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An update on the Royal Commission into Victoria’s Mental Health System

Michael Gorton AM, Felicity Iredale and Audrey Capasso

With public hearings finishing up on 26 July 2019, now is a good time to reflect on how the Royal Commission into Victoria’s Mental Health System has progressed and what we can expect moving forward.

The Commission signifies Australia’s first ever holistic inquiry into the adequacy of mental health care services. Accompanied by the Victorian Government’s commitment to implement all recommendations, it offers a significant opportunity to effect meaningful change and improvement to our frameworks.

Reasons for and aims of the Royal Commission

In Australia, data indicates that almost half of all adults will experience mental health issues in their lifetimes. One in five Australians aged 16-85 experience mental illness each year, and a substantial number of those with mental health conditions will have more than one mental illness occurring simultaneously.[1]

This demonstrated prevalence of mental health conditions, coupled with the development of a more progressive, collective attitude toward the prioritisation of mental health, has led to a realised need within Australia to ensure its delivery of a robust and effective mental health system.

Commissioners Bernadette McSherry, Professor Allan Fels AO and Dr Alex Cochrane undertook to investigate within the bounds of the Commission’s Terms of Reference (detailed below) and are headed by Chair Penny Armytage. An Expert Advisory Committee was also established to assist the Commission at each stage of its inquiry.

The first stage, comprising of community consultations to inform the Commission’s Terms of Reference, concluded in May. The second stage comprised of a set of public hearings held from 2 – 26 July, and focused on the following ten themes:

  1. Stigma;
  2. Prevention and early intervention;
  3. Access to and navigation of the mental health system;
  4. Carers and family;
  5. Rural;
  6. Aboriginal and Torres Strait Islander people;
  7. LGBTIQ+ and linguistically diverse communities;
  8. Community resilience;
  9. Suicide prevention; and
  10. Prioritisation and governance of mental health services.

Progress so far: Salient findings from the community consultations and public hearings

In its public hearings, the Commission received evidence of people’s own lived experiences dealing with mental illness and accessing care within the current frameworks.

In her opening statement, Chair Penny Armytage acknowledged the above-mentioned prevalence of mental illness in Australia today, remarking that, in terms of offering adequate care, “doing more of the same will not be enough”. Ms Armytage baldly acknowledged that “the mental health system is broken”.

In her final statement at the conclusion of the hearings, Ms Armytage highlighted that the provision of culturally-appropriate and inclusive services to ATSI and CALD communities has, in particular, emerged as a matter of critical importance. She quoted witnesses who shared that Aboriginal conceptions of mental health are “shaped by connections to culture, land, extended kinship, ancestors and spirituality”, and that current frameworks lack the cultural competency to understand this.

The hearings have further directed the Commissioners’ collective focus toward the importance of support networks for mentally-ill patients, the tendency for mental health stigmas to be compounded by racism as well as general intolerance and gender misconceptions, challenges faced by carers, fears of the LGBTIQ+ community when seeking care, and the “tyranny of distance” faced by rural and regional communities as they try to access mental health care services.

The Commissioners have heard of carers’ desperation as they receive inadequate support, and of people being advised that they “were not sick enough” to receive clinical care for their mental illnesses.

The third and current stage of the Royal Commission will run until October. During this time, the public’s online submissions will be reviewed and the Royal Commission will engage targeted stakeholders to extrapolate on and offer their own submissions within the scope of the Terms of Reference.

The Royal Commission’s Terms of Reference

The Terms of Reference are centred on the following:

  • The effective prevention of mental illness and suicide, and the effective support of peoples’ recovery;
  • The delivery of the best mental health outcomes and the improved access to and navigation of the system, for people of all ages and backgrounds;
  • The support of family members and carers of people living with mental illness;
  • The improvement of current mental health outcomes for those in the Victorian community, and especially for those at greater risk of experiencing poor mental health due to their variously increased vulnerabilities; and
  • The support of those in the Victorian community who are living with both mental illness and problematic alcohol and drug use.

Ultimately, we can expect to hear conclusions and finalised recommendations that fall squarely within these lines of inquiry.

What to expect next

The Royal Commission has undertaken to deliver an interim report by November 2019. This will likely detail the conclusions reached so far through its receipt of public and stakeholder submissions and its public hearings, as well as a general update on its progress.

The Royal Commission will deliver a final report by October 2020. In this, we can expect to see the full list of recommendations flowing from the Commission’s investigation, in the interests of implementing an altogether improved system that will more effectively meet the needs of Australians. 

You can visit the Royal Commission’s website for further details on the Terms of Reference as well as ongoing updates on the Commission’s progress.

If you would like to keep in touch with alerts and insights from our expert health team, you can subscribe to our mailing list here.

[1] Data provided by the Black Dog Institute, based on information provided by the Australian Bureau of Statistics (2009), National Survey of Mental Health and Wellbeing: Summary of Results, 4326.0, 2007, ABS: Canberra.

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