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.
Australians who want to get involved in dismantling stigma can get involved in SANE Australia’s StigmaWatch program at [http://sane.org/index.php?option=displaypage&Itemid=266&op=page]
Visit [http://www.twotreesmedia.com/links] for other organizations around the world.
You can read a summary of the Access Economics report Bipolar Disorder: costs—an analysis of the burden of bipolar disorder and related suicide in Australia, an Access Economics Report for SANE Australia 2003 at http://www.sane.org/images/assets/Research_reports_and_images/bipolar_costs_es.pdf
Madeleine Kelly is the author of the award-winning book Bipolar and the Art of Roller-coaster Riding (Two Trees Media ISBN 0-646-44939-7). More information about managing bipolar disorder can be found at [http://beatbipolar.com]
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