CEO Update - The little house that highlights a much bigger problem
If a picture paints a thousand words, then let me try and paint you a picture…
A picture of a little weatherboard house, surrounded by state-of-the-art medical facilities on a huge hospital campus. A little house, highlighting a much bigger problem in relation to service delivery and stigma.
I recently visited a small alcohol and drug treatment facility, in one of these little houses.
A small, old, weatherboard house with a crowded dirt carpark out the front. Oversubscribed on a daily basis, and with a substantial long-term waiting list.
Inside, its expert staff are quite modestly paid and despite bringing years of experience to the table, are frequently funded via short term contracts with government.
The little house was recently ‘developed’ to provide a large common room sufficient for all, and some residents had begun to create a little ‘kitchen garden’ for the little house.
Building a community, despite their surrounds – a healthcare precinct of professionalism with facilities that tower over the little house on three sides.
The surrounding modern, multi-story buildings house operating theatres, medical research laboratories, private consulting rooms, supporting pathology and imaging services, outpatient clinics, rehabilitation clinics, administrative offices, cafes, multi-story car parks and more.
If an ambulance brings you to the Emergency Department you will most likely receive world class medical care, regardless of your wealth of social standing. But not if you turn up to the little house.
If you work in mental health and or alcohol and drugs in many parts of Australia, you will recognise this kind of facility, or little house… and the disparity between the two.
Disparity which like it or not says to the users, ‘you are not as important as the other people using this precinct’. Disparity which reinforces stigma.
I was recently reappointed to the Australian National Alcohol and Drug Advisory Committee, and hope to use the opportunity to help overcome some of this disparity, and the barriers that seem to exist for alcohol and drug services and mental health services.
In my local community in Canberra, I am also the Board President of an alcohol and drug treatment agency, Directions ACT, where we strive to provide ‘joined up’ services regardless of the barriers.
Mental health services, like alcohol and drug services, are too often the last in line for funding. Our operating budgets are frequently set on an annual basis and we celebrate wildly if we secure a three-year contract for a program.
If we don’t spend all our funds in a year, governments frequently take the money back.
We often work in premises that are donated and repurposed – leftovers from other, bigger parts of the system. And we never get a mention when governments talk about vast investments in ‘infrastructure renewal’.
Our staff, who are frequently modestly paid, are often asked to ‘suspend disbelief’ and keep working through the tremendous uncertainty of contract renewals, endless tendering and re-tendering, and constant program reform.
We are frequently unable to provide the high quality, evidence based care that consumers and carers deserve. Let alone provide the early interventions and preventative activities that would ease the burden on our services, and the community in general.
As we approach Budget 2018, we will continue to advocate for mental health services to be funded as a key priority, rather than an afterthought.
We will continue to advocate for joined up services, rather than fragmented service offerings.
And we will continue to ask governments to get the house in order. Bigger and better houses for the services that too often get hidden away.
Chief Executive Officer