Monday, February 22, 2010

McGorry urges mental health overhaul

An article published in today's edition of The Sydney Morning Herald:

By Julia Medew

The Australian of the Year, Patrick McGorry [pictured], has called for a massive overhaul of the mental health system to direct funds away from acute hospital services to more community-based care.

Only weeks after accepting his award, Professor McGorry has moved to capitalise on his role by asking the federal Health Minister, Nicola Roxon, for at least $200 million in new services this year.

On top of his list is a significant expansion of specialised treatment facilities for young people aged 15 to 24 who are experiencing early psychosis and other serious mental health disorders such as schizophrenia.

He said the only such facility in Australia, Orygen Youth Health, should be used as a model for 10 new centres in other cities this year, with a commitment to another 10 in regional hubs over the next five years.

The rollout would cost $100 million this year, he said, with recurrent spending rising to about $250 million a year when all 21 centres are operating.

"This investment will be recouped three times over because early intervention is highly cost-effective and rapidly shrinks the need for care in the medium to long term," he said.

"This will free up resources for the long-term disabled cases and the broader range of mental disorders. The health economics case is unassailable."

Professor McGorry, who directs Orygen Youth Health, said he had also asked for 60 new "headspace" centres, which currently provide mental health, education, employment and drug and alcohol services to young people aged 12 to 25 at 30 sites across the country.

He said this expansion, which would cost $100 million to set up and the same in recurrent spending, would make headspace centres the first port of call for young people showing signs of mental illness, who could then be referred on to the specialised treatment facilities if need be.

"This is a low-risk reform strategy with rapid and dramatic benefits in health gain and cost savings. Failure to invest in early psychosis reform will result in another lost generation of young Australians consigned to unnecessary disability as well as premature death from suicide and cardiovascular disease," he said.

Professor McGorry said he wanted to see the centre of gravity of mental health services shifted away from hospitals to community-based facilities because the sector had suffered enormously from being moved out of "asylums" and into hospitals in the 1990s. He said the transition was like "boarding a sinking ship" for mental health professionals who had struggled to work with scarce funds ever since.

''The acute pressure [on the hospital system] has made mental health budgets very vulnerable,'' he said. ''The mental health system needs to be scaled up significantly now. It needs to double in size and the states can't do it alone.''

Professor McGorry said that after consulting widely in recent weeks, he also hoped federal and state and territory governments would fund more mobile treatment teams for people with delayed recovery and persistent conditions so they were not forced to go to hospital emergency departments during crises.

"We need to disinvest in emergency departments as the place for acute and crisis care. EDs are the wrong places for people with mental health problems to be treated," he said.

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