Not really a joke

My Australian friends are particularly offended when I say that it is effectively illegal in Australia to be disabled; and much more so for men. They want to leap to defend their country's programs and actions, then after a moment's thought, surrender the point.
When I point out with cynical laughter that Australia is concerned about male suicide, but effectively has no mental health system, their faces drop. I usually let the subject go there. Often, someone will have found another topic like the beauty of the sunset or a complaint about the weather. It's best to just go along...

With some, usually people who'd like to take their professions seriously -- like teachers or social workers -- the discussion continues.
The cynicism and distrust of government soon fills the air.
Australian government will spend billions celebrating young, healthy images from sports or fashion, but has essentially forgotten millions of those who were once young and healthy. The instant image is of the elderly, or of broken people who are not so lucky -- as in "The Lucky Country."
Many of these people are not old.
From "Faults in services for the mentally ill" The Age, 7 Jul 2006:

HUNDREDS of thousands of mentally ill Victorians are "falling between the cracks" each year because there are not enough treatment services to tackle a growing crisis.

The finding is contained in a report to the State Government that says about 700,000 Victorians suffer some form of mental illness each year.
The report, commissioned by Premier Steve Bracks, says the problems caused by lack of services are particularly acute in Melbourne's outer suburbs and among children.

"Around 80,000 children (aged four to 12) and 150,000 youth (aged 13 to 25) in Victoria are believed to have some level of mental disorder," it says. "However, the number actually diagnosed and receiving appropriate services is incredibly small. .."

The report is laudible, but further in the article it shows that Bracks is looking to make this issue a political football to obtain other priorities in the upcoming elections.

It's not hard to see the rationale that will be put forward.
In yesterday's Herald Sun, it was reported that mental illness -- mostly stress related -- costs Victoria $10 billion a year in productivity. Further in the article, it states that an expense of $26 million will be required to expand mental health services 1 %. That one percent will only recoup $7 million in productivity. (A very similar story, although less informative, was run the same day in the Herald Sun by a different author.)

It says extra funding would be a good economic "investment" — spending a further $26 million would cut the burden of mental health by about 1 per cent and could produce a net benefit of $7 million to the state economy.

But it warns that extra funding alone will not be enough.

This issue is set for the too hard bin already.

Recommendations in the report include creating specialist mental health GP positions in growth suburbs and offering bonuses to encourage psychologists and psychiatrists to work in outer suburbs and regions.

What the report only hints at is that these specialist positions and community mental health clinics do not exist. There is no system in place. The $26 million cost is to establish a minimum system. How much of the $10 billion in wasted productivity may be regained as a system grows is not mentioned.
How much will be gained by the next $1 million in expenditures? -- the next $5 million?

Entrenched Prejudice and Ignorance

There is an modern joke: "One in five suffer from mental illness. Look around at your 5 best friends. If none of them is crazy -- It's you!"

Mental illness continues to suffer from its traditional stigma. Those with little direct experience of it often cling to a belief that it represents a lack of willpower, determination or courage and that mentally ill people should just “pull up their socks” and “get on with life”.
...

Governments have happily pocketed the savings made by closing the old institutions but failed to spend anything like enough to deliver adequate community support. As a result, many mentally ill people wind up in doss houses, prisons or homeless.

Despite persistent misrepresentations by the media, mentally ill people are no more dangerous than anyone else, except when their illness is active, meaning they have stopped adhering to their treatment plan, often because the necessary support wasn’t available. The Hollywood stereotype of the mentally ill bogeyman does not help.

The disabled and mentally ill are seen as simply dole bludgers. They are social pariahs, essentially outlawed and persecuted by the petty prejudices and ignorance.

State and federal agencies employ investigators to follow them around to attempt to prove they don't deserve pensions or payouts. Admittedly, without a functional system, there are too many who rort the system. There are stories on A Current Affair nearly every week.
Despite the need to expose those who are cheating, the stories only feed the childish resentment in the public perception.

This is a cruel, childish prejudice, unworthy of a schoolyard, yet it pervades the social services and legal system.

Mental Illness and Women

Another childish prejudice is that more women have mental illnesses than men.
The common dismissal of women's mental illness is to say that "She's just hormonal." It's another childish prejudice simplified into a mindless dismissal of reality.

The reality is men and women are equally susceptible. In fact, since men take on more physically and emotionally stressful work, it can be argued that men are more susceptible.

The fact that it is more socially acceptable for women to seek help is a blinding prejudice in Australian society. There is a stigma against men seeking emotional help that may be the cause of many physical disabilities.
This stigma will be broader due to the sense of distrust in government reflected in "Disabled in 'disclosure trap'" The Age, by Annabel Stafford, Canberra,June 30, 2006

DISABLED or otherwise disadvantaged people may opt to work in jobs that are beyond their capacity rather than have sensitive personal information passed on to Job Network providers under the Government's new Welfare to Work rules.

