$70 million in Queensland budget for Adolescent Mental Health

NEWS

The opening story on the 12 June bulletin on Queensland’s ABC television News was that the Palaszcsuk’s 13 June 2017 state budget – released this week – includes just under $70 million dollars to not only proceed with the establishment of the new extended treatment and rehabilitation facility at Chermside but to create four other complementary services aiming to support young people with mental illness in the community. (Online summary of ABC report here.)

Future plans include two new Step up Step Down facilities in south-east Queensland and two day programs to be based at Logan and the Gold Coast.

Justine Wilkinson, who lost her daughter Caitlin following the closure of the Barrett Adolescent Centre, has welcomed the allocation of funding but acknowledges that there is still much to be done to provide young people and their families with the full range of support that will make a significant difference to lives that can be indescribably turbulent and challenging. Ms Wilkinson’s ongoing advocacy has meant that she – along with other consumers and carers with lived experience in this area – has played a significant role in the ongoing co-design of new services following the government’s commitment to act on all the recommendations from the BAC Commission of Inquiry.

The engagement of Health Consumers Queensland has ensured that consumer and carer representatives sit on all committees and working groups undertaking planning to fulfil the recommendations and that people throughout Queensland have had opportunities to provide meaningful input into future service provision. This commitment to co-design ensures that those with lived experience not only are heard but heeded and can actively help to shape future services – a collaboration that should lead to programs and support that genuinely meet the needs of those in the community that require them.

Health Minister Cameron Dick believes the funding package to be a landmark step for young people so the community affected by youth mental health issues can only hope that innovative approaches to planning and needed funding continue to be at the forefront of the minds of all those responsible for providing vital services at all levels and in all sectors.

(More comment on this announcement can be found at the Blog post: ‘A Budget Boost –its implications for the Future and the Past.)

Advertisements

A Budget Boost – its implications for the Future … and the Past

A BLOG POST

The announcement of just under $70 million dollars to not only proceed with the establishment of the new extended treatment and rehabilitation facility at Chermside but to provide two new Step Up Step Down facilities and two new Day Programs to support young people with mental illness (online summary at the ABC website here) demonstrates the current government’s ongoing commitment to those who have been sadly overlooked in the past. Bi-partisan support for these positive moves would begin to ensure some long-needed stability and security for the futures of those in this most vulnerable of groups.

An adolescent extended treatment facility (AETF) fills a dangerous gap in service provision and Step Up Step Down and Day programs are vital in the full continuum of treatment and support options that are required to meet the needs of all young people with mental health issues. Extended inpatient treatment has proven essential for those young Queenslanders with severe and complex issues who have failed to make progress accessing community-based care and outpatient/intermediate care service options. The additional new programs will – if they are accessed in a timely way – provide some young people with the help needed to circumvent a stay in a residential facility. AND for those for whom extended inpatient care is essential, they will ensure that transition from one environment to another is gradual and fully supported according to the individual needs of the young person. Those affected by youth mental health issues across Queensland will be hoping that these kinds of service options will become readily available across the state. As community-based care remains the optimal environment – when the circumstances are right – then all communities must have access to every level of treatment and support.

The plans for the new facilities and programs have come from the process that commenced following the government’s commitment to act on all the recommendations from Justice Margaret Wilson’s report following the BAC Commission of Inquiry. Queensland Health then undertook to utilise a “co-design” process i.e. where bureaucrats, clinicians, specialist architects and other professionals work alongside consumers and carers to plan services that will be most effective. (Acknowledging that expertise lies not only in professional knowledge and practice but in lived experience is currently seen as innovative but should inevitably become standard procedure. Omitting those with practical, pertinent and comprehensive knowledge of the lived experience can only add an important dimension to planning for services in any area.)

