Tuesday, August 16, 2011

Dear Professor Patrick McGorry

Congratulations on your victory confirmed in the last Federal budget. Your reform campaign successfully wedged the government on mental health issues during a closely contested election, and you successfully pressed those reforms with a minority government to an outcome which favors organizations associated with you. Whether through beginners luck or carefully crafted political lobbying, you won. Well done.


But. There ain't no such thing as a free lunch. You took around $350 from my family a year to do that. We don't know for sure how much because the reforms haven't cascaded through the health system yet. But it looks like $350 a year. At least.


I was surprised to read in this morning's Age newspaper your assertion that mentally ill Australians and their families have not spoken out against the reforms to mental health funding you obtained in the last Australian Federal budget. My family did not get an opportunity to express an opinion. You did all your maneuvering behind closed doors, and ambushed the sitting government with your proposals without notice. Or public consultation. Perhaps if you had run public forums to explain your position you might have been surprised by the many people using the services you had subsidies removed from. Or perhaps not. After all, the subsidies for psychological services you successfully campaigned against were labelled middle class welfare, after your reform campaign.


What can be labelled can be hated. The stigma attached to mental health issues almost guarantees many won't speak out publicly against your reforms. Don't you know that?


Like you, I once campaigned long and hard, backed by a big University, for reform in a particular sector of Australian endeavor. And saw my proposals accepted, implemented by legislation and put into practice. What a joy that is, to have a life's work affirmed in public policy. Unlike you, I saw the accusations of partisanship and special interest coming, and did not stay in the position I had before the reforms. So I don't know what it is like for you now to be accused of putting your own special interest above that of other Australians. It must be awful. And I don't believe for a moment you are.


But. There Aint No Such Thing As A Free Lunch. The TAANSTAFL principle applies to politics in spades, You can't be half a political virgin. There is a price for everything, even being right. Perhaps if you don't want to be accused of partisanship you might consider stepping down from the organizations you got funded. Most of us involved in special interest politics do, sooner or later. Better to go sooner then.


Or perhaps, like me, you consider you still have something to offer to Australian life. So I'll continue to struggle to pay my own way, without the benefit of either private insurance or government support, for my own mental health needs. As long as I can. As you will have to struggle on the best you can, amidst all this political fallout you didn't see coming. Politics is like a mental illness, you don't know how debilitating it can be until circumstances and symptoms overwhelm.


It is worth mentioning that when I was young I was told it was a pity there were no services for young people with mental health issues, and I was on my own. Now I am old I'm being told there are no services for older people with mental health issues, and I'm on my own.


A couple of hundred years ago I may have been happy seeing a priest rather than a psychologist. But that was before your scientific method gutted respect for the Churches, and the child abuse scandals that psychiatrists didn't recognize the symptoms of did the rest. Now I see very clearly a future that includes making my way to a government pharmacist to be prescribed my government medication. You know, the stuff with all the side effects that leave me passive, disinterested, uncaring, dehumanized.


We aren't bullies on this blog. So I'm not going to pose a whole lot of questions that makes me look clever, and you look bad. I'd just like to point out that you cost my family around $350 a year. And you didn't ask, you took.


I guess that sooner or later I'll be forced, by the policies and politics you favour, to make my way to a government pharmacist for some government medication. You know, the stuff that makes me feel like I'm in outer space. Until then, here's some opposition to your position to consider. From a usually silent and silenced bit of Australian society taking responsibility for themselves and their own mental health. And, thanks to you, with greatly reduced government assistance. You have disadvantaged me in terms of choice, cost, and outcome. And I'm not alone.


I'd rather see a psychologist than take your medications. But it looks like I won't have a choice, if you get your way. So with the greatest respect, and only because you say there is none, I offer my opposition in principle here to your political position, and to the outcomes which you seek to achieve, if only to begin a dialogue we must have, if mental health reforms are really for all.


20 comments:

  1. It is not exactly clear what the $350 per year you mention is associated with? Rise in the price of prescription medicines, costs associated with seeing a psychologist or rise in costs of private health cover? It does sound like you are stating that because of some cuts to government finding that instead of being able to attend a subsidized psychologist you may instead, have to rely upon drugs to mask or control your condition. How is Prof McGorry implicated in this, from what I know he is a leading advocate of change for the mental health sector, especially, though not exclusively in regards to youth mental health.

