Mental Health Royal Commission, and why it matters?

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By Girish Nambiar

As someone who has personally experienced mental health difficulty, I don’t usually like to divide the world into categories of people, but for the sake of discourse and as a preliminary introductory to this piece, I will do so in this article. You might say the world is divided into two groups; On the one hand, one group of people are able to handle, seemingly with ease, the various trials that life besets upon them while the other group of people struggle tremendously to do the same. In Adlerian psychology, this is a concept that is understood and accepted as principle in that some people simply find it more difficult to shoulder responsibility and that this does not speak to their inability in a negative manner, rather it is indicative of the way that people grow in their individual lives and environments.

The reason I mention this alleged division is because, as we are aware, some individuals in society face mental health predilections, and in many cases their own conditions are completely unbeknownst to them and the people who surround them until it is too late. Human beings are resilient creatures and will endure many things for the sake of perseverance and in the pursuit of happiness but as the saying goes, every person has a breaking point, and that point comes sooner rather than later for certain individuals. Let us now end the division here.

To help alleviate this state of affairs, the Victorian government of Melbourne has proposed an initiative that is being called the Royal Commission into Mental Health which will derive judicial powers from the Inquiries Act 2014. Essentially, an inquisition will be launched to unearth the stigmas and mysteries surrounding mental health problems in the Victorian state of Melbourne, Australia, in which an expert committee has been formally gathered to better understand the plethora of mental health issues that individuals suffer from in the state. The team is to be led by Professor McGorry AO, Professor James Ogloff AM, Ms Anne Doherty, Dr Gerry Naughtin, Ms Erandathie Jayakody, Mr Julian Gardner AM, Ms Honor Eastly and Mr Jim Williamson supported by a committee of supporting members.

According to the official website of the Royal Commission on Mental Health (https://rcvmhs.vic.gov.au) the purpose of the committee as such is to “provide the community with a clear and ambitious set of actions that will change Victoria’s mental health system and enable Victorians to experience their best mental health.” The committee will be looking into effective ways and means of reducing the proverbial stigma attached to mental health illnesses with the aim of promoting more inclusive communities that are better equipped to manage the spectrum of ailments that hinder the productive and joyful life of the citizens that live there. Towards that end, the commission conducted community consultations in various locations around the state of Victoria in April and May of this year. A total amount of $13,600,000 has been allocated for the purposes of the inquiry.

The commission has stated on their website that they will be committed to six base targets, foremost of which is “respecting the expertise of people living with mental illness”. The commission wishes to recognize that the people themselves, naturally, have lived with their own unique disorders for a period of time and have likely learned from that experience. This would imply that they have much to offer in terms of ideas on how to best manage and cope with their conditions, which is why their feedback and input should be heard and explored in as much detail as possible. 

The commission also aims to be completely bias free and wishes to commit itself to a fully inclusive modus operandi. Another significant aim that the commission wishes to pursue is to promote integrity, accountability and more interestingly “transparency” with regards to its operational methods and general administration. The specific mention of transparency, in particular, would be a healthy and refreshing addition to a system that has for too long stood in the shadows of doubt, uncertainty and, as was previously mentioned, unnecessarily stagnative stigma.

The commission has put out it’s Terms of Reference (ToR) to outline the details of this undertaking and appears to have spent no small amount of energy and resources in doing so. Within the ToR, they have highlighted key practices that will be looked at in addressing how best to go about managing the various mental health concerns in Victoria. Among the issues sought to be addressed include “how to most effectively prevent mental health illness and suicide” particularly “early in life, early in illness and early in episode”. This may be a crucial factor as many mental health patients are identified only once their conditions have progressed to the point of a breakdown, as such, it would be incredibly helpful to identify and treat their conditions as early in life as possible.

The commission will also seek to improve access to mental health care facilities with an emphasis on ensuring that a wider net is cast in terms of age groups being attended to. Furthermore, families and caregivers of people living with mental illness are to be heard from and better catered for. It is not unheard of for families and caregivers to suffer from sympathetic pains as a result of being in close proximity with someone suffering from a particular condition for prolonged periods of time, making this another welcome inclusion into the inquiry. Another point of contention highlighted in the general ToR is to assist in the curbing of alcohol and drug abuse within the community by implementing “harm minimization approaches”. According to the NCETA, “Harm minimisation acknowledges that some people in societies will use alcohol and other drugs and therefore incorporates policies which aim to prevent or reduce drug related harms. Harm reduction is a central pillar of the harm minimisation approach.”(NCETA – The National Centre for Education and Training on Addiction, http://nceta.flinders.edu.au/society/harm-minimisation/)

The commission has also put out a Simple English format series of documents that highlights the key components of the committee in plain language with pictorial assistance. The infographic is available on their website under the Key Documents section and is a remarkably thoughtful and effective means of getting the information out to individuals suffering from mental health disorders. These are condensed in such a way that allows the reader to not be inundated by the ordeal of having to read through the expansive and meticulous research papers that have been put out but rather lightly peruse through the intended material at the reader’s desired pace. A clever notion indeed and one that is equally vital in addressing the concern of getting this information out to those most in need of it.

