May 15, 2025 • 40 mins
We are a few weeks on from The 2025 Australian federal election (May 3) which resulted in a more than convincing victory for the incumbent Labor government led by Prime Minister Anthony Albanese. So, as the federal government begins its new term, and we await the Victorian Government's State Budget next week (May 20), ermha365 CEO Karenza Louis-Smith thought it was a good time to catch up with Mental Health Victoria's CEO Phillipa Thomas to talk about what mental health reform and investment will look like for Australia.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Get Real is recorded on the unceded lands of the Boon
, Wurrung and Wurundjeri peoplesof the Kulin Nation.
We acknowledge and pay ourrespects to their elders, past
and present.
We also acknowledge that theFirst Peoples of Australia are
the first storytellers, thefirst artists and the first
creators of culture and wecelebrate their enduring
(00:21):
connections to country knowledgeand stories.
Celebrate their enduringconnections to country knowledge
and stories.
Speaker 2 (00:28):
Welcome to Get Real talking.
Mental health and disabilitybrought to you by the team at
Burma 365.
Speaker 1 (00:34):
Join our hosts, Emily Webb and Carenza Louis-Smith,
as we have frank and fearlessconversations with special
guests about all things mentalhealth and complexity with
special guests about all thingsmental health and complexity.
Speaker 3 (00:49):
We recognise people with lived experience of mental
ill health and disability, aswell as their families and
carers.
We recognise their strength,courage and unique perspective
as a vital contribution to thispodcast so we can learn, grow
and achieve better outcomestogether.
Speaker 4 (01:12):
Welcome to Get Real talking mental health and
disability.
I'm Emily Webb.
We are a few weeks on from the2025 Australian federal election
, which resulted in a more thanconvincing victory for the
incumbent Labor government ledby Prime Minister Anthony
Albanese.
So, as the federal governmentbegins its new term and we await
(01:34):
the Victorian government'sstate budget, my co-host and
Irma365 CEO, carenza Louis-Smith, thought it was a good time to
catch up with Mental HealthVictoria's CEO, philippa Thomas,
to talk about what mentalhealth reform and investment
will look like for Australia.
Speaker 5 (01:56):
So excited, pip, to have you join, get Real.
And these are the conversationsthat we love.
You know the frank and fearlessconversations, and our topic
today really is mental healthand what's happening in the
federal, I guess, landscape herein Australia, but also what's
going on in Victoria too.
But let's start a little bitfirst about Mental Health
Victoria.
I mean, you're the peak bodyfor mental health services here
(02:17):
in Victoria and you know we'relucky to have you, as the CEO,
join us.
Give us a.
You know people that perhapsdon't know MHV.
What does Mental HealthVictoria do?
Speaker 6 (02:32):
Yeah, it's a different kind of mental health
organisation, isn't it?
It's very different MentalHealth Victoria to maybe some of
the other names in the mentalhealth landscape that people
would be familiar with, thingslike maybe Movember or Beyond
Blue that have a differentprofile and a different focus
and engagement with thecommunity.
But the role of Mental HealthVictoria and any other peak body
is to be a translator, acommunicator, between decision
(02:54):
makers, so governments andfunders and the sector that
implements the policy andresponds to the community need
that the decisions about thatparticular portfolio area are
about.
So in Victoria, mental HealthVictoria, because of the design
of Victoria's mental healthsystem, we as a peak body
(03:14):
represent a couple of differentkinds of services and we think
really holistically about all ofthe mental health sector in
Victoria.
So we have conversations andrepresent the views of the acute
and clinical sector, so thehospital and health service
providers.
We represent the non-governmentorganisations, so those
(03:36):
organisations that typically arebased more in the community,
and we also work with privateproviders to understand what
they're contributing to themental health landscape in
Victoria so that we can giveadvice to government and
advocate for policy and forinvestment that is going to
(03:58):
ensure that every Victorian hasaccess to the enablers of
positive mental health andwellbeing.
So that's about thinking aboutmental health policy.
In Victoria We've got a hugefocus on mental health reform,
but it's also thinking about theother kinds of policy domains
and factors that affect people'smental health outcomes, and so
(04:18):
we work really closely tounderstand what's happening in
the community.
What's influencing theirexperience of mental health,
what's their experience oftrying to access services like,
and how can we raise awarenessof those issues on the
community's behalf to influencechange.
Speaker 5 (04:35):
Such a really important piece, isn't it?
Because when I think about theRoyal Commission here in
Victoria, what it kind of saidwas this is a really hard system
to navigate, like, if you needmental health supports, it's
really hard to work out where togo, how to get supports when
where you need them, how youneed them.
