Money Over Mental Health

Dear all,

I’m sure you are aware by now that last Tuesday the Government, as part of the budget, announced a cap to the Mental Health Nurse Incentive Program (MHNIP). What the Government announced in the Budget papers was that there will be an additional $17.6 million for the Mental Health Nurse Incentive Program, BUT this additional funding will not be enough to keep up with the growth of the program. It is only enough funding to maintain MHNIP at its current level of activity.

In effect the MHNIP will be frozen at 2011-2012 levels. This means no organisations (GPs, psychiatrists, headspaces, Aboriginal health services) and no new mental health nurses, unless someone else exits the program. Organisations and nurses are also expected to keep activity at existing levels, so won’t be able to increase their capacity to meet demand.

The day after the Budget, I met with Minister Butler’s Office and their message was that in this tight Budget this level of funding was a good outcome for the program. However, I have to say that I would prefer slightly less surplus and the money put back into MHNIP.

In our opinion this decision has much larger ramifications than seems to have been considered. The College is very unhappy with this decision and we have commenced a campaign against the funding freeze.

First and foremost, there will be thousands of people with severe and complex mental illnesses who will miss out on services. There is no other program that provides clinical coordination services specifically to people with severe and complex mental illnesses. We know this group of people frequently fall through the gaps between other services. Based on current uptake the program it expected to provide services to 47,000 people this year, but can’t expand to provide services to the many thousands more who need the program.

One of the things that makes this decision hard to fathom is that the Department of Health and Ageing has only just commenced an evaluation of the program, so the decision to freeze the funding has been made without this evaluation. The evidence we do have, such as the case studies commissioned by the National Advisory Council of Mental Health and small scale evaluations by individual organisations or nurses, consistently show the program providing good outcomes for the following:

– Reduced hospitalisation for clients who have a history of repeat hospitalisation.

– Improved social functioning including better relationships with family.

– Increased capacity to manage their lives, work, study etc.

I also know that there will be a broader impact on primary mental health care. The Government has said that it is committed to better integrated primary care and to nursing in general practice. But this decision shows they aren’t committed to integration and nursing in mental health in primary care. Unfortunately this funding freeze will undermine the progress we’ve made over the last five years with our hard work towards getting more mental health nurses in primary care and towards engaging and working with GPs and psychiatrists. Of course, it will be the GPs, psychiatrists and community mental health teams who will feel the impact of these changes because consumers who can’t access the MHNIP due to the funding freeze will once again be reliant on these services.

The following is an excerpt from a newspaper report on the weekend, which shows that Minister Butler knows that this will be the result of the decision.

Minister for Mental Health Mark Butler said the extra money in the budget would ensure people can continue to get the service.

“This funding will ensure that people currently in the program continue to receive the care and support that they need,” he said.

“An evaluation of the program’s effectiveness is underway and will help determine funding needs in future years.

The evaluation is due to report towards the end of 2012.

“In addition, people living with severe mental illness can continue to be referred by their GP to Medicare subsidies consultant psychiatry services and community mental health services including the Day to Day Living and Personal Helpers and Mentors Programs which target people with severe mental illness.”

Not only will this cost more to consumers, Medicare and hospitals, but it also shows a fundamental lack of understanding of the program and what specialist mental health nurses do. The consumers this program targeted to need more than GPs, psychiatrists and community mental health teams can provide, that’s why the program was developed in the first place. And while Day to Day Living and Personal Helpers and Mentors Programs do a great job, they don’t provide the same type of service. I also wonder why there is enough money for practice nurses for GPs but not mental health nursing services.

As I’m sure you would appreciate we are working hard to make sure consumers, nurses and the organisations they work for are aware of the changes and what it means for them. We are also lobbying the Government to overturn the funding freeze on MHNIP until the evaluation of the program has been completed and then for them to consider the future of the program based on the evidence.

We would like your support in our campaign – to raise awareness about the decision and for you to get behind our call for the funding freeze to be overturned.

We need your help and support have this decision to overturned.

We need to act quickly and keep up the pressure.

Mental health Nurses and consumers of the mental health system need your support.

Simply click on this link to directly send Minister Butler your letter of support.

Thank you for your support.

Kim Ryan

Kim Ryan Adjunct Associate Professor Sydney University.
CEO Australian College of Mental Health Nurses.
Chair Coalition of National Nursing Organisations.                                                                                                                                           Credentialed Mental Health Nurse.