The Royal Australian and New Zealand College of Psychiatrists (RANZCP) welcomes the comprehensive draft report of the Productivity Commission’s inquiry into mental health which identifies key areas for reform in Australia’s mental health sector, in particular the importance placed on early intervention.

‘We strongly support its focus on building a more productive and effective mental health system better able to meet the requirements of health funders and governments, and more responsive to the needs of individuals and the wider community,’ said the President of the RANZCP, Associate Professor John Allan.

‘The report clearly shows a strong case for reform, based on the view of the mental health system as seen by patients, families and carers.

‘It is well known that the current mental health workforce is insufficient to meet the demands of the future, with a significant shortage of psychiatrists a key contributing factor.  

‘The report correctly identifies the number of psychiatrists available in the community is not keeping up with our needs which are increasing due to population growth and distribution, ageing, clinical trends and patient expectations.

‘The shortage and maldistribution of psychiatrists in regional, rural and remote Australia is of particular concern,’ said Associate Professor Allan.

As well as shortages in regional areas, the report also acknowledged the shortages of psychiatrists in certain subspecialties, such as child and adolescent psychiatry.

The RANZCP strongly encourages investing and intervening in early life, from prenatal periods to adulthood.

‘There are too few psychiatrists and training posts to meet infant, child, adolescent and youth mental health needs,’ said Associate Professor Allan.

‘We also know young people are particularly unlikely to seek help, so targeted funding and programs aimed at bolstering support for child and adolescent psychiatry will also assist with prevention and early intervention in younger Australians.’

Associate Professor Allan highlighted the report’s recognition of the impact on communities of a lack of access to services in acute and subacute settings.

‘One of the biggest blockages to beds is suitable housing being available for people in their recovery from mental illness.

‘Regardless of how a person enters the mental health system, it is it is fundamental that they receive care and support which is of the highest quality, appropriate to their needs and seamlessly delivered.

‘There should be significant new investment to ensure there is an adequate range of beds available, including acute beds, intensive care beds, beds in secure extended care units and community-centered step up/step down options, to reflect the assessed needs.

‘The attention given in the report to providing access to specialist, early intensive and multi-disciplinary care especially for those people with moderate to severe mental illness should be commended.’

Associate Professor Allan emphasised the transition to a recovery-oriented and evidence-based model of care throughout the mental health system would require funding arrangements to match this in practice and the commensurate government commitment to implement these reforms.

Other key Productivity Commission recommendations include:

• Evaluation of effective suicide prevention measures that reflect the needs of local communities
   
• A program to provide access to timely, effective aftercare for every person who presents to a hospital, GP or other service following a suicide attempt or in suicide distress
   
• Staged roll-out of stigma reduction programs, including for interactions between health professionals and mental health consumers
   
• An expansion of online portals to provide more information on e-health, telehealth and group therapy services, including the expansion of clinician-supported online mental health treatment
   
• Funding more positions in regional and remote areas, and increase the availability of supervision for trainees, including through remote models of supervision for trainees outside major cities
   
• Additional homelessness services following a Housing First approach for people with severe mental illness who are persistently homeless