Thirty years of public inquiries, royal commissions and increased government spending have not improved the effectiveness of mental health strategies. Now what?
Every day nine Australians fall through the cracks of a mental health system plagued by workforce shortages and a lack of evidence-based suicide prevention strategies, taking their own lives.
That has to change, says the AMA, which is calling for the health workforce to be reprioritised in the national suicide prevention strategy.
“To have meaningful impact on reducing the rate of suicide in Australia, emphasis must be given to prevention measures by a capable, adequately resourced workforce,” the AMA said in its submission to the National Suicide Prevention Office’s draft Advice on the National Suicide Prevention Strategy.
“The AMA would like to see scientific quantitative evidence that the suicide prevention strategy is preventing suicide, and that funding is tied to such progress.
“The effectiveness of mental health strategies over more than 30 years has not improved, and may indeed have declined, despite public inquiries, royal commissions, and the involvement of people with lived experience, along with significantly increased government spending.”
The submission, released yesterday, said that suicide prevention needed strong evidence-based strategies, and called on the government to reprioritise the health workforce in its national suicide prevention strategy.
AMA president Dr Danielle McMullen said it was not only workforce shortages, but maldistribution that was the issue.
“We are currently facing severe workforce shortages or inadequate staffing in our mental health system,” she said.
“In psychiatry alone we have just under 4300 psychiatrists working in Australia, which is nowhere near enough.
“Psychiatrists are also unevenly distributed across the country, with close to 80% of the workforce in Melbourne, Sydney and Brisbane.”
The federal government recently invested in psychology study and training, which was welcomed by Dr McMullen.
But there was still much to do, she added.
“With the shortage of psychiatrists and psychologists, the burden on GPs in managing the caseload of patients has increased,” she said.
“We are urging the government to invest in the psychiatry workforce as well as measures to support well-designed, medically governed multi-disciplinary teams.
“For people living with more significant mental illnesses, a multidisciplinary team is likely to result in effective suicide prevention and ongoing support.
“Investment is needed to develop capacity in mental health services in GP and private psychiatrist practices and this extends to embedding accredited mental health nurses and social workers.
“These ‘wrap-around’ services will deliver improved health outcomes, particularly in rural, regional and remote areas.”
The AMA also called for a voluntary register, possibly housed at the Australian Institute of Health and Welfare, for valuable data to better inform suicide policies, as data collection remained piecemeal.
“Prioritising people’s wellbeing to be equally as important as people’s health requires transformative change and system-wide approaches to improve outcomes and close gaps,” said the AMA.
“This will take time.
“For the short-term, a suicide prevention strategy that incorporates fundamentals: accountability, quantitative evidence of progress and tangible improvements to the mental healthcare sector will save lives.”
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It also raised concerns over the lack of coordination across federal and jurisdictional governments and the need for improved governance, drawing attention to the terminated National Mental Health Commission.
“The National Suicide Prevention Office has now relocated to the Department of Health and Aged Care (1 October 2024),” the submission reads.
“The AMA recommends the government decide whether mental health becomes incorporated into the ‘Department of Health, Wellbeing and Aged Care’, or to reinstate a reformed National Mental Health Commission, and ensure a long-term vision beyond parliamentary cycles is implemented.”