The commission intends for there to be public hearings which are open for anyone to sit in on. These will commence on the 15th and 16th of July 2019 at Maryborough and the Aborigines Advancement League Inc in Thornbury, respectively. These hearings are set to run from 10am to 1pm and 2pm to 4pm and will be open to the public from 9.45 a.m. daily. The key themes of the public hearings will be suicide prevention, stigma, accessing and navigating the system and prevention and early intervention. These public hearings will also be covered by the media with news crews and journalists expected to be in attendance. Additionally, counselling services and support groups will be made available to anyone who requires it. These hearings will essentially be purposed towards the ultimate end of ensuring that those individuals and their families suffering from mental health complications are heard in full detail and without reservation.

Among the topics that will be covered at these hearings, accessibility to the workforce with regards to the impact that stigmatic approaches have had on individuals suffering from mental illnesses will be addressed. The commission hearings will also cover prevention and early intervention and will look into the factors that contribute to the variety of mental health conditions. A further consideration will come in the form of investigating and shedding light on access and navigation of the mental health system in Victoria. The way and means in which the mental health system recognizes and responds to people of various backgrounds including gay, lesbian, transgender as well as those from ethnic and culturally diverse groups will so too be inquired upon. Of significance, the full schedule for these hearings are available at the commission’s official website.

Under the background section of the ToR, the commission has stated that it wishes to address, among other concerns, the issue of “systemic discrimination and barriers to accessing services” that some members of the community are facing. The commission wishes to convey its findings that racism targeted at ethnic minorities as well as the Aborigines and Torres Strait Island may be salting the wounds or even directly causing severe cases of psychological trauma, which when go unchecked can result in dire consequences. The section goes on to convey that this may be causing those members of the community to experience difficulties in securing proper housing, maintaining engagement with employment and education, feeling included in the society, participating in the community, and connecting with friends and family. 600 lives were lost in the state of Victoria alone in 2017, all of which were by way of suicide, which the report states was more than double the amount of lives lost to road accidents in the state. 

Another issue raised is that the mental health services themselves face several obstacles which hinder their ability to respond to the needs of the public at large. Population growth, which as we know to be an ongoing global concern, is one of the primary impediments towards better responsiveness. A solution to this might come in the form of better internet-based tracking systems which connect the mental health services to individuals suffering from mental health complications. Social media platforms and digital apps could be created to bridge this apparent gap. A further hindrance faced comes in the form of changing patterns of drug use. The ease of availability and the protraction of drug types in the last 10 years alone must surely cause difficulties to the health services in Victoria with regards to their ability to cope with the rapidly changing landscape of substance usage. The report goes on to state that ‘greater complexity of need” is a supplementary issue being faced by medical faculties in the state of Victoria. According to the NCBI “Patients made complex by multiple co occurring medical conditions have been the focus of recent discussions, with concerns expressed about potential vulnerability created by the current approach to quality of care assessment and accountability in health care” (Patient Complexity: More Than Comorbidity. The Vector Model of Complexity,

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2219701/)

In essence, this speaks towards the notion that some individuals in the community who suffer from mental health problems have more than one, singular disorder that they are experiencing. In addition, they may, for instance, be exacerbating their condition in a plethora of ways and are hesitant or unable to communicate themselves effectively to their doctors.

The ToR then states that this is juxtaposed by two structural considerations, these being funding arrangements and geographical factors. Value and support are cited as key requirements on all sides of the spectrum. Only with sustained and continued efforts by the state and its members can there be real and effective changes made to improve the conditions faced by persons experiencing mental illnesses, their individual family members as well as the medical caregivers themselves who are increasingly exhausted in their efforts to provide better care to patients.

It is this author’s opinion that the Royal Commission into Victoria’s Mental Health status is a vital and well thought out effort to prop up and protect the interests of individuals suffering from mental health conditions. The approach appears to be holistic, targeting systemic faults and there is a clear determination to get to the root of the variety of issues faced without fear or favour, an inspiring endeavour indeed and one that is exemplary and should be adopted on a greater scale both nationally and abroad. It should also be noted that alternative self-healing techniques such as mindfulness classes, meditation sessions, yoga, and, culturally diverse methods, such as Ayurvedic treatments should so too be looked at in greater detail (if it has not already been proposed) as these are equally important techniques and impart individuals with the skills needed to treat their own conditions. Understandably, only so much can be done to bring the horse to the proverbial water, but this writer believes that belief itself only becomes possible when all bodies and minds come together in a sustained manner to inspire movements for the greater good.    

Written by Girish Nambiar

Girish Kumar Nambiar is a freelance copywriter and entrepreneur who resides in Kuala Lumpur, Malaysia. He is 31 years of age and graduated with a law degree from Aberystwyth, Wales roughly 5 years ago. He is presently working to start-up a 3D printing service provider enterprise in addition to the copy-writing work that he does. He is also working on a Comic Book called Mud City as well as two other paperback books, one of which is a novel while the other is more of a personal piece or self-help guide to people suffering from mental health issues. The latter is called A Mind of Our Own and is very much still a work in progress. He was diagnosed with Bipolar Disorder roughly 10 years ago and have has had his ups and downs in life just like any other person would. He believes that there are systemic problems in society that need to be remedied, particularly in the Asian region and thus is happy to work with MHFA to reach more readers and shed more light on Bipolar Disorder and other mental issues so attached such as ADHD and OCD.

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