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  2. Medicare rebates for adult psychology services I use cut in the last budget in favor of funding organizations associated with the Prof after a turf war during the last Federal election. Clever politics but it cuts deep into community care programs in favor of hospital type care. It was the community based programs that got me walking again, and using my hands effectively. Interestingly, there is a concerted campaign to have my nervous system damage declared a disease, for funding purposes. That will limit my options even more, or exclude me from mainstream medicine altogether. I really should learn to take my meds and be a cripple hey :) regards s

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  3. It's difficult isn't it deciding who should have access to limited funding - I guess it was time for youth in under privileged areas of Melbourne to have access to benefits - since one in four will experience mental health issues. Also, I suppose the government decided those who can afford private health insurance can surely pay $350 per year extra ($7.00 per week)for services they access. Are services such as physiotherapy/ swimming also affected?

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  4. I'm not sure how deep the cuts to managed healthcare services are. But I'll be finding out during the next 12 months or so because those are the services I rely upon. I'm being driven back into the Hospital system, where I'm a number not a human being. I lose choice and independence. Whether that will be a problem for me or not remains unanswered.

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  5. I'm sorry you feel that way Steve. I've had little to do with hospitals, but when I have had dealings with them my experience was that nurses and doctors treated me with respect and concern. I'm sure that they would be utterly distressed if they thought that a patient considered they were being treated simply as a number, rather than an individual, since their primary concern IS for the patient.
    I've actually experienced discrimination in the community context, where, although the health care professionals are exactly that - professionals, often the front desk staff or administrative staff treat you like you are less than human - just a number to process.
    I do hope that when you are back in the hospital system (and I'm assuming that is private NOT public) that you will be treated well.

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  6. I chose to self manage, a strategy which kept me out of a wheelchair. I did that using the support services that have been de-funded. Don't know what that means for me in the future, but its unnerving to be labelled as somehow undeserving, ripping off welfare, because I chose to stay on my own two feet.

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  7. I am very confused - can you explain what the $350 is for and where the evidence is that Mcgorry took it? Which service has been completely de-funded in favour of headspace. I have googled and not been able to see any announcements.
    Also I have never seem anyone call the medicare subsidies "middleclass welfare" - negative gearing, some family benefits or baby bonuses for people on more than 100K but not access to psychology. Can you please post a link to this evidence? thanks

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  8. see this
    http://www.smh.com.au/national/mcgorry-accused-of-conflict-of-interest-20110806-1igxd.html

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  9. Here you go

    http://www.medicareaustralia.gov.au/provider/budget-2011/NMHR-better-access-initiative.jsp

    http://www.australianreview.net/digest/2011/06/stebbing.html

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  10. I found this

    http://www.theage.com.au/national/health-plan-blowout-to-reach-3bn-20110312-1bs9p.html

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  11. thank you for the links folks. Don't know what the answers are but it is appropriate to ask questions and have the discussion, i think. (typing with one hand sucks)

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  12. I think you will find that you can still have access to Allied Psychological Services - 12 sessions per year, rather than the 10 per year, so that is an improvement, rather than a cut in funding. See:

    http://www.health.gov.au/internet/main/publishing.nsf/content/mental-boimhc-ataps

    Also, I got one extra comment in my email, but it is not showing up here - whatever happened to it?

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  13. And just one more thought. I don't think it is because you are undeserving, it is that there is limited funding and the government must choose who has the greater need, this occurs in every sector, not only in Aged care.
    I don't know how these measures in any way label you as 'undeserving'. I don't think being in a wheelchair would give you access to any more services. Anyway, since you can walk might that be a reason for joy? Sorry to hear that your arm is still sore - I'm currently typing with arthritic pain in right wrist. I purchased a gel rest, which helps, but we must endure...

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  14. the number of sessions I'm eligible for have been cut from 18 to 10 AFAIK. It's not aged care it's GP care in the community. Someone posted a link to the Proffessors assertion that the program was most popular in wealthy suburbs and took funds from the disadvantaged (TY) What was a bipartisan approach to mental health funding got broken. There was no public discussion.

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  15. Well, it IS under the governments aged care program and I think you'll find that if you really need psych services then you can easily get into the program mentioned in the link I provided above. But I'll post it again:

    http://www.health.gov.au/internet/main/publishing.nsf/content/mental-boimhc-ataps

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  16. This comment has been removed by the author.

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  17. Quote from this site:

    Through ATAPS, patients are eligible for a maximum of 12 sessions per calendar year - six time-limited sessions with an option for a further six sessions following a mental health review by the referring GP...

    In addition, the referring practitioner may consider that in exceptional circumstances the patient may require an additional six individual focused psychological strategies above those already provided (up to a maximum total of 18 individual services per patient per calendar year).

    So, your fears are ungrounded!

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  18. That web page is dated October 2010 and is superseded by the 2011 federal budget. Confusing isn't it?

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  19. Google ate one of the comments that was posted here. It does that sometimes, we don't know why. I'll keep comments open for another few days therefore in case there is a repost.

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  20. I'll close comments on this post now then. My final word is the transformation of our universal health system to a raft of welfare entitlements is proceeding almost unnoticed,

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