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mental health crisis « Previous | |Next »
November 23, 2007

Larry Hermann, a psychiatrist has an op-ed in The Age entitled Mental health system in crisis, that goes behind the slogans, headlines and the focus group words:

It is well known that mental health services have been underfunded for many years; not only crisis community teams but the whole public mental health system. Community treatment teams are not the issue; their dilemmas are symptomatic of not only long-term underfunding, but an ever diminishing workforce of expert staff. There simply aren't enough expert providers in mental health, both public and private, and never have been.

That's the description. What to do? What can be done? What could be done? Hermann adds:
My colleagues and I lament at the dumbing down of mental health expertise, which is only becoming ever more tangible....Governments, but no more so the current one, have for some time been introducing methods and policies to allow lesser trained personnel take over what used to be the domain of expert providers. No one would argue that it is absurd to suggest that surgery should be performed by anyone other than a surgeon. Yet in mental health it is increasingly common to see complex patient treatments occurring at the hands of inadequately trained staff.

Hermann includes psychiatrists in this as he refers to the common perception of psychiatrists as prescribe medications and out sourcing a complex level of their own expertise, i.e. psychological therapies, to others.

Hermann's solution is limited---it is for highly skilled clinicians to reclaim holistic and direct treatments of patients. But there are so few psychiatrists or even psychologists. Workforce shortages hit access hard in mental health as well as physical health.

| Posted by Gary Sauer-Thompson at 6:05 AM | | Comments (1)


In the days when I was the chair of an Area Health Service,unlike the greater part of the service, it was not money that was the major problem but availability of mental health workers in all categories. Yes there is shortge of all health worker categories but it was far worse for mental health.That was due to our continuing cultural attitude towards mental illness. It is a very rewarding field but is not an attractive one to most young people.
The shortage of trained people makes it hard enough for the public system to give the required care but it also diminishes efforts to develop deeper understand of the issues relating to each individualand thus provide more appropriate care.As you know I believe the Ten Social Determinants of Health, if given due recognition by Government and Practioners, would have in the long run an enormous impact on all our lives. Many of the mental health problems we now see would not arise.
Larry Hermann has it so right.