The Productivity Commission has savaged the ‘alienating, inadequate, ill-informed and under-resourced' mental health and suicide prevention system.
A new interim report out of the Productivity Commission has identified major flaws in the National Mental Health and Suicide Prevention Agreement, which it said has resulted in a system where services remain unaffordable and do not respond to population needs.
As the agreement’s expiration date of June 2026 approaches, the Productivity Commission has recommended urgent action on the national stigma and discrimination reduction strategy and comprehensive national guidelines on regional commissioning and planning.
The agreement itself was signed by state, territory and federal governments in 2022 and sets out co-funding commitments alongside a set of five objectives, five outcomes and 14 priority principles.
According to the commission report, this is where the trouble starts.
“The Agreement covers … a plethora of commitments for national and jurisdictional actions – with no obvious links between them,” the report said.
“Without an articulated and evidence-based logic connecting the actions set out in the agreement and its overarching goals, it is difficult to assess the agreement’s effectiveness.
“It is hard to see what is being achieved and how, and to hold governments accountable for their commitments.”
Technically, governments have delivered on eight of the 13 outputs listed in the agreement; most of these have not necessarily led to better outcomes.
Many of the outcomes relied on measures that were either broad in scope or lacked a specific definition.
“Where data is available, it cannot be readily used to assess progress,” the Productivity Commissioner wrote.
“The most recent data collections are at least two years old and the intended improvements to data collections included in the agreement are yet to be fully realised.”
The areas where outcomes are measurable by the data do not necessarily tell a positive story about the efficacy of the agreement.
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While measures of mental health and suicide have not improved over recent years, the suicide rate among Aboriginal and Torres Strait Islander people has worsened.
Other issues identified by the Productivity Commission included key commitments being left unfunded and scant detail on how some objectives were to be achieved.
The agreement emphasises, for example, the need to incorporate the voices of people with lived experience of the mental health and suicide prevention system, but it does not describe how this may be achieved.
According to the Productivity Commission review team, feedback from the public indicated that there had been limited input from people with lived experience in the creation of the agreement.
As a priority, the review team recommended urgent work on two of the key outputs which have been left outstanding – a national stigma and discrimination reduction strategy – which has been developed but not yet released, and guidelines on regional commissioning that would bring PHNs into line nationally.
It also recommended extending the current agreement by 12 months to June 2027 to allow more time to build foundations for the next agreement. The commission’s interim report, which was released on Tuesday, will be followed up by a final report in October.
