What does an ethical, moral, human rights informed, fit for purpose mental health system aligned to The Hippocratic Oath of At First Do Harm etc etc…

What does an ethical, moral, human rights informed, fit for purpose mental health system aligned to The Hippocratic Oath of At First Do Harm:

• look like?
• sound like?
• feel like?

Initial ponderings based on personal lived experience post-diagnosis bipolar

TLDR

Key success factors:

1. seeking solutions
2. seeking those who’ve achieved a sense of healing and recovery
3. letting go of what does not / is not working
4. boundary building
5. re-evaluating legacy
6. re-evaluating values hierarchy
7. repatterning relationship between the neuro, the linguistic and the programming
8. reconfiguring the relationship between the head, the heart, the gut and the autonomic nervous system – through breathing
9. re-evaluating family history and inherited inter-generational trauma
10. going with the flow

The above is a first “draft” of my reflections on what worked for me personally over the past decade since my diagnosis in 2011 of bipolar.

I say “draft” because I conclude that mental health and mental illness are complex and often rooted in inter-generational issues and therefore any conclusions are personal and non-linear in terms of attributing cause and effect.

The underlying foundation of my success in achieving what I’ve achieved I believe is seeking the wisdom of those who’ve gone before me and my diagnosis – the memoirs of those diagnosed bipolar, the bipolar support groups, the online bipolar bloggers.

And so my belief is that we will only ever see an ethical, moral, human rights informed, fit for purpose mental health system aligned to The Hippocratic Oath if it is lead and managed by those with lived experience at all levels and in all organisations.

And so to the speech below from 2020 by the Australian Prime Minister.

Maybe the checklist of key success factors can be seen permeating this speech?

Make your own conclusions.

SPEECH

16 Nov 2020

Parkville, Victoria

Prime Minister

E&OE
Source: https://www.pm.gov.au/media/speech-parkville

PRIME MINISTER: Well thank you very much Pat and it’s great to be here at these headquarters, at the premises which I’ve had something to do with over the years. But no one has driven this agenda like you, and I want to thank you in particular for being so available to me and to Greg and so many of my Ministers and other advisers. When Pat McGorry’s calling, you pick up the phone, I can assure you of that, to speak about these issues because he will be telling you about what is happening on the ground with patients and with others in distress and he always has very practical suggestions. We get to the practical element very, very quickly. So Pat, I want to thank you for your leadership throughout this crisis and I am sure that is shared by the Premier here in Victoria, Premiers in other states and territories as well and the magnificent work that is done.

To Christine Morgan my national suicide prevention adviser, and Ruth Vine our deputy Chief Medical Officer. Ruth and I have spoken on many occasions over the course of this last six or seven months, but this is the first opportunity we have actually been able to be in the same room together. I want to thank Ruth and Christine for the tremendous work they have been doing over the course particularly of this year in not just responding to the crisis, but also the foundational work that has been done in terms of how we deal with what happens after this crisis.

And I think we all understand in this room in particular, the legacy that we will have to live through as a result of the scarring impacts of this crisis on Australians all around the country. We understand that and that is why we are doing the things that we are doing.

To the acting Chief Medical Officer, Paul Kelly, who is here with us as well today, thank you, Paul. Paul of course is very focused today on the other challenges we have in relation to the pandemic, particularly in South Australia and he’s been working on those issues and we have been meeting on those earlier today and has been meeting with the AHPPC, the medical expert panel earlier today, to address those issues. So I know you will have to get away quickly, Paul. But I thank you for being here as well.

And of course to Greg Hunt, my Minister for Health, but a great Victorian, and someone who – he I together working in a partnership that has been very important when it comes to the national response to the pandemic. But, there are many other areas of passion that Greg and I share when it comes to the Health portfolio. The PBS is one that we have shared, both as Treasurer and now as Prime Minister. But also in the area of mental health. And I remember, in particular, not long after becoming Prime Minister, I spoke to Greg on the phone one day and we were looking forward to the next Budget. I said, Greg, we just have to do more in this area, let’s get to work. And Greg hasn’t stopped since that time, whether it is drawing Christine into our team of very high-level advisers and working through these issues and engaging the sector and particularly through people like Pat. Greg I want to thank you for your leadership in this area, and your input and carrying that along with the many other burdens.