So the role that you're talkingabout that Mental Health
Victoria plays in this isbringing everyone together
(04:57):
because ultimately, I think wehave the same shared view that
we want the best mental healthsupports for people, don't we in
the community?
Speaker 6 (05:09):
when, where and how they need them the most.
Yeah, that's right, and itmeans having a really clear
understanding of what that lookslike for the community, and
it's about you know to yourpoint.
It's about accessibility havingservices that are accessible.
It's also about understanding,particularly when you're working
in an area like mental health,where there still is,
unfortunately, quite a bit ofresidual stigma around mental
(05:29):
health, and a lot of folks willoften delay help seeking because
of that stigma.
It's also really important,then, that when we're thinking
about accessibility, that we'realso thinking about what
acceptability of those serviceslooks like.
So it is so important thatwe're having conversations to
understand Victorians and tounderstand what a mental health
(05:53):
service could and should looklike in order for them to feel
comfortable and confident to goand engage with that service.
Speaker 5 (06:02):
So I'd like to talk a bit about the advocacy that you
do.
That start there.
So I mean, I'm looking.
Obviously I'll come back to theVictorian landscape.
But on the big national stageand national scale, one of the
things that really stood out tome is the what we now call
Medicare mental health centres.
Other people might have knownthem as head to health, but NHV,
you know you actuallyco-designed this model.
(06:24):
You know of these big centresright around the country and so
through your advocacy you wereable to persuade the federal
government to invest in theseand now we're starting to see
these pop up in all sorts ofplaces in Australia and again,
really driven by what you'retalking about, what consumers
are saying, what services weresaying, but actually being able
(06:45):
to have that voice to government, which I think is a really
important part of the work thatyou do but what an impact on the
national stage that has been.
Speaker 6 (06:54):
MHV is so proud of that contribution that we were
able to make.
That was a piece of work led, Ithink, late.
We developed the model late in2018, before my leadership, so I
must acknowledge the role ofour former leader, gus Cleland,
in that work.
That was a great example of MHVworking with the sector through
(07:17):
policy networks andcollaborating, thinking about
the experience of people tryingto access services and noticing
an opportunity for improvementand spending that time thinking
about what that could look like.
The outcome of that at the timein the federal budget the 2019
federal budget that resulted inan investment of about $115
(07:40):
million over five years to trialthose centres across Australia
and of course, you know the sortof prototype of that obviously
was integrated into the RoyalCommission recommendations here
in Victoria, which is a reallypositive thing.
You know there's a similarmodel in the local mental health
and wellbeing centres, but atthe time, I think the Minister
(08:02):
set a vision that they wouldlike to see.
The government would like tosee over 100 of these across the
country and of course, nowwe're seeing, as an outcome of
the last federal budget, I thinkyou know, over 90 in Australia.
So that's a great example ofhow peak bodies can really drive
the change and be of service togovernment by being that
(08:24):
connection between what peopleare observing, what people need,
and being able to have themechanism to be able to put all
of that together and be a bitpropositional with government
with a solution.
Super important work.
Speaker 5 (08:38):
You had launched a groundbreaking report at the
time.
It was called Saving Lives,Saving Money.
It was a very powerfulstatement as to actually, if
governments did this, they couldnot just save lives, they would
actually save some of the spendand things they were doing.
How did you kind of work thatout that by doing this it would
be beneficial in so manydifferent ways?
Speaker 6 (08:59):
Yeah, it comes from working really closely with
experts in the sector andworking with service providers
to be able to get really closeand understand the trajectory of
illness and, when opportunitiesare missed, what the
consequences of that are.
So, understanding what preventspeople getting earlier care,
(09:23):
understanding what might preventyou know the efficacy of that
care, understanding how thingslike geography might affect your
ability to access services andthen being able to look at well,
okay, the need doesn't go awayjust because somebody didn't
access services earlier, whereit's most likely to present
itself later in a higher costenvironment.
(09:47):
And we know from the evidencethat the longer we leave mental
illness untreated, the harder itcan be to treat and the more
distressing it is for theindividual and their family.
And by that point, what we alsosee in the Productivity
Commission often will thinkabout things like this but the
economic participation of people, their ability to go to work,
(10:11):
their connection with communitythat decreases and that
ultimately costs money.
We want Australians to be, weneed Australians to be thriving,
we need them to be contributingto community, to our economy.
And so, thinking about the costopportunity, there was, I think
(10:32):
, probably for a match made atthe time, pretty obvious that we
were spending a lot of money onthings just too late and that
we really could be doing a lotbetter and seeing a lot better
outcomes earlier.