Those young people (current and former) and family members who have taken part – and continue to be dedicated to – the process of genuine collaboration have demonstrated a level of commitment that is rare. People whose lives are affected by severe and complex mental health issues find themselves most often in situations where days and nights are to be survived moment by moment; plans are seldom made and often abandoned; and significant trauma, suffering, isolation and emergency management of the effects of illness must be regularly dealt with. And during recovery, the right approach for so many will be to look forward, to put strategies in place to navigate through daily challenges and to resist rumination on issues of anxiety and trauma. So participation in design of future services may be something that could be extremely problematic for the stability of some people’s mental health. There is great understanding throughout the mental health community for all who have suffered to make the right choices that will best support healing and not put mental health at risk and equally, there is deep gratitude for those able to put time and effort into a co-design process, sometimes at personal emotional risk.

And then there are those for whom looking forward provides a view with a void that can’t be filled – the families and communities who have lost loved ones will be experiencing mixed emotions at this announcement. The families of Talieha Nebauer, Will Fowell and Caitlin Wilkinson Whiticker will no doubt be relieved that there continue to be moves to ensure others might not have to suffer the personal tragedies that still shape their lives. Justine Wilkinson, herself a key participant in the co-design process, has told the ABC in relation to the budget commitment (particularly in relation to the continuation of planning for the Chermside AETF):

That’s absolutely fabulous, but this change has to continue, this is just the beginning and it has to be just the beginning. … We need to keep feeding these changes and innovations down the system to pick up young people before they get to that point.

However, we must recognise this news can only be bittersweet for those whose young people did not have the benefit of a government with such a strong commitment to confront youth mental health issues and to listen to those affected to order to provide the needed services. So our thoughts must also be with those whose bereavement continues as we hear this news. We must assure them that we will never fail to remember those who will not have the opportunity to access planned new services and we will continue to support those families for whom an inquest may provide some answers but will inevitably be a traumatic process and will never ever restore what they have lost. Talieha, Will and Caitlin and those that will continue to feel their absence from their lives are always in our thoughts.

The complexity of severe adolescent mental health issues is reflected in the reactions of those with lived experience to this positive budgetary news. There is relief, hope and gratitude but there is also caution and uncertainty from those who have experienced innumerable disappointments and who know that politics can play an inappropriate role in what is necessary in service provision across our communities. And there is renewed reflection on the tragic losses that will continue to impact people’s lives, whatever the future holds.

Severity and complexity in relation to mental health issues is not confined to a small group of young people. It is pervasive. It is challenging. And so it has become a situation that a significant proportion of the population have to live with and an issue that every single one of us must acknowledge.

The support that has been provided to the former Barrett families throughout the community has demonstrated that the capacity to care is our greatest strength. It is the strongest choice that any human being can make and it is undoubtedly the most rewarding. So with, gratitude for all everyone has done to lead us to a day when $70 million is committed to the next generation of Queenslanders, it’s hoped that the future contains not just all the services required but the ongoing support of an impressively caring population.

MENTAL HEALTH WEEK – Time for ACTION

A BLOG POST

It’s Mental Health Week. And in the past, that has meant a lot of awareness-raising, stigma-quashing and acknowledgement of an issue that has for too long been treated like a shameful secret. And that’s all good, useful stuff. But the time has long since passed for more than knowing nods and pleasant words from those with the capacity to DO instead of DISCUSS.

Mental illness needs ACTION. NOW.

Health service providers, governments, mental health commissions/ advocates/ peak bodies and communities must move from rhetoric to establishing equitable service provision immediately. Otherwise how can anyone believe that mental health issues are, in fact, the cruel scourge afflicting millions unfairly as the annual PR tells us? We know they exist. And, thankfully, we now have knowledge of a range of pharmaceutical adjustments, treatment methods and support programs that mean these issues can be addressed. People CAN heal and progress and discover lives without the agony they once believed was infinite. BUT until the money, time and effort allocated to mental health is in line with those physical health issues that have the same level of impact, people affected by mental illness can’t feel as far from personally responsible for their health concerns as those with a blood disease or multiple sclerosis can. Continue reading