To the team from the productivity commission here, Innes Willox is here representing industry and that is a very good understanding that this is first and foremost a health issue, but health issues have very significant and serious economic consequences as well. And if there has ever been a year to understand that, it is the COVID-19 pandemic of 2020. Our nation’s health is as linked to our nation as prosperity as any other thing and we need no reminder about that going through this year.

That is something that I believe our Indigenous Australians have always understood. And I want to acknowledge and pay respect to the Wurundjeri people and the Kulin nation as the original and ongoing owners and custodians of this land.

I also want to acknowledge Australia’s mental health workers. Every day you reflect the very best of our humanity to others. I want to acknowledge all of those Australians who live with mental illness. Those who have lived experience of suicide, their loved ones and their communities. Their carers. In particular, I acknowledge the many veterans who struggle with mental health challenges, who carry a burden because of their service that we must always remember and a debt that we owe to them that we will never be able to fully repay. I thank all of our serving members of our defence forces as well and honour them.

Mental health issues and suicide do not discriminate. It doesn’t matter where you live, what you do for a living. 1 in 5 Australians will experience a mental health illness every year and half of us will be diagnosed during our lifetime.

In 2018, 2.4 million Australians aged 18 and over experienced high or very high levels of psychological distress. Now that was in 2018. Now this is before COVID-19 which we know had a significant impact on mental health and wellbeing, not least so here in Melbourne and in Victoria.

In just the last four weeks, Lifeline, Kids Helpline, Beyond Blue together answered over 112,000 contacts for help, around a quarter higher than the same time in 2019.

65,000 Australians, 65,000 Australians attempt suicide each year.

Just let that figure sink in.

We know that last year 3,300 Australians died by suicide.

So that is 9 Australians each and every day.

On average, every suicide impacts around another 135 people.

Men and boys account for three quarters of all suicides, and our highest rates of suicide are among men over 85, men in their 30s, 40s and 50s.

But there is also an increase in self-harm and suicide amongst women and girls. I can tell you as a father of two daughters, this is something that terrifies me.

Most confronting and heartbreaking is that suicide is the leading cause of death amongst our young people.

As we know, Indigenous communities bar the scars acutely. Last year, 195 Indigenous Australians were lost to suicide. I know Indigenous Australians Minister Ken Wyatt understands this only too well.

Indigenous Australians die by suicide at double the non-indigenous rate.

And of course, as I mentioned, our veterans are also vulnerable. From 2001 to 2018, 465 Australians who had served over the previous 17 years died by suicide.

Phil Thompson, a colleague of Greg’s and mine, has been to too many of those funerals. It is an experience that I can’t pretend to imagine.

And I applaud all of those veterans in the way they stand by each other and deal with this.

Today, I want to speak to you about the road ahead, though. I want to talk to you about where we are going on mental health and suicide prevention.

Of course it is a big challenge. The figures I have just shared with you are quite overwhelming. If you dwell on them for too long.

They are intended to confront us and so they should – brutal truths should have that effect. But our response shouldn’t be to fall victim to them, but to chart a better way forward and a road out.

I want to affirm the government’s commitment today to providing Australians with the mental health support they need, particularly in these challenging times.

In my first Budget, as I reflected before as Prime Minister, this included an additional $740 million over 7 years to improve access to mental health service and to combat the tragedy of suicide.

This included our $509 million youth mental health and suicide prevention package, the largest in Australian history, which is growing the national HeadSpace network to 153 centres around the country by 2021. That’s right, next year. While reducing wait lists and boosting funding for youth psychosis and eating disorder services.

Now both HeadSpace and the early youth psychosis services I have just mentioned, they are the brainchild as we all know of Professor Pat McGorry who is with us here today. I want to acknowledge Pat’s enormous contribution, developing and scaling-up early intervention and youth mental health services. And Pat knows, because he equally acknowledges it, that when HeadSpace was set up under the Howard government and particularly with Christopher Pyne, who was the Assistant Minister for Health at the time, of the many things that we have done as Coalition governments, both present and in the past. I can think of few more important than the services that we have established in the community for assisting young people with their mental health through HeadSpace. And again, I thank you, Pat.

