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Wednesday, April 24, 2024

ACT community mental health sector facing funding cliff

Canberra’s community-managed mental health sector is facing a funding cliff, according to the Mental Health Community Coalition (MHCC) ACT and the ACT Council of Social Services (ACTCOSS).

Half the ACT’s community sector organisations expect their financial situations to worsen, while federal funding for psychosocial support programs could stop in June 2023.

Funding shortages will lead to longer wait times for consumers, reduced staffing levels, staff burnout and fatigue, program closures, fewer new programs starting, and less program innovation, the MHCC ACT fears.

“The impact on the already struggling mental health services will be huge, and will flow onto the Canberra community,” said Bec Cody, CEO of the MHCC ACT.

MHCC ACT and ACTCOSS have called on both the ACT Government and federal candidates to commit to adequate ongoing funding for psychosocial support programs beyond next June.

“Community sector organisations in the ACT have deep concerns about their funding sustainability,” Ms Cody said.

The recent Australian Council of Social Services (ACOSS) Community Sector Survey found that half of the ACT community sector organisations surveyed expect their finances to worsen in 2022, the highest figure of any jurisdiction in Australia, and well above the 29 per cent average.

In the last Budget, the Federal Government did not commit to continued funding for the community-managed mental health sector’s psychosocial support programs after June 2023.

“This is particularly worrying for the community-managed mental health sector,” Ms Cody said.

“Demand for mental health services more than doubled over the last decade, and is even higher now with the implications of the pandemic,” said Adam Poulter, acting CEO of ACTCOSS.

Seventy-two per cent of Canberrans experienced anxiety or depression during the pandemic, according to the Australian Counselling Association.

Lifeline Canberra answered 4,400 calls in July 2020 – 900 more than any single previous month, and a 35 per cent increase in calls compared to the previous July; 43 callers needed immediate assistance from emergency services. 

Some Canberra community mental health services say demand has increased more than 40 per cent since the pandemic began. Other key services for people with complex and ongoing needs have waiting lists of more than a year.

Globally, bereavement, isolation, and loss of income have triggered mental health conditions or exacerbated existing ones, according to the World Health Organization. Many people are drinking and using drugs more, or suffering insomnia and anxiety.

In September 2021, Lifeline’s daily call volumes nationally increased 33.1 per cent compared to 2019 – a historical record. Calls to Kids Helpline and Beyond Blue also increased, according to the Australian Institute of Health and Welfare.

“But funding for mental health services has not kept pace, and the share of funding to community mental health services has decreased,” Mr Poulter said.

The MHCC ACT noted that federal spending for mental health-related services had increased by 3.2 per cent annually between 2015–16 and 2019–20, while state and territory government funding had increased by 2.8 per cent annually. In 2019–20, the national recurrent spending on mental health-related services was $11 billion, 3 per cent more than in 2015–16.

However, according to the Counting the Costs report commissioned by ACTCOSS, the recurrent expenditure on specialised mental health services by the ACT Government increased by less than 50 per cent, even though the number of people receiving mental health services more than doubled from 2009-10 to 2018-19.

Funding for community-managed mental health services declined dramatically (15 per cent) between 2014 and 2019, coinciding with a sharp increase in ACT Government funding for specialised psychiatric units and acute care wards in public hospitals (21 per cent), MHCC ACT stated.

Funding for non-government organisations accounted for only 11.5 per cent of overall ACT Government spending on mental health services in 2018-19.

Since the National Disability Insurance Scheme (NDIS) was introduced in 2016, per capital funding for community-managed mental health services outside the scheme has halved, “leading to a dramatic loss of services for the vast majority of Canberrans living with mental health conditions,” an MHCC ACT spokesperson said.

In fact, approximately 154,000 Australians with severe and complex mental illness did not receive support from the NDIS or any other Commonwealth or state/territory psychosocial program, according to a 2020 report by the Productivity Commission.

And according to the latest Report on Government Services, only 41.9 per cent of people seeking psychiatric care at the ACT’s emergency departments were seen on time in 2019-20 – 26 per cent below the national average.

(The ACTCOSS Counting the Costs Report uses the 2021 Report on Government Services as a source; the latest ROGS data only goes up to the 2019-20 financial year.)

True, the ACT and Federal Governments recently agreed to invest $38 million on mental health and suicide prevention ($25.2 million from the Commonwealth and $12.9 million from the ACT over the next five years); and the ACT Government budgeted $14 million for mental health and community health care support packages, on top of $2.5 million during last year’s lockdown.

MHCC ACT said it welcomed these commitments. “However, these are largely for piecemeal measures that do not reflect the demand on, and vital role of, the community-managed mental health sector,” a spokesperson said.

“Similarly, although we have seen some welcome commitments from major parties related to mental health during the election, none have committed to providing a clear path to mental health reform.”

The MHCC ACT wants to reverse the decline in mental health funding, and shift the balance from the expensive crisis, hospital-based care to community-based care, which they say “prevents mental ill health, intervenes early to stop people reaching a crisis stage, and helps people with ongoing mental challenges to recover in the community and live well”.

“This chronic under-funding of the sector by the Federal and ACT governments is severely impacting the services that community-managed mental health services can offer, at a time when the need for quality services is so high,” said Mr Poulter.

“It also has grave impacts on the sector’s workforce,” said Ms Cody.

“This funding uncertainty is a major factor in the high levels of burnout and staff attrition we are seeing. How are we meant to keep quality staff if they’re constantly overworked and don’t know if they will have a job next year?,” she said.

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