Speaker 5 (10:44):
I think it kind of the analogy I like to give is
you know, when you've got abroken leg, you know you're not
going to go to ED and they say,oh, that's going to be fine,
walk on it for the next sixmonths, you know, and then the
surgery that you need is verydifferent.
It's the same kind of thing,isn't it?
What you're talking about hereis actually, if we have what
we're now calling the MedicareMental Health Centres a bit of a
mouthful, but if we, you know,have those and you can walk in
(11:06):
at any point and any timewithout a referral to get
support earlier, earlier what animpact that has.
Speaker 6 (11:15):
Yeah, and I think you know to draw on that.
You know that analogy of thebroken leg.
We wouldn't put a clinic abroken leg clinic on a 14th
floor with only stairs to getthere, right, so it requires
thinking about where do youlocate it?
What are the things that aregoing to make it more accessible
to the person so that when theyhave that moment that they need
(11:36):
it, it's really easy for themto get there?
Speaker 5 (11:40):
And I think, if we look at the last, you know,
crikey, it's been five yearsright since we went into the
COVID lockdown.
That blew my mind and that cameup on my Facebook feed actually
just the other day and I wasthinking, oh my goodness, did we
really do all of these things?
Speaker 6 (11:53):
Did it inspire you to make some sourdough Corinza?
It did not.
Speaker 5 (11:57):
Pip.
It got me thinking.
You know, and you know we'vehad all of that.
You know which was huge, Ithink, in Victoria that
significant lockdown, the impactthat's had on people's mental
health.
We've now got what we'recalling the cost of living
crisis.
You know, everything is skyhigh.
People are more worried thanthey've ever been, more
concerned about how am I goingto, you know, make ends meet?
(12:18):
How am I going to buy stuff formy kids?
Can't afford for my kids tojoin this club.
What are the things that I letgo?
You know, I think people'smental health, or the what's the
word I'm looking for it'sworsened.
I think that's the word I'mlooking for broadly across the
whole of the community.
In this last five years, theneed for these kind of programs
and services has never been moreimportant than it is now, in my
(12:42):
view.
Speaker 6 (12:43):
That's right.
You know it was reallyinteresting to see our
colleagues at Mental HealthAustralia, in the lead up to the
federal budget and in the leadup to the election, release a
survey that they undertook where, you know, nearly 60% of
Australians were reporting whoresponded to their survey were
reporting that cost of livingincreases had negatively
(13:04):
impacted their mental health.
If the system that provides aresponse to that also requires
you to pay money to be able toaccess to the right
professionals in a timely way inthe right place, then it's just
a barrier that begets anotherbarrier.
So these kinds of services,like the Medicare mental health
(13:27):
centres, are really importantbecause they remove that barrier
and that's never been moreimportant than now.
I think also coming out of COVIDor the experience of COVID
raised people's awareness aboutmental health and that's a
really good thing.
(13:47):
I think what it has done isit's probably shaped help
seeking, and so it's reallyimportant that we've got the
right services and theavailability and the capacity to
be able to meet the demandthat's been created, because
people are identifying, as wewant them to do earlier, that
you know, I think something'saffecting my you know my mental
(14:08):
health and I want to engage withsomebody to improve.
You know how I'm feeling, sothis doesn't get worse.
So it's really important thatthose services are available.
Speaker 5 (14:16):
You're absolutely right.
That is so not okay.
So, pip, you obviously play atMHV a huge role in advocacy and
you know I think the Medicaremental health centres nationally
are fantastic, you know, andthat advocacy is huge and you
know you're speaking on behalfof all of your members as well.
You know the hundreds of peopleand thousands of people that
(14:37):
work in mental health servicesthat see every day all of these
challenges.
Now, obviously, we're talkingabout the national level.
We've got a Labour government.
They've been re-elected.
They made some pledges as wellabout mental health services and
wanting to continue to investin mental health.
What were your thoughts aroundthat?
And obviously, the continuationof those Medicare mental health
(14:59):
centres as well.
Speaker 6 (15:01):
Yeah, look, it was really pleasing to see that
public commitment.
It was pleasing to see thatpublic commitment, I think, from
both sides of politics.
It was pleased to see the publiccommitments came relatively
early, and so what that tells usis that our politicians hear
and understand that this is anissue that matters to
(15:23):
Australians and you know, Ithink at the time about 81% of
Australians were saying it wasmental health was an issue that
they were concerned about.
When I think about theinvestment commitment, the
devil's always in the detail,right, and so I think what I'm
curious to understand is how weare going to work on the
(15:46):
enablers of those investmentsbeing successful and impactful.
