I happened to be talking to my local politician before Christmas
because a fine website on depression, [http://www.DepressioNet.com.au]
was about to lose funding for its crucial 24 hour support forums as a
result of failure by the Australian government to fund its programs.
So
I pinged the pollies and Bill, my local politician, wanted to chat. The
one illuminating aspect of our 45 minute conversation was that it was
very hard (for politicians) to decide what other health programs should
be cut in order to increase funding for mental health because of myriad
vested interests.
Watching news reports around the world and back
home I see similar difficulties arising. It is somewhat reminiscent of
the ‘Yes Minister’ dilemmas that Sir Humphrey Appleby would put to his
boss, thereby stymieing him every time.
Just last week in South
Australia an identical furore erupted. There, the government was brave
(or hassled) enough to announce increased mental health funding. The
opposition was equally mean enough to demand to know what (more highly
valued) general health programs were to be sacrificed for the increase.
Read the report here:
Now
to get back to Yes Minister, Jim Hacker in his early days would have
said ‘But we should just fund health needs according to the cost to the
community, the individual and the carer. And that should be the minimum
amount needed to restore the ill person’s health so as to function in
relationships, at work and in the community.’ You wish!
The
unfairness is obvious when authoritative reports state: ‘Stigma is
systemic in decision-making at the highest political levels. Ultimate
responsibility for mental health services lies with government leaders
at Federal and State levels.
‘It is they who have ensured these services have had such a low priority in policy-making and funding…
‘The
proportion of Australia’s health budget spent on mental health services
is under 8%. In comparable OECD countries, the proportion is 12% or
more.’ Dare to Care, SANE Mental Health Report 2004 at http://www.sane.org/images/assets/Research_reports_and_images/MHR2004text.pdf
A
report by Access Economics for SANE Australia in 2003 calculated the
costs of bipolar in Australia as being ‘$16,000 on average’ per year for
each sufferer. Yet spending is ‘only $3,007 per person.’
It gets
worse. The report states that this paltry $3,007 is even less than
spending on the average Australian’s health care, even though ‘the
burden of disease – the pain, suffering, disability and death – is
greater for bipolar disorder than for ovarian cancer, rheumatoid
arthritis or HIV/AIDs, and similar to schizophrenia and melanoma.’
And
who makes up the shortfall? According to the report, ‘around half (i.e.
$8,000) of this cost is borne by people with the illness and their
carers.’
‘Mentally healthy’ public outnumber the mentally ill by a
factor of 4 to 1. They want their subsidized spas and perfect teeth at
the expense of us getting into hospital when we need it! But because
they still view the behaviors of mental illness as not symptoms but as
plain bad behavior, our health needs are viewed as less deserving than
theirs, and funded accordingly.
Because of the ‘Yes Minister’
factor, I think we face an uphill battle persuading the politicians.
They won’t shift until public opinion does, to say nothing of favors and
kickbacks.
The 4 people in 5 who don’t have a mental illness have
something much worse—prejudice. They are the ones who need persuading
that mental health deserves equitable funding.
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