Today, I am releasing the Productivity Commission’s report into mental health. Now, this is the most comprehensive report of its kind in our history in Australia. And I have got the executive summary here because I can’t carry the other two volumes that sit with this report. It is well worth the read for all of us who care about the mental health of our fellow Australians.

It examines the interaction and effectiveness and outcomes of policies, systems and programs across all jurisdictions and I’ll talk more about that. As well as assessing the economic and social impacts of what we are doing right now.

The commissioning of the report was one of my earlier decisions as Treasurer. Followed through, of course by Treasurer Josh Frydenberg, and I want to acknowledge Professor Stephen King and Ms Julie Abramson and Professor Harvey Whiteford commissioners on the PC’s Mental Health Inquiry.

Last year, I appointed Christine Morgan, who is here with us, on the Minister for Health’s very strong recommendation. It took many of all of half a second to agree, as Australia’s first National Suicide Prevention Adviser, seeking new direction on how we can prevent the loss of so many Australians each year and today I am releasing her suicide prevention interim advice. There will be further volumes coming I know in the final and, again, these reports given the events of 2020 could not be more timely.

When we set out on this path, nobody could have foreseen a global pandemic impact every facet of our way of life. Separation from family members, the loss of jobs and businesses. The disruption to our community and social networks.

Devastating, for some the loss of a loved one. And being constrained and restricted from being able to process that loss through the normal human interactions we would have at that time.

Understandably, that couldn’t take place, but it doesn’t take away the pain or the lost opportunity that is presented by how we deal with grief in attending the funeral of a loved one. You can’t replace that. And so, that has made that experience so much more difficult than it always is.

COVID-19 has exposed a new vulnerability to a range of known mental illnesses. A substantial year on year increase in child and youth contacts for eating disorders, with hospital admissions up 40% in most states.

For others, the pandemic has triggered mental health, mental ill-health for the first time.

We know the pandemic is taking an immense toll on business owners. I was with business owners here in Melbourne this morning. In late September, around 54% of small business owners and managers reported being concerned for their personal health and wellbeing. And those I spoke to this morning talked about their concern for their staff’s personal mental health and wellbeing.

And as a Government, we’ve held nothing back in our response. Since the onset of the pandemic, we’ve invested more than $500 million in additional mental health and suicide prevention services. Switching on telehealth for all Australians, and making more mental health services subject to the Medicare rebate. Setting up a new Beyond Blue COVID-19 wellbeing service and getting extra resources into Lifeline and into Kid’s HelpLine and other support services.

Establishing 15 pop-up Head to Head mental health clinics across locked down Victoria. Doubling the amount of medicare funded psychological services from 10 to 20, under better access. And ensuring better culturally appropriate help for Aboriginal and Torres Strait Islander Australians, and people from cultural and linguistically diverse groups.

I would especially like to acknowledge as I already have, both Dr Ruth Vine and Ms Pam Anders for their support in establishing the Victorian mental health clinics during Victoria’s lockdown.

With investments made this year, the Commonwealth’s health portfolio expenditure on mental health is expected to reach a record high of some $5.7 billion in 2021. Those seeking the additional support, I can assure you, have been pushing on an open door right from the outset, and I believe that’s been their felt and lived experience as well in dealing with our Government, and I’m sure with state governments as well.

A key focus has been on prevention and early intervention. And today, I announce a further down payment on prevention and early intervention, for young people in particular. We will extend the early psychosis youth services program for a further year to June 2022 with funding of some $53 million to support that work.

We will extend the National Mental Health Initiative, called Be You, delivered by Beyond Blue, for a further two years with funding of $46 million. 70% of schools are participating in Be You nationally, and in that context, I also acknowledge the announcement on the weekend by the New South Wales State Government and the work they’re doing on putting mental health nurses and supports into public schools, into schools around New South Wales. States are doing their share as well.

And thirdly- fourthly, I should say – extending the important work of emerging minds for a further 2 years with funding of $16 million.

