The election issue neither side wants to tackle

October 4, 2004

Health promises have come with much fanfare, but not when it comes to mental health, writes Greg Barns.

Iris Gray lives in a modest brick home in the working-class Hobart suburb of Glenorchy. She is 74, and frail. Her main preoccupation is her 50-year-old son, Rodney. Rodney Gray suffers from schizophrenia and has been institutionalised for much of his adult life at a mental institution called Royal Derwent in New Norfolk, about 40 kilometres from Hobart.

Since the closure of Royal Derwent a decade ago, Rodney has lived alone in a small flat in North Hobart. He has suffered malnutrition, been admitted to hospital for drinking cleaning fluid, and regularly forgets to take his medication.

Despite a letter-writing campaign to state and federal politicians, a personal visit from the former Labor premier Jim Bacon in 1998, and an article in The Mercury last year highlighting her plight, Mrs Gray has been unsuccessful in her efforts to ensure her son lives in supported accommodation.

A month ago, I went to see Iris Gray and as she walked me to the front gate of her home, she shook her head, cried and said, "what will happen to Rodney when I die?"

This story is heart wrenching. As is the plight of "George", a middle-aged man whom my mother and I found crying alone in Middle Park in Melbourne earlier this year. While George sat alone in tears, at least 50 people sat literally a few metres from him sipping coffee and reading the weekend papers. My mother, who has spent more than two decades working in the welfare sector, told me George only had access to supported accommodation from Monday to Friday.

Unlike the Tasmanian forests, Iris Gray hasn't had politicians beating a path to her home to see what they can do to help her and Rodney.

And George doesn't get Mark Latham's attention when he comes to Melbourne.

When Latham launched his mental health policy last Tuesday he chose to do so in the clinical safety of a maternity ward to emphasise his fight against postnatal depression. What a pity Latham didn't head to the streets and meet some of the thousands of homeless mentally ill people who have nowhere to live safely.

It must also be said that Latham's promise of $100 million to tackle mental health is underwhelming. For a start, it seems a pitifully small amount compared with the $1.6 billion for child care Latham announced a day earlier or his $350 million for hospital emergency departments.

The ALP package does not tackle the 20-year-old running sore of the disaster that is deinstitutionalisation. There is no plan to work with the states and territories to address the damning conclusions reached by psychiatrists Carol Harvey and John Fielding in the Medical Journal of Australia last year. Harvey and Fielding wrote that the increased number of homeless people in Australia with mental illness is likely to be a consequence of inadequate implementation of the deinstitutionalisation policy and inadequate provision of alternative community mental health services.

Having made no mention of mental health in his $6 billion re-election pitch last Sunday, Prime Minister John Howard launched his mental health policy only 24 hours after Latham. Like Latham's package, it throws resources at the national depression initiative Beyond Blue and GPs, but fails to address the deinstitutionalisation crisis and is only worth $10 million more than Latham's proposals.

In short, both leaders have missed an opportunity to think laterally and recognise mental health as a national issue.

The Public Health Association of Australia, a group representing thousands of health professionals, has previously made some useful suggestions that would assist individuals such as Iris and Rodney Gray and George. They include the Federal Government actively pushing each state and territory to deliver high-quality community-based treatment, care and disability support, including rehabilitation and recovery programs and pre-vocational programs.

The crass materialism and cynical environmental vote buying of the election campaigns prevents the national scandal of the mental health crisis from seeing the light of day, except in a cursory and piecemeal way.

Meanwhile, Iris Gray battles on helping Rodney, and George has to find somewhere to sleep every weekend.

Greg Barns has been a state and federal Liberal government adviser and member of the Australian Democrats.