So my mind, my questionsnaturally, as a recovering
bureaucrat who's worked onimplementation, my mind
naturally starts to wonder aboutthings like okay, well, what
does the workforce look like?
(16:07):
How ready are we to do this?
You know, what are the sorts ofthings that we might be able to
do to expedite rate limitingfactors like the availability of
workforce, so that we can getthese services up and running
and working effectively?
I think we've seen thisexperience in Victoria with the
(16:27):
local mental health andwellbeing services.
We have 15 of those.
Speaker 5 (16:31):
That's great, but the time that it takes.
That doesn't scratch thesurface, though, does it, pip?
Let's be honest.
Speaker 6 (16:37):
No, not even nearly.
And also, without thinkingreally carefully about those
implementation enablers.
What happens is, you know, thecommitment to stand them up goes
out there, the work starts, butactually the lead time for
those services to actually beable to deliver impact can be
(16:57):
quite long.
So it's really important, Ithink, coming out of, you know,
this election and having thatbudget commitment I mean, one of
the things that we can begrateful for is that we haven't
had a change in minister.
I think that will make things alot easier to progress.
This working with a ministerwho's already, you know,
demonstrated commitment andworked effectively in the
(17:18):
portfolio going to help.
But it is going to necessitatesome real reflection and some
real reform, thinking about, ifwe want these centres to work,
you know, what can we dodifferently to make it happen
sooner and to not experiencethat delay.
(17:38):
We heard that in Victoria,coming out of the last budget,
that there was no investment infurther locals in this financial
year because government feltthat the availability of
workforce wasn't there, and sowhen we're hearing messages like
that, what we need to see isnot just the announcement on
we're going to build thesethings and the number of how
(18:00):
many there are.
We actually need to hear.
Well, what are you going to do,though, to make this achievable
and possible and to deliver onyour promise?
Speaker 5 (18:08):
Let's go to the Victorian context then, because
you know the Royal Commissionwas quite groundbreaking here.
I mean, you know, it was brutalin some ways and hard to read
the experiences of people thathad tried, unsuccessfully, to
get mental health supports andsome of the really tragic
stories where people had diedwaiting to get.
(18:30):
You know that you can'tsugarcoat that waiting to get
the treatment and supports andthings that they needed.
So I mean it's really, reallyimportant we're about to come
into a state budget, you know,and the Royal Commission made a
number of recommendations, andthat they also included a levy
which taxpayers are paying.
You know, let's be a little bitcontroversial now to actually
fund these mental healthprograms and services.
(18:50):
You know, so, as the peak body,you know, you've been
incredibly vocal at a federallevel and you know that
investment in those Medicaremental health centres which
you've co-designed is huge.
How is Mental Health Victoriaworking with all of its members
to, you know, to hold thisgovernment to account for all
the things that the RoyalCommission recommended and the
(19:10):
government said it would do?
Speaker 6 (19:12):
Well, I think.
Firstly, mental Health,victoria.
We strongly support the mentalhealth levy, but we think the
need for transparency around theallocation of the revenue
that's generated by that levy isreally important.
This is an additional tax onVictorian business, and
(19:36):
Victorian businesses have aright to understand how that
money is being spent.
Speaker 5 (19:43):
I think you're right, pip.
No one would disagree thatspending money on mental health
is bad.
I think anyone and everyonewho's stopped them in the street
, they would all say, yes, Ithink this is a great thing to
do, but where is it?
Where is it going to be andwhat does it look like?
I would be asking, that's right.
What?
Speaker 6 (19:58):
are the outputs and what are the outcomes?
So there's a difference betweenspending money and spending
money well.
And so thinking carefully abouthow the allocation of that
really precious resource isallocated is really important,
and also working really closelywith the community and with the
(20:21):
sector to understand really well, before those allocations are
made, whether that investment isthe right investment.
Is it the right time?
Are we approaching it in theright way?
That's really important.
So we're not wasting money,we're not missing opportunities.
Speaker 5 (20:39):
I think everyone listening to this podcast would
100% agree with you.
So, pip, what do you think theVictorian government should be
doing?
You're obviously listening toall of the mental health
services, whether they'reclinical, whether they're
community-based.
You're also listening to peoplethat access those services, to
consumers, families, carers.
What are you hearing?
(21:00):
What do you think if you couldtalk to the Victorian government
on both sides of parliament,all sides of parliament,
government?
What are you hearing?
Speaker 6 (21:11):
Well, look, we're lucky enough to have the
opportunity fairly frequently tospeak to people on all sides of
politics here in Victoria aboutthese issues, and I would
comment that on both sides ofpolitics there is an interest
and a commitment to this as anissue.