These investments build on the $45.7 million expansion of the individual placement and support program of the 2020-21 Budget to assist vulnerable young people with mental illness to participate in the workforce. A clear message from our advice is that we need to, must look at the whole person and these reports say the same thing. And take into account their whole life circumstances in our approach to mental health services.

Counselling alone isn’t going to alleviate distress. Not if you’re about to lose your house, your job, your relationship. Looking at the whole person means working with the states and territories in the community and business sectors to reduce the risks of loans defaulting, home evictions and even, of course, going without food. Investing in financial counselling, food relief, domestic violence services and family support programs – all essential. We need to keep this going. We need to keep the dialogue going. But, we’re well under way.

With more Australians experiencing mental health challenges, we are in the dialogue about it more as a nation, together. More Australians know, now, it’s OK not to feel OK. And to talk about that, and to raise it.

It’s okay to talk about it.

It’s a good thing to seek help and others will encourage you in that. We’ve been helping each other now I think more than every, certainly in my lifetime.

Connecting in new and different ways. It’s a reminder of the untapped force of the human spirit. Our compassion and love for one another. The family and friends and our fellow Australians.

Mateship isn’t just something that is talked about as a form of identity that we like to celebrate, it has a very practical relevance for every single Australian, because it goes to our deep affection for one another, and that’s what we’re enlisting to deal with this great challenge.

Collectively, as Australians we must set ourselves the goal of making COVID-19 an inflection point, on a path to a new and better mental health system. Both the Productivity Commission’s final report on mental health and Christine Morgan’s interim advice on suicide prevention offer very detailed and sober reflections based on excellent research on where we are as a country, and more importantly, what needs to be done.

Christine’s advice is particularly compelling. It’s data-rich, but importantly, it draws, and I commend you to read that first report in particular. Read them all, but I must admit, I was really sat down on reading the first report. Because it draws on the voices and experiences of almost 2,000 people who have lived with this in their own experience and amongst others.

This is a process that has listened hard and the listening is not easy. Among them are those who survived suicide attempts or lived with suicidal thoughts, and those bereaved by suicide, who I think often believe, don’t think their voices are heard. That their experiences are shut out of the policy process. Not so, in what Christine has done in bringing forward her report and the extensive listening and narrating of their stories back to Government.

The Productivity Commission report also offers detailed data on the basis for reforms. So I like how these two come together. They support each other. Evidence that is absolutely critical. And I’ve often said, the economy is about people. And the Productivity Commission has framed it in a similar way in addressing this issue. They’ve said, it’s not necessary to quantify the cost of mental illness and suicide to understand the damage that they impose on the lives of individuals and the community as a whole.

That’s true. We don’t need convincing of that. We know it’s a big problem. But quantifying these costs, they say, helps to identify where reform efforts should be focused. And that’s very, very wise.

So how much does mental ill-health cost? What’s the update? The answer is at least $200 billion a year. That’s more than a tenth of the size of Australia’s entire economic production in 2019. It’s around $550 to $600 million each and every day. When you add up the impacts on work, as Innes would know, on health and life expectancy, that’s what you get. And as the report says, these costs are borne by those people with poor mental health and the people who care for them. And by governments, employers, insurers and the wider community, it’s the cost that doesn’t discriminate. It falls right across-the-board. The cost of lost opportunity, lower living standards.

You know, when young people disengage from education. When those with mental illness and their carers have reduced hours of work or cannot work or are less productive at work. It’s also the social and emotional costs of suffering, exclusion and in worse cases, premature death.

Both reports shine a very bright light on the existing challenges and, as I said, it’s not easy reading. But despite our efforts, people are still falling through the cracks at different points. Too often, mental health services aren’t looking beyond the symptoms to work out what help a person needs to recover and remain well.

There is a sense in which the mental health system has been tacked on to the physical health system and when you think about it, it’s obvious that we can’t use the same template for a national mental health system as we use for a physical health system. If you have a broken bone or cancer or other physical problems, Australians seek help from within our universal health system but we tend not to react the same way when we’re experiencing mental illness or risk of suicide.