Male Suicide

Recently released statistics show men commit suicide 5 times more often than women; yet the bias in the (pitiful) mental health system shows 8 times more women diagnosed with mental illness. Even higher rates of suicide occur for men in rural or regional Australia.
These high suicide rates are dramatic evidence of the results of childish social stigm, ignorance, and the focus of mental health professionals on treating women, not men.

(from "Beating the bush blues", by Orietta Guerrera, Rural Reporter, The Age June 29, 2006)

The chairman of the national depression initiative, Jeff Kennett, said yesterday research showed that a male farmer commits suicide every four days.

How many men commit suicide because of the notorious prejudices in the Intervention Order and Family Court process is not being tracked because of political pressure, yet it has been estimated at least half of the male suicide rate is because of injustices in the system.
The focus on the bush suicide rate will detract public attention from this question.

Community Mental Health

A good example is an article in today's The Age which reveals that 700,000 people in Victoria alone suffer from treatable mental illness, -- yet less than half receive even poor treatment. The most common treatment is a GP writing a prescription for a psychotropic drug, and telling the person, "You'll be right."
General Practitioners are unqualified to make a diagnosis of mental illness. The structure of a GP's office is to make referrals to specialists for such diagnoses, but there are very, very few specialists.

There is a call for community mental health clinics for towns and suburbs. Sadly, the bulk of the mentally ill are in suburbs and cities, yet most of the press has been focused on the bush. An alarming number of male suicides occur in the bush or regional Australia.

Cheap thrills -- the local support groups

Australia has depended on largely unfunded community support groups for its mental health and disability system. These groups are often developed in community centers, and subject to the whims of the centers' managers for space and advertising.
If a group applies to the local council for funding, they are often ignored. The few dollars a council may grant is inconsistent with the needs of the group; and often the managers of the community centers see any funding as rightfully being subject to their control. Many support groups have disappeared after getting a few thousand dollars because of wrangles with the community center management.

I watched this happen to the Injured Persons' Support group at the Mahogany Community Center. The group had grown to 40+ members over three years; about 10 regular attendees to each meeting. It was doing good work recognizing the emotional and physical stress, distress and traumas of having a life-changing injury.
Often these people could barely walk to the weekly meeting, but one of the managers of the community center had a pet project: She wanted to beautify the neighborhood.
It would have been comical if it weren't so insensitive. She, a professional psychologist, appeared at a meeting one day supposedly to help 'organize' the group, then made the suggestion that the money be spent on teams from the group going around the neighborhood cleaning up yards and doing small fix-it projects.
She wanted people in walkers, with broken backs and necks from accidents, to do yard work for others -- when many could hardly walk from their cars to the meeting.
After two weeks of management intervention, the group effectively disbanded. The money from the council, along with the funds collected from the weekly meetings, went into the center's bank accounts.

A little private investigation revealed this was a common phenomenon across Australia.

These support groups are usually formed bythose who realize a need and take the initiative to hold meetings. Usually, the groups have no professionals, which is probably an advantage. Peers discuss and share the problems they face.
Each group faces a crisis when it decides to apply for funding. In order to get funding, they must show an acceptable organization structure, which threatens the peer-to-peer basis of the group. Too often, the funding is stolen or misused by the chosen officers. Councils and others cite this fact as reason to withhold funding.


What happens now?

The need for federal and state cooperation has been established for years. It was the main topic of the 1990 Disability Act, yet the call is there again. Based on past experience, state governments will use the disabled, mentally ill and elderly as political leverage -- but will not act to solve the problems. The political leverage will be applied to other matters.
The result will be the cooperation required to tackle such large issues will not exist.

The Australian population is aging quickly. The baby boomers are retiring. If the elderly, disabled and mentally ill were to vote as a block, they would be over 40% of the electorate -- an undeniable force in politics. And their numbers are growing.

There is no law to protect the elderly and disabled in their own homes. Once they stop working, the protections of equality before the law disappear. Abuse of the elderly and disabled in their own homes is considered a civil matter.
This may be another source of the growing suicide rate.

( from "State blamed for 500 patient deaths" by Ashley Gardiner, 08jul06 Herald Sun

A SENIOR doctor has likened Premier Steve Bracks and Treasurer John Brumby to funeral directors for the way they are running the hospital system.
Dr Peter Lazzari yesterday said about 500 Victorians died every year because of the system's shortcomings.
...
Dr Lazzari, who represents Victorian hospital medical staff, said the hospital funding system did not take into account pain suffered by waiting patients, the deterioration of health, and deaths.

"Successive governments continue to collude together to under-fund our public hospitals and fund their re-election. It's as simple as that," he said.