My messaging, you know we're atyear four now, post the Royal
(21:34):
Commission, and my messaging toboth sides of government has
really been about the importanceto exercise situational and
contextual leadership.
The Royal Commission wasundertaken at a particular point
in time.
It had a terms of referencethat was not exhaustive, it had
(21:55):
a limited scope, it was quiteretrospective in its analysis,
and so it was, you know,learning from things that had
happened in the past.
And one of the things obviouslythat wasn't apparent, you know,
to those working on the RoyalCommission was that we were
going to go through COVID.
That significantly, you know,context changing situation here
(22:20):
in Victoria.
And so my message to governmentis very much that we need to be
working really closely with thesector and with the community
to understand new and emergingissues, to not think solely
about reform and sort of take atick box approach to
(22:41):
implementing particular projectsin silos, that we're at a point
here in Victoria where we'veinvested over $6 billion into
this reform so far.
Speaker 5 (22:53):
That's a lot of money , isn't?
It that is a huge amount ofmoney.
Speaker 6 (22:57):
It is huge, and so it's only right that we're
starting to that.
We need to have answers tothose questions about are we
seeing any impact?
Have we put the investments inthe right place?
Are there steps, perhaps, thatwe missed that we need to go
back on?
Are we paying enough attentionto the parts of the sector that
aren't the focus of reforminitiatives to be able to
(23:21):
anticipate changes in whatthey're able to do or the demand
that they're experiencing orthe health of those particular
parts of the sector?
So my messaging to governmenthas, or to both sides of
politics, has been about reallyneeding to take some time to
(23:42):
work really intentionally withthe community, with the sector,
with peak bodies, to make surethat what we're doing is right.
We could continue to spend alot of money and a lot of time
and not see the change or theimpact of the change that this
Royal Commission and that thisgovernment promised us.
Speaker 5 (24:01):
When I think about reforms as well.
We've.
Obviously I can't talk aboutthe end.
You know anything withouttouching on the NDIS.
We're about to see huge changein the NDIS around what's called
foundational supports, and soat the start of the NDIS, you
know, a number of people who hadwhat you know is defined as a
psychosocial disability foundthemselves in the NDIS system
(24:21):
rather than in the mental healthservice system.
Just for our listeners,psychosocial disability and
mental health, right, are theythe same or are they different?
Like what's the?
You know the differentlanguages and different terms.
And why are some people in theNDIS and some people not in the
NDIS?
And I don't know if that'ssomething you can answer, that's
just a very technical question.
Speaker 6 (24:41):
It is a technical question, but it's a good
question because I think it's aquestion that you know there
will be a lot of Australians whoare needing to access services,
who will be facing the dilemmaof trying to understand why they
fit in a particular part of thesystem or not in another, or
perhaps nowhere.
I think my sense of this isthat, you know, the ambitious
(25:02):
design of the NDIS looked torespond to permanent and
enduring disability and thatconsiderations of enduring
mental health issues and theirimpact on a person's ability to
live their best life would alsorequire some responsiveness.
(25:22):
But I think the design aroundthat for people with mental
health, with psychosocialdisability, in the NDIS probably
could have done with a bit morethought.
And so, post this review of theNDIS, we are seeing those
changes and I think when I firststarted thinking about, or when
(25:43):
I first started interactingwith, the implementation of the
NDIS, what struck me as beingsignificant was that there is a
difference, fundamentally, insome of the philosophies that
underpin, you know, the NDIS andthe disability sector and the
mental health sector.
So in mental health, we think alot about recovery, we talk a
(26:03):
lot about recovery.
We believe that you know people, it will take different amounts
of time and different inputs.
But you know, we genuinely dobelieve that people recover from
mental illness and indisability.
When somebody has a permanentdisability, of course there's a
different framing around that.
So I think there was, rightfrom the start, there was sort
(26:25):
of some foundationalincompatibilities in the way
that we think about these things, and what that meant is that
then trying to design responsesor trying to design
accessibility criteria becamereally complicated.
We do know that there areindividuals who have enduring
(26:47):
mental health issues from whichthe impact is significant and
journeys with them over time,and that's where the thinking
around this being a psychosocialdisability comes in.
This condition, this experiencethat I have, limits my ability
to be able to participate insociety.
(27:07):
It might limit my independence,it might mean that I require
support and I might requirethose things over a long period.
So it's a nuance.
There's, you know, there's very, like you said, very technical
and sort of philosophicalunderpinnings to those
constructs.
There has been, you know, somemisalignment, I think, in those
(27:31):
concepts and how they've beenapplied.
