The dominoes are starting to tumble

A few weeks out from the State budget and one week out from a Federal Budget, we are beginning to see the direct effects of winding back health care for all, but especially for those with mental illness.

Yesterday The Age in Melbourne reported the State Government would no longer fund St Mary’s house of welcome in Fitzroy, as well as many other institutions that genuinely support and care for those with severe mental illness.  

I remember St Mary’s house of welcome from my training days. Back then it was a bustling place, a care and respite space for many inner urban patients with a mental illness. It provided a community, a haven, hot meals, clothing, shelter and love. Nowadays, it is even busier, and would have been full to the brim for years to come had it not received the news it would no longer receive government funding the day after the state government budget was delivered.

Many of the patients we knew within our service would feel safe going to St Mary’s when unwell, rather than calling a crisis team or attending an emergency department. In fact, most patients experiencing a relapse of severe mental illness avoid psychiatric services. St Mary’s provided a bridge between patient and service, our service could be alerted by their staff if somebody was unwell. They would do this in discreet and compassionate way, and would discourage psychiatric services from attending at St Mary’s to keep it as a safe place. However, services could follow up after hours and ensure treatment was provided.

There is no doubt that such wonderful facilities never come to the attention of politicians except as a cost on a piece of paper, to be cut when needed. There is no human element to the decision making. Where will these people go as these services break down? What will happen to their mental health? And if they can’t afford meals how will they afford to pay their GP’s $7.00?

Little is known about taking payments from patients in public hospitals. This seems to have been pushed to the State Government’s discretion. Will an acutely mentally unwell patient lost from services be asked to pay? Even when extremely paranoid and actively avoiding services? What is the point of newer medications and modalities of care if we are actively discouraging patients from seeking help, by taking away their places of refuge and charging them for care that they have no insight they need.

What will be the next domino to fall?