Yet both, obviously, life-threatening. As serious as cancer. Many suffer in silence. Many never reach out. Even for those who do reach out, the health system isn’t always as helpful as it could be and it’s rarely the whole solution.

Now, I don’t think that that is because people don’t care. I don’t think that it is because the system doesn’t want to provide every support it can or governments, likewise. But we’re not getting there yet. Both reports tell us that the mental health system needs to look beyond the symptoms to work out what help a person needs to recover and remain well. Because multiple factors, biological, environmental and social, affect mental health and wellbeing.

Another clear finding from the report says that too many Australians are treated too late or, sadly, not at all. Up to half of those who die by suicide have not interacted with the mental health system in the months leading up to their deaths.

And finally, the system is too complex and uncoordinated. Our mental health system fails too often because it is too complicated to navigate. And that system is despite the incredible care and efforts of mental health professionals. People who need help and their families are left to try and find and coordinate their own care without clear guidance about what is available, affordable and appropriate. And this happens at a point in their lives when they are most vulnerable and they will be finding it most difficult to try to access the services. The services that are there. Well intentioned, well supported, well funded. But difficult to access.

Both reports are emphatic. We need new approaches. Together they set out three directions for changing reform.

First, we must take an investment lens when it comes to a person’s mental health and wellbeing. That means our first line of defence in preventing mental health and suicide is, as Pat McGorry has often reminded me when it comes to young people, is having a strong economy and communities and a strong safety net. Housing, employment, psychosocial services that support people to engage in the community can be as or more important than healthcare alone.

Both reports are adamant one of the most important protective factors is a job. Now, I don’t need to establish the Government’s credentials in terms of how keen we are on creating jobs, and of course, that has an enormous benefit to the Australian economy and people’s livelihoods. But a key plank in promoting mental health and wellbeing is getting Australians into work and back into work, particularly right now. Because there’s strong evidence that not having a job, even for a short time, can impact your mental health in a very negative way. It is a significant disruptive life event that can trigger many mental health episodes.

People receiving unemployment benefits are three times as likely to have anxiety or depression as wage earners are. This is not only as a result of financial hardship, but often associated with limited social support, loneliness and a decreased sense of personal control and achievement.

The second line of defence is addressing stigma once and for all. I believe we are making progress on this. So different from what it was a generation ago. So people can reach out for support when they need it, and we can’t wait for risk factors to eventuate or for warning signs to escalate. 75 per cent of adults with mental illness first experienced mental ill-health before the age of 25.

To identify the early warning signs, we all need to play a role at various levels. We need to go beyond Government. We need to go far beyond the health system, and we need a whole of economy approach, whole of community approach, partnerships between all levels of Government, sectors, organisations. All of us are involved in this.

And we also need to harness the power of our business and community organisations to ensure people remain socially connected and feel supported. Participants at the PC’s business round table, and I want to thank them for their participation and the business community’s prioritising of this issue. It’s not new, they have long done that. And they suggested there that mental health in the workplace should be elevated from the HR department to the boardroom and that’s good advice. That’s a powerful endorsement of the approach we need, but also about leadership in the corporate sector when it comes to dealing with mental health issues right across our economy.

Secondly, this must be comprehensive and compassionate and provide the right care at the right time. This involves a range of supports for easier to access support and low intensity services for those needing help every now and then, right through to coordinated community support for those with moderate to complex needs. That means filling gaps in the system,particularly for those with mild and moderate needs in what’s called in the report, in the Productivity Commission report, the missing middle, who are not sick enough for hospital care, but do require more care and support than provided by the GP.

A comprehensive system would also harness the power of technology. But when we think about this missing middle, this is the grey zone between federal and state governments. Both of which I can assure you, as we often speak of these matters, as you would expect us to around the National Cabinet table. And indeed last Friday, when we said the National Federation Reform Council’s priority on the next agenda would be this issue.

There is a grey zone. At a federal level, we deal with that primary care. At a state level, they deal with hospitals. But in between, both in prevention and dealing with those who may have had suicide attempts on the other side of hospital, there is a role for both in community-based mental health care. And we have to get that partnership right between the states and the Commonwealth, and I am looking forward to having a discussion later on today with Premier Andrews, who I know is very passionate about this topic. He and I may not agree on everything, but I can tell you that we agree on this very, very firmly. And I think together with other Premiers, who I do know are very committed to seeing that we can get the right set of arrangements in that we can get it right.

