It has been a year since Josh Frydenberg requested the Productivity Commission inquire into the effect of mental illness on the Australian economy. The Commission submitted their report in June this year. It is available online and contains many insights into our crisis of mental illness. A disquieting statistic: suicide is our leading cause of death between the ages of 15 and 44.

The report is extensive - three volumes and appendices from A to K. The difficulty, therefore, is distilling its advice into a memorable takeaway. If there is a key theme, it is 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 different psychiatrists and medical practitioners. Also, we are not islands. We lean on friends, employers, family, and community. The report notes the current system has a “disproportionate focus on clinical services” – it overlooks those factors. In their view, the ideal system would coordinate all of these different strands of a person’s care. The ideal system would enable the person in need to transfer information and messages between all of their supporters. This would save time and enable continuity of care.

What the Report has actually found is that Australia’s mental health care system “is geared to the needs of service providers”, not to “the people who need its services”. It’s established that “people in regional and remote Australia have long faced unequal access to mental healthcare”. This is because it is more inconvenient for psychiatrists to practice in rural areas. The result? They don’t. As the report states, there are “substantial shortages” of qualified mental health workers outside the capital cities. Another flaw of provider-centred care was discussed in The Sydney Morning Herald  earlier this month. Because psychiatrists can claim less from the Department of Veterans’ Affairs when they treat a veteran than what they can charge a civilian in the normal system, “there is a fairly significant disincentive for psychiatrists to see veterans”.

Another possibility of a more patient-centred system: if information about an individual’s mental health is better streamlined, we can “establish an evaluation and monitoring system” (p. 163). As mentioned, suicide rates are a massive concern of this whole conversation. A richer and more coherent framework of personal data may warn carers of an impending crisis. Apps abound which have users regularly updating their emotional status, their quality of sleep, their thoughts- together, can be predictive.

In essence, the Report condemns the current health care system as being to users like “a roundabout with many points of entry regarding the direction to be taken”. What is wanted, what is needed, is not a roundabout, but a “one-stop-shop” which “bring[s] multiple services into one location […] making it easier for consumers to access the services they need” (p. 692). This is ambitious. The Commission looks to “greater use of technology” as a solution. We now have an unprecedented opportunity to  communicate,  link data, and empower people in the agency of their own care. It looks as if the future of healthcare is going digital.

Written by Lewis Orr.