her physical health. She’s had cancer for “a very long time”, according to the oncologist. The primary cancer in her bowel has metastasised into the liver where two large tumours have developed.
She undergoes chemo this week. She’s scared but on good days surprisingly able to take the situation in her stride. On bad days, it is heart-wrenching to watch someone who has suffered so much forced to suffer even more. And there’s only more suffering to come.
If there is one change families of the mentally ill would like to see, it is the approach to care that is currently being administered. It is no longer acceptable for doctors to attempt only to improve a patient’s mental well-being. Their physical health must come into play. Psych patients are known for their poor hygiene, lack of nutritional care to themselves, their obsessive nature to self-medicate through drugs and alcohol, through binge eating and smoking, all of which takes its toll physically. If the psych drugs don’t take them out early, conditions such as diabetes, respiratory disease and cancer will. As ’80s English musician Adam Ant suggests, it’s time to face up to and deal with the mental health facts.
Judy Wilkinson is a freelance writer and blogger whose family has spent in gaol-terms, a lifetime navigating and dealing with an often hostile and inadequate mental health system.