And that will include through the digital area. We’ve begun through digital service platforms and telehealth, as well as expanding access to NDIS rebates. What’s recommended here in the report itself, and we’ve already taken action on those – extending out telehealth and mental health for two years. And obviously, understanding its longer term value.

A comprehensive system needs a skilled, comprehensive workforce. So central to every single health challenge we have in this country, whether it’s mental health, whether it’s aged care, whether it’s disability support. Building up our care workforce, and in particular, our mental health workforce, will be vital to how successful we are. We must build a workforce inside and beyond the health system from peer workers, community workers. And as well, of course, our clinical workforce. It must be compassionate and it must take a recovery-based approach.

Compassion means going to where people are, rather than waiting for them to present. Why I’m so thrilled to see how Headspace is trying to get their services out in the community, not waiting for people to come in, Pat, a chat we’ve had many times, particularly with those who work within Headspace.

And third, we must build a system centered on the experience of those with mental ill-health and their carers. In the Productivity Commission’s words, the mental health system is plagued by a bewildering array of unpredictable gateways to care. We must value the input of people who have lived that, who understand it better than the politicians, better than the policy makers and administrators and the bureaucracies that do this. You want to know how to fix it – then the people who have had to live with it have got a pretty good idea about how we can help them navigate a system that has become complex.

The lived experience of mental illness at all stages of planning, commissioning and reviewing services should be paramount in our thinking. Focused on the outcomes and views of these individuals who receive those services. It’s about empowering people to make decisions for themselves and their loved ones, and this is important – never leaving them alone to do the heavy lifting or feeling alone.

So what’s at stake if we don’t implement these reforms? According to the Productivity Commission, 84,000 quality adjusted life years lost, and about $18 billion. According to Christine Morgan, more lives lost, more lives impacted. Recently, the National Cabinet agreed to establish a health reform committee – one of only six. National Cabinet has been cleaning house when it comes to a lot of the committees and councils and things that can drag down our Federation and distract it and slow it down.

So we’re going to focus on six key areas reporting to National Cabinet. This is one of them – a Health Reform Committee whose first priority is to deliver a new agreement on mental health and suicide prevention by November 2021. That’s this time next year. And if we can get there sooner, we will. The agreement matters because it will clarify that grey that I was talking about between the states and federal in the most important areas of where mental services have been found to be ambiguous or missing.

Over recent years, there has been great bipartisan support around Australia to improve the system and there have been many reports and inquiries. The Royal Commission, of course, here importantly in Victoria and there’s tremendous good will. But that framework isn’t there and we need to put it in place, agreed by the Commonwealth, states and territories. We all have responsibility here that we’ll all have to get our cheque books out, too. Australians don’t care who is responsible for delivering mental health care services. They care about them being delivered. They don’t care about whose particular part of the job it is in their role to prevent suicide. They simply, rightly, want suicides prevented.

So, that’s how it will be. People focused, coordinated, comprehensive and compassionate. This agreement will be at the heart of delivering just that. The Health Reform Committee will be led by my good friend and Federal Minister for Health, Greg Hunt, who is, as I said before, a passionate advocate for mental health reform. I know Greg and all the state and territory ministers will leave no stone unturned to deliver the first ever agreement under the auspices of the National Cabinet in this area, to ensure that whole of Government and lived experience input.

We need the Health Reform Committee to be supported also by a small strategic advisory group which brings together the views of experts, and importantly, Australians with lived experience of mental health, ill-health and the business sector.

So today, the National Mental Health Commission also launches a suite of resources for our workplaces. Practical guidance on how to be a mentally healthy workplace in COVID. These resources have been developed with a mentally healthy workplace alliance, a group of dedicated organisations representing the needs of workplaces across Australia. These resources will help sole traders, small businesses and medium and large organisations right across Australia.

So as we strive for these better days ahead, I commit my Government to a number of principles that will guide our way and governments around the country to honour them as well, as I have no doubt that they will. Moving towards preventative and proactive support for all Australians, starting with infants and families.