That has resulted in thesituation that we're in at the
moment, where there is someuncertainty around.
Well, how do people with youknow mental health issues,
enduring mental health issues,experiencing, you know,
structural or socialdisadvantage because of that.
How do they fit in to thesystem?
Where do they fit?
And we're working wherever inand across Australia, we're
(27:55):
advocating to governments toprovide some clarity on the
future of that.
There is uncertainty acrossAustralia, and that's another
stress for people.
It's a stress for providers,and particularly for groups of
people who, when we think aboutthe origins of mental illness
and we think about people'sexperiences of trauma and where
(28:17):
trauma plays out inrelationships, and so we've got
folks who've been engaging withNDIS services through
psychosocial supports, who havebuilt up relationships, and
that's not necessarily easy,because relationships haven't
always worked out well, you know, for folks who who've got an
experience of trauma.
So these changes are reallysensitive, and we have to think
(28:41):
about what impact these changeswill make and how we can work
with people to support themthrough any change.
The way that we approach this,though, needs to be informed by
clarity on what the future lookslike, and, unfortunately, at
the moment, we don't have that.
Speaker 5 (28:57):
It's probably quite hard to get lifelong mental
health supports, pip, you knowin.
You know in the mental healthservice system.
So where the NDIS has kind ofstepped in, you know, supports
for those day-to-day functionsof living for people who have a
lifelong mental illness havebeen wonderful.
But I think that the change andchanges are happening
everywhere is that, you know,with foundational supports some
(29:18):
of that will change and will nolonger be part of the NDIS too.
I mean, I guess that's the sortof stuff that you're probably
hearing from your members, pip.
Speaker 6 (29:26):
Yeah, and concern about you know, obviously there
have been changes in you knowthe funding arrangements for
these kinds of services thatoccurred when we made that
transition to the NDIS.
So there are real questionsaround, not just what it's going
to look like, but who's goingto be providing these services,
(29:47):
where are they going to be?
They're big questions, bethey're big questions and
thinking about.
Are the services going to besuitable and appropriate to
support people over that longerperiod around maintaining
stability in their mental healthbut also being able to make
(30:11):
progress towards their personalgoals around?
You know what living ameaningful and contributing life
looks like.
It's different for everybody,but for somebody who's
experiencing a psychosocialdisability, having support that
can work alongside them over alonger period is really
(30:31):
important.
Speaker 5 (30:33):
I think you know, across all of this conversation,
the thing that still strikes meis how complicated and
difficult this service system is, how hard it is for people to
navigate consumers, carers,families, sometimes even for
service providers and how is allof this stitched together?
And I think a lot.
You know what.
I think that you know, pip,we're lucky, you know, to A a
have you on the podcast.
I mean, you're a tremendousadvocate and mental health,
(30:55):
victoria, you know, really leadsthe way.
I think, when it comes toputting these pieces together to
inform policy, practice andthinking.
It's such a crucial rolebecause otherwise we just have
this bowl of spaghetti that noone can kind of, you know, work
their way through.
Right, it's just so difficultand so hard and I think people
listening will feel like crikey.
(31:16):
There are all of thesedifferent bits and how does any
of this stitch together andchange?
You know the role that you'replaying here is huge in this,
pip.
So you know we were obviouslylucky enough to have you as a
guest on a panel at our 2025Complex Needs Conference, where
you were talking a lot aboutcomplexity and service system
complexity and having tonavigate those parts being, you
(31:38):
know, really difficult.
And you know, I've seen youobviously speak at other events
and you've recently again justpublished some thoughts with
other peak bodies as well andI'm probably going to get the
name of this one wrong, becauseagain I stumble over words the
royal australian and new zealandcollege of psychiatrists, and
you've released a position paperon the role of mental health
(31:59):
services in the delivery of drugand alcohol treatment and care
and support, which again is ahuge thing, isn't it?
People will often say whichcame first, the drug and alcohol
problems or the mental healthchallenges, and then when you
put those things together, it'syou know, it's quite difficult.
Speaker 6 (32:15):
It is, and we're humans, right, we're complex
beings.
We're never simple tounderstand, and one of the
challenges that lots of peoplein the community face is not
knowing the right place to go toget help.
What if you know if I've gotthis particular need?
What if I've got two needs?
And, equally, for people tryingto provide services as well,
(32:37):
who will be talking to peopleand identifying?
Oh gosh, you know, look, itsounds like there are some
mental health issues here, but,you know, a significant
contributor is, you know, thesubstance use that's occurring.
And so you know, in order todeal with one, well, we need to
deal with the other.
