People who experience mental health stress often grapple with multiple challenges simultaneously – like social isolation, youth homelessness, bullying at school, family violence, grief, job loss or sleep or eating problems. Younger people can experience stress just as they are seeking to participate in higher education and employment, form relationships and set out on adult life.
Mental health care is largely clinically focused as our health system was developed to manage physical health issues. As a result, a clinical approach to mental health care dominates most people’s treatment.
Programs, interventions and treatments in mental health and wellbeing abound, yet often lack a robust evidence base.
In November 2019, the Victorian Royal Commission into Mental Health’s interim report concluded that ‘the system had catastrophically failed to live up to expectations and was under-prepared for current and future challenges.’ The following themes identified in the final report are issues of national relevance. They are also issues that can be addressed using the Open Dialogue approach.
Supported decision-making principles and practices are not routinely used. Many consumers have their human rights breached through compulsory treatment and the use of seclusion and restraint.
Families, carers and supporters are left out. Families, carers and supporters can feel excluded by the system, and are often left out of engagement that would strengthen their caring role.
The system has become imbalanced, with an over-reliance on medication. There is a lack of focus on therapeutic interventions and recovery-centred treatment, care and support.
Power imbalances throughout the system mean that people with lived experience of mental illness or psychological distress are not valued or recognised.
A disproportionate number of people who experience mental distress face systemic socio-economic challenges making even access to a GP difficult to afford.
The need for trauma-informed mental health treatment, care and support is being recognised, but there is much work still to be done.
A failing system can in itself cause trauma.
The focus on personal recovery needs to be strengthened. The current system focuses primarily on the goal of ‘clinical recovery’, where symptoms abate. However, the central focus needs to be on ‘personal recovery’.