We will not wait for risk factors to eventuate or warning signs to escalate, but offer the right intervention as early as possible. It will support Australians where they live, where they learn and where they work. There will be more front doors into support. If you knock, we need someone to hear you and for someone to open that door and for someone to help. And proactive help for people who can’t knock on that door or ask for it.

This also means better identifying points of transition or disconnection, where our mental health and suicide prevention efforts are most needed. It will require health systems to better integrate with schools, businesses, civil society organisations, non-health sectors where people at risk or in distress are most likely to be identified early.

To provide that triple A care – appropriate, affordable and accessible. No matter where you are on the mental health spectrum, or how persist your suicidal thoughts are, support must be there to meet your needs and this means timely proactive care that treats the person as just that – a person. Not a case, not a number. Not even an experience, but as a fellow human being.

We will build a system of comprehensive coordinated and compassionate care. That must be our goal, bringing together clinical care and social supports in the community and understanding how they connect, particularly for Australians with complex needs. And this means holistic care based on the needs of the person, their carers and their family, and we’ll commit to a system that is consumer, person-driven, carer driven. This means facilitating power and choice, recruiting people into support networks into the individual’s recovery journey and listening when something isn’t working.

Of course, we must be driven by evidence, by the data, enhancing our understanding of what is happening in our communities. Understanding what works and why it works, and using this information to arrive at further decision making. We’ll build a system that is scalable. The pandemic has shown that we need a system that is adaptable and scalable, up and down as needed.

Given the breadth of our ambition, mental health will be a feature of the budget not just next year, not the one that we just had and the one before that, but it will be a feature for many years to come under the governments that I lead.

This is a reform agenda for all Australians. Those who are currently receiving or requiring support for their mental health, their carers, their families, their colleagues, their mates. And those who might be well right now, but may, one day, like so many will, seek help for themselves or someone they know.

We all have a part to play as individuals, as families and communities. As businesses, non-profits, governments, and ensuring Australians get the support they need. And as one submission to the Productivity Commission said, those of us with mental illness need much more than weekly therapy to bring back the health and stability. We need support and companionship. Help connecting to communities. Help with friendships. Support to study and to work.

So, in conclusion – my Government will be carefully considering all of these reports but with a view to action. Reinforcing the actions we’re already taking. Better coordinating and linking together the actions we’ve already taken. Those of state governments as well. Developing a comprehensive report to the Productivity Commission’s report by the May 2021 Budget and other measures earlier if possible.

This will be informed by public consultation as well as other key reports and especially the advice of Christine Morgan’s final report due next month. Of course, he Victorian Royal Commission on mental health and the work of Gayaa Dhuwi on Aboriginal and Torres Strait Islander suicide prevention, the National Children’s Mental Health and Wellbeing Strategy, and the findings of the independent taskforce on the mental health workforce.

No shortage of source material for us to use to transform our system which is mammoth and it will be a long-term undertaking. But we will make the progress. It’s not just about money and resources. It’s about the way we pout it all together, ensuring how this health apparatus interacts and supports how we support each other.

It will also require some good doses of humility and some good faith as we engage with each other, acknowledging where weaknesses have been and where vulnerabilities may continue to present. Because we must all be prepared to call those out and acknowledge them and learn from each other to understand the complexities of our humanities and strive to support each other much better.

No government, no not-for-profit, institution or mental health professional has all the answers to this. None of us can pretend to. But I am an optimist. I am always one who votes for hope. By working together, we can make tremendous progress so that Australians suffering from mental ill-health will have more better days and fewer bad ones.

That’s always our goal, whether in treatment or therapy or as a nation. Thank you so much for your very patient attention. Thank you.

Resources available at the below links:

1. PC report on mental health: https://www.pc.gov.au/inquiries/completed/mental-health/report 
2. NSPA interim advice: https://www1.health.gov.au/internet/main/publishing.nsf/Content/mental-national-suicide-prevention-adviser 
3. NMHC workplace resources: NMHC workplace resources: https://www.Health.gov.au/mentally-healthy-workplace