But the systems are separatedand there's really complicated
(32:59):
and maybe not so complicated,but there's some boring policy,
funding and governance issuesthat contribute to those systems
being separated into the silosthat people experience.
That makes finding the rightcare at the right time a lot
harder.
(33:19):
And I think in Victoria at themoment, we have been trying to
raise awareness with you know,the government and with the
Department of Health as stewardsof our system, that, while
we're really happy to be seeinginvestment in new types of
services across the state, thenature of the implementation,
(33:42):
the way that it's working hasprobably created more confusion
for people, not knowing where togo, not knowing which service
is right for them, and ourposition paper on the alcohol
and other drug system and themental health service
contribution to that system wasreally Mental Health Victoria
(34:03):
and the College of Psychiatristsas leaders in the sector, as
representatives of the mentalhealth service system, to be
able to say to government weneed to be more intentional in
our planning about this.
We need to remove unnecessarybarriers, we need to be really
(34:24):
clear about what we're talkingabout in our vision for
accessibility for people whoexperience co-occurring mental
health and alcohol and otherdrug needs, and make it seamless
for people to walk through thatsystem.
One of the challenges thatpeople face is that you don't
(34:46):
come prepared with a detailedmap and knowledge of
accessibility criteria orrequirements for mental health
services.
We're not born with it and sooftentimes when people are
needing to access those services, unfortunately it's occurring
at a point of crisis and youknow crisis situations um are
(35:10):
not the right time to be tryingto learn new information, and so
having you want.
Speaker 5 (35:16):
You want the response then?
Speaker 6 (35:18):
though, don't you when you're in that crisis, you,
you can't wait.
Speaker 5 (35:20):
You know that's right , it's the same.
Back to the broken leg, isn'tit?
You're not going to sit andwait.
You need that leg x-rayed.
You need the plaster cast orwalking boot, you need it sorted
now.
Speaker 6 (35:42):
But if you have to spend I don't know eight hours,
you know, on Google or textmessaging people or calling the
wrong places to find out whereyou fit in a system, all that's
going to do is exacerbate thecrisis that you're in and make
you feel more isolated.
So we've been talking a lotwith both sides of politics
about the importance ofsupporting system navigation,
making it easy for people tofind their way around.
In Victoria at the moment.
(36:03):
We are really happy to see thegrowth of those community mental
health providers, but we have alandscape that has local mental
health and wellbeing services.
There are head to healthclinics, there are mental health
and wellbeing hubs, medicaremental health locals.
(36:26):
How does the average Victorianunderstand where they're meant
to go?
And what if you're in a part ofVictoria where none of those
things exist at the moment?
Where do you go?
Where do you fit where?
Where are the answers to thesequestions?
Who helps you?
And I think, for me.
As you know a former clinician,but also somebody who's, you
(36:47):
know, worked in theadministration of mental health
I know personally that not aweek goes by where I don't get a
text message from somebodysaying oh, oh yeah, can you help
?
Speaker 5 (36:58):
Can you help my daughter, my son, my sister?
Speaker 6 (37:02):
Yeah, yeah, and I'm disappointed to say that it's
not always easy actually toprovide the answer no it's not,
and if I can't answer thosequestions easily and make those
connections happen, then who can?
Speaker 1 (37:17):
I don't know who can what?
Speaker 5 (37:17):
chance have they got Pip?
What chance have they got?
Exactly happen, then who can?
Speaker 6 (37:20):
like I just I don't know who can exactly.
Yeah, so we have a, you know.
So investment is great, butinvestment and funding and
announcements are very, verydifferent to reform.
And, yeah, the those importantthings you know are often can be
, you know, more difficult tomeasure or perhaps, you know,
aren't as exciting to announce,but they're things that are
(37:41):
actually going to make adifference and we are really
calling on the Victoriangovernment to think carefully
about the investment, about whatthe right next steps are to
make sure that they areimproving things for Victorians
today.
Yes, we're four years in.
We need to start seeing thosethings changing.
Speaker 5 (38:02):
I 100% agree.
I just want to kind of end bysaying what a phenomenal role
Mental Health Victoria plays.
People will be listening.
They'll be wanting to know moreabout your services.
How can they become members tofind out more about the really
important advocacy that you'redoing, the way that you're
bringing all of the parts of theservice system together to
(38:23):
facilitate reform and facilitatechange?
How can people find out moreabout your work?
How can they get in touch?
How can they even join thiswork?
Speaker 6 (38:32):
Well, people can reach out to us.
They can access our website,follow us on LinkedIn for some
of our commentary.
We've got information on thewebsite about you know the work
that we do, who we work with,how we do it.
There's also the ability tosubscribe to our e-news.
