Every dollar of the announced record spend on mental health in the federal budget is well overdue, and I am sure it will save some lives. However, this spending does not provide the structural reform that will fix our broken mental health system. Sadly, it seems the government cares more about the short-term political cycle rather than the long-term health of our country.  

In their mammoth Inquiry into Mental Health last year, the Productivity Commission estimated mental health costs Australia $220bn per year which to provide some perspective represents close to 13% of our estimated GDP in 2021. The key recommendation of the Inquiry was that Australia needs a mental health system that places people at its centre. We now recognise that a mentally ill person can and should be at the centre of a web of support. For example, people may over time consult many psychiatrists and medical practitioners. Also, we are not islands. We lean on friends, employers, family, and community. The Inquiry notes the current system has a “disproportionate focus on clinical services”—it overlooks those factors. In their view, the ideal system would coordinate all these different strands of a person’s care. The ideal system would enable the person in need to transfer information and messages between all their supporters. This would save time and enable continuity of care.

A thorough analysis of the government’s spending reveals this budget will not deliver a person-centric system. First, $2bn over four years is a drop in the ocean to fix a $220bn per year problem. Second, the spending primarily focuses on reactive measures rather than proactive ones to address mental health issues. Only around 25% ($500m) focuses on prevention and early intervention services. Yes, reactive measures are necessary, but can we stop people from slipping into the abyss of a mental health crisis before they receive support? Equally, this spending on proactive measures is not person-centric. The spending mainly funds clinicians to conduct the services like the $158.6m allocated to universal aftercare services for individuals discharged from hospital following a suicide attempt. The small scale of the spending and the focus on reactive measures means we can expect a shortage of mental health care.  

There was another aspect the budget missed. I recently completed the Hawaiian Ride for Youth in Western Australia where we spoke to students about mental health. A key takeaway from the ride was that our youth are highly susceptible to mental health issues and suicide. Yet, they are technologically able and have a huge hunger to talk and learn about mental health. They are breaking the stigma of mental health that halted previous generations from taking meaningful action. Is there anything in this budget that can inspire the young generation to confront mental health? I hope that part of the funding to headspace will do this.  

Finally, $39bn of the $220bn cost of mental health in Australia is because of the lost productivity of our employees because of mental health issues. Although there is some progress towards better management of employee wellbeing, a recent report by McKinsey & Co reveals a disconnect between employers and employees. 71% of employers felt they were supporting their frontline employees while only 27% of employees agreed. Only $10m in budget spending went to supporting employee wellbeing (allocated to FIFO and healthcare workers). A pittance to solve the $39bn per year problem of lost productivity.

Record low-interest rates. The end of the debt and deficit mantra dominating Coalition thinking. This budget was a once-in-a-generation opportunity to make necessary structural reform to our broken mental health system. Leaders of government and the corporate world, it is time to listen and address this silent illness.

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