The horrific attack on independent MP Helen Haines has shocked Australians. It has also brought into sharp focus an issue that successive governments have failed to adequately address for decades: the treatment of people living with serious mental illness.
We are quick to express outrage when tragedy strikes. We demand answers, announce inquiries and promise that lessons will be learned. But when the headlines disappear, so often does the political will to address the underlying problems. And in the case of mental illness, those problems have been staring us in the face for years.
In a recent column, Peter Hartcher referred to comments by leading psychiatrist Professor Patrick McGorry about the thousands of Australians with serious mental illnesses who cannot access appropriate treatment. McGorry pointed to the closure of standalone psychiatric hospitals decades ago and the failure to adequately replace them with properly funded community-based services.
There were sound reasons for moving away from the old institutional model. Too many people had been isolated from society, sometimes in appalling conditions. The promise of deinstitutionalisation was that people would receive better treatment, greater dignity and appropriate support within their communities. It was a worthwhile objective, but there was one fundamental requirement: governments had to fund the services that would replace the institutions they were closing. And that is where successive governments failed.
Closing psychiatric hospitals was relatively straightforward. Building comprehensive community mental health services, employing sufficient specialist staff, ensuring continuity of care and supporting people with complex psychiatric conditions required sustained investment and long-term political commitment. Too often, that commitment simply wasn’t there. The consequences have been devastating, with people cycling through emergency departments, short hospital admissions, homelessness and, in some cases, the criminal justice system.
And behind many of these people are families whose experiences rarely make the headlines. Imagine being a parent watching your adult child deteriorate, knowing they desperately need psychiatric treatment but being unable to secure it. Imagine spending weeks trying to arrange an appointment, being told there are no beds available or that your loved one does not meet the threshold for admission. Then, when treatment is finally provided, imagine seeing them discharged after a brief admission with inadequate follow-up and little practical support.
For some families, this cycle continues for years. Parents become carers, advocates and crisis managers. Partners struggle to maintain relationships under extraordinary pressure, while siblings watch helplessly as someone they love becomes increasingly isolated or unwell. Families can find themselves living with constant anxiety about what might happen next, while navigating a fragmented and overwhelmed system.
Here lies one of the great contradictions of our mental health system. Families are frequently expected to shoulder enormous responsibility for the welfare of someone with a serious psychiatric illness, yet they may have remarkably little influence over the treatment and support that person receives. They provide accommodation, financial assistance, emotional support and day-to-day care, but can encounter barriers when they seek information or raise concerns about a loved one’s deteriorating condition. Patient autonomy, privacy and consent are fundamental rights, but surely we can protect those rights while finding better ways to involve and support families.
What makes this particularly unacceptable is that none of it is new. Successive governments have received inquiry reports, expert recommendations and repeated warnings about the inadequacy of mental health services for decades. How many more inquiries do we need before governments act on what they already know?
For those of us living in regional Australia, the difficulties can be even greater. Access to psychiatrists, psychologists and specialist mental health services is limited. Waiting lists can stretch for months, and travelling hundreds of kilometres for treatment is hardly realistic for someone struggling with a serious psychiatric illness. In communities such as Tamworth and across the North West, we understand the challenges of accessing specialist health services. Geography should not determine whether someone receives timely psychiatric treatment, yet too often it does.
We constantly hear governments talking about early intervention, prevention and the importance of mental health. Yet we have a system that too often responds only when someone reaches breaking point. Surely there is something profoundly wrong with a system that can recognise someone needs help but cannot provide it until their condition has deteriorated into a crisis.
We also need to be careful about the way we discuss mental illness following acts of violence. The overwhelming majority of people living with mental illness are not violent. Many are themselves particularly vulnerable to abuse, discrimination, homelessness and social isolation. Nor should we automatically attribute violent behaviour to mental illness. The circumstances surrounding the attack on Helen Haines must be properly investigated, and simplistic explanations serve nobody. But concern about stigma should not prevent us from confronting the very real failures in the treatment of serious psychiatric conditions.
Over recent decades, we have made considerable progress in encouraging people to talk openly about mental health. Campaigns have helped reduce the stigma associated with anxiety and depression, and that is worth celebrating. But there is an enormous difference between raising awareness of mental health and providing effective treatment for serious mental illness. People living with schizophrenia, severe bipolar disorder and other complex psychiatric conditions may require intensive treatment, specialist intervention, supported accommodation and continuing care. Their families need practical assistance, not simply another telephone number to call.
We need properly staffed community mental health teams, accessible psychiatric services, sufficient inpatient facilities and coordinated follow-up care that does not disappear the moment someone leaves hospital. These are not unreasonable expectations. They are the foundations of a functioning mental health system. We cannot keep telling people to seek help when the help they need is unavailable, nor can governments continue to congratulate themselves on mental health initiatives while some of the most vulnerable people remain without appropriate treatment.
This is not a failure belonging to one government or political party. It is a collective failure of public policy stretching across decades and across state and federal jurisdictions. Responsibility may be divided between governments, but that cannot become an excuse for nobody accepting responsibility. Deinstitutionalisation was meant to replace isolation with dignity, treatment and community support. That is not an argument for returning to the institutions of the past, but for finally delivering the services that should have replaced them.
The attack on Helen Haines is a terrible tragedy. But if it prompts another round of expressions of concern, another inquiry and another set of recommendations that gather dust, we will have learned very little. A society should be judged not by how often its leaders speak about compassion, but by how effectively it cares for its most vulnerable members, including the families who have been left carrying responsibilities that should never have been theirs alone.
We have talked about mental health for years. We have commissioned the reports, heard the warnings and made the promises. The problems are well documented, the consequences are painfully evident, and many of the solutions have been identified. What has been missing is the sustained political commitment to deliver them.
We need to talk about mental illness. But after decades of talking, isn’t it time we actually did something about it?
Denise McHugh is an experienced educator in Tamworth. She is Chair of the NSW ALP Education and Skills Committee and Deputy President of the Independent Education Union (IEU).
All opinion and comment on New England Times Engage is the opinion of the writer and not New England Times.
Got something on your mind? Go on then, engage. Submit your opinion piece, letter to the editor, or Quick Word now.