Volume 201 - Issue 6
Getting mental health reform back on track: a leadership challenge for the new Australian Government
Authors: Ian B Hickie, Patrick D McGorry and Helen Christensen
Med J Aust 2014; 201 (6): 323. || doi: 10.5694/mja14.00841
Published online: 15 September 2014
Published online: 15 September 2014
In reply: More work is needed, but there is sufficient evidence for action now
In reply: We welcome the opportunity to respond to Dignam's four key points.
First, the commitment in 2006 to a 5-year national mental health reform process gave birth to major funding and program initiatives, such as headspace and Medicare funding of psychological services. However, despite new funds in the 2011 Budget and the new National Mental Health Commission, clear national targets are still not agreed.1
Second, detailed evaluation of individual headspace services,2 as well as the national picture,3 indicates the extent to which these new service models are engaging with young people who are experiencing significant disability but are still in the early phases of illness. We agree that further systematic evaluation of pathways to care and their impacts on longer-term outcomes are required. However, systematic evaluation of early intervention services for those with psychotic disorders provides a basis for further action.4
Third, our view is that systematic suicide prevention is ready for deployment at scale and we offer further evidence to support this.5
Fourth, early intervention applies to clinical services provided early in the illness course. The peak age of onset for most major mental disorders is 12–25 years, hence the focus of headspace services on adolescence and early adulthood. During childhood, we support a focus on population-based strategies for primary prevention and expansion of early intervention services for anxiety, attention-deficit and autism-spectrum disorders.6
Competing interests
Ian Hickie is a Commissioner of the National Mental Health Commission and Chair of the Scientific Leadership Council of the Young and Well Cooperative Research Centre (CRC). He was previously a Director of headspace (Australia's National Youth Mental Health Foundation). Patrick McGorry is a Director of headspace and a member of the Scientific Leadership Council of the Young and Well CRC. Helen Christensen is a member of the Scientific Leadership Council of the Young and Well CRC, was previously a member of the Australian Government's E-Mental Health Advisory Group and is the developer of a number of e-health tools, including MoodGYM.
References
- Hickie IB, McGorry PD, Davenport TA, et al. Getting mental health reform back on track: a leadership challenge for the new Australian Government. Med J Aust 2014; 200: 445-448. 1
- Scott EM, Hermens DF, Glozier N, et al. Targeted primary care-based mental health services for young Australians. Med J Aust 2012; 196: 136-140. 2
- Rickwood DJ, Telford NR, Parker AG, et al. headspace — Australia's innovation in youth mental health: who are the clients and why are they presenting? Med J Aust 2014; 200: 108-111. 3
- Orygen Youth Health Research Centre. Early psychosis feasibility study report. March 2011. Canberra: National Advisory Council on Mental Health, 2011. http://www.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-e-earlypsy-toc (accessed Jun 2014).
- Hegerl U, Mergl R, Havers I, et al. Sustainable effects on suicidality were found for the Nuremberg alliance against depression. Eur Arch Psychiatry Clin Neurosci 2010; 260: 401-406. lefthere
- Cappo D, McGorry P, Hickie I, et al; Independent Mental Health Reform Group. Including, connecting, contributing: a blueprint to transform mental health and social participation in Australia, 2011. http://www.patmcgorry.com.au/sites/all/files/BLUEPRINT%20-%20Release.pdf (accessed Jun 2014).