Australians face a potential new Medicare levy as state and federal governments respond to “systemic and devastating failures” in the nation’s mental health system.
Victorian Health Minister Martin Foley has called on the federal government to roll out a nation-wide ‘mental health tax’ to support Australia’s ill-equipped services.
The Victorian state government has already signalled plans to create its own tax if a federal funding base is not created, after a separate state-based royal commission found there were “insufficient services to meet demand”.
But Mr Foley said reports from the Victorian royal commission and national Productivity Commission underlined the need for federal and state governments to join forces in the fight against mental illness.
Although a new tax or increase to the Medicare levy will be unpopular, it could save the economy billions of dollars every year if the revenues are used appropriately.
A previous Productivity Commission (PC) report put the annual cost of suicide and mental illness to Australia’s economy at $180 billion – roughly $500 million every day.
Roughly $50 billion of that is lost through direct expenditure on healthcare ($18 billion), lost productivity ($10 billion to $18 billion) and informal care provided by family and friends ($15 billion).
The remaining $130 billion comes from the “cost to individuals of the diminished health and wellbeing of living with mental ill-health”, the PC’s mental health draft report found.
Those figures, though immense, don’t include the “broader social costs” associated with mental health, such as the negative stigma attached to mental illness and mental health patients’ reduced social participation.
Mr Foley said the PC’s “staggering” figures highlighted the need for federal and state governments to work together and implement “urgent reform”.
“We lose billions to poor mental health every year, but the cost of inaction isn’t just measured in dollars – all too often it’s measured in human lives,” he said.
Mr Foley’s comments come a month after federal health minister Greg Hunt pledged $64 million for suicide prevention and mental health initiatives.
That money will go towards better aftercare services for Australians who have recently attempted suicide and improving school-based services and resources for young Australians.
Funding alone won’t be enough
University of Melbourne Emeritus professor Anthony Jorm told The New Daily it is encouraging to see state and federal governments acting on the Productivity Commission’s report.
But Professor Jorm said those recommendations alone wouldn’t be enough to fix the problems created by years of “lobbyist-led reform”.
“People lobby health ministers, who implement these so-called reforms which aren’t evaluated – or when they are evaluated don’t look so good – and they’re not really looking at the evidence clearly or testing things rigorously before implementing them,” he said.
It’s a mess of a system really.’’
In many cases, mental health funding is even being directed to the wrong areas, Professor Jorm said.
One example is in the use of prescription antidepressants, subsidised through the Pharmaceutical Benefits Scheme (PBS).
Professor Jorm said the people who are most likely to suffer from depression and require medication are young to middle-aged Australians.
But PBS data shows those over 65 years old are by far the largest recipients of such medications.
70 per cent of subsidised and co-paid mental health prescriptions were for antidepressants.
Professor Jorm did not suggest those aged 65 and over should not receive subsidised antidepressants.
Instead, he noted that most antidepressant scripts are written by general practitioners rather than specialists, and that this might suggest a need for greater mental health training for doctors.
What’s more, Professor Jorm said most Australians receiving psychiatric therapy can’t access enough sessions to successfully treat their condition.
Perhaps most worryingly, Professor Jorm said most funding is currently directed at treating, rather than preventing, mental illness.
“The public aren’t aware of all the things they can do for their mental health the way they are for preventing cancer and heart disease,” he said.
Professor Jorm said government must improve its focus on prevention and overhaul the existing system.
“Whatever they do, government needs to test it out in real-life conditions first,” he said.
“Because what they tend to do is the health minister becomes convinced something is a good idea and it’s rolled out nationally and then doesn’t work.
“They should try it out in one region, then have some comparison regions and test it out and then if it works, roll it out.
“What we’ve got now is roll out first, evaluate later – and that’s really hard to go back on.”