We put out a newsletter everyfortnight and that's not just
(38:56):
limited to our members, sothat's something that we
encourage anybody to access sothat you know you can be a part
of the conversation.
You can hear about the thingsthat we're talking about, and it
gives people the opportunity,if they think that we're missing
something or they want to makea contribution, to be able to
join in and be a part of thatconversation.
Speaker 5 (39:13):
I love it and we'll include all of the information
in our show notes as part ofthis episode.
What an awesome job you do.
I know you don't have a hugeamount of money as an
organisation.
Mhv you well and truly, youknow, do such a huge amount of
work for our community.
You're fearless advocates.
You are in there always talkingabout mental health and, you
(39:35):
know, looking to get the rightsupports for people.
So you know, I think, on behalfof every consumer, carer,
family member in this state, ahuge thank you, because I think
that message about saving livesis such a big thing and
sometimes this is what it is,this is what it comes down to.
So, yeah, please keep doing allof the things that you do at
(39:55):
Mental Health.
Victoria I mean, emma, we'rehuge supporters.
We love your work.
We are completely biased,obviously, because we've chosen
to be members as well of such areally important peak body.
I just really want to end onthat note.
So a huge thank you for joiningus, pip.
Speaker 6 (40:09):
Thank you so much for the time and for the
conversation.
Speaker 2 (40:12):
You've been listening to Get Real talking mental
health and disability, broughtto you by the team at Irma 365.
Get Real is produced andpresented by Emily Webb, with
Corenza Louis-Smith and specialguests.
Thanks for listening and we'llsee you next time.
Get Real is recorded on the unceded lands of the Boon
, Wurrung and Wurundjeri peoplesof the Kulin Nation.
We acknowledge and pay ourrespects to their elders, past
and present.
We also acknowledge that theFirst Peoples of Australia are
the first storytellers, thefirst artists and the first
creators of culture and wecelebrate their enduring
(00:21):
connections to country knowledgeand stories.
Celebrate their enduringconnections to country knowledge
and stories.
Speaker 2 (00:28):
Welcome to Get Real talking.
Mental health and disabilitybrought to you by the team at
Burma 365.
Speaker 1 (00:34):
Join our hosts, Emily Webb and Carenza Louis-Smith,
as we have frank and fearlessconversations with special
guests about all things mentalhealth and complexity with
special guests about all thingsmental health and complexity.
Speaker 3 (00:49):
We recognise people with lived experience of mental
ill health and disability, aswell as their families and
carers.
We recognise their strength,courage and unique perspective
as a vital contribution to thispodcast so we can learn, grow
and achieve better outcomestogether.
Speaker 4 (01:12):
Welcome to Get Real talking mental health and
disability.
I'm Emily Webb.
We are a few weeks on from the2025 Australian federal election
, which resulted in a more thanconvincing victory for the
incumbent Labor government ledby Prime Minister Anthony
Albanese.
So, as the federal governmentbegins its new term and we await
(01:34):
the Victorian government'sstate budget, my co-host and
Irma365 CEO, carenza Louis-Smith, thought it was a good time to
catch up with Mental HealthVictoria's CEO, philippa Thomas,
to talk about what mentalhealth reform and investment
will look like for Australia.
Speaker 5 (01:56):
So excited, pip, to have you join, get Real.
And these are the conversationsthat we love.
You know the frank and fearlessconversations, and our topic
today really is mental healthand what's happening in the
federal, I guess, landscape herein Australia, but also what's
going on in Victoria too.
But let's start a little bitfirst about Mental Health
Victoria.
I mean, you're the peak bodyfor mental health services here
(02:17):
in Victoria and you know we'relucky to have you, as the CEO,
join us.
Give us a.
You know people that perhapsdon't know MHV.
What does Mental HealthVictoria do?
Speaker 6 (02:32):
Yeah, it's a different kind of mental health
organisation, isn't it?
It's very different MentalHealth Victoria to maybe some of
the other names in the mentalhealth landscape that people
would be familiar with, thingslike maybe Movember or Beyond
Blue that have a differentprofile and a different focus
and engagement with thecommunity.
But the role of Mental HealthVictoria and any other peak body
is to be a translator, acommunicator, between decision
(02:54):
makers, so governments andfunders and the sector that
implements the policy andresponds to the community need
that the decisions about thatparticular portfolio area are
about.
So in Victoria, mental HealthVictoria, because of the design
of Victoria's mental healthsystem, we as a peak body
(03:14):
represent a couple of differentkinds of services and we think
really holistically about all ofthe mental health sector in
Victoria.
So we have conversations andrepresent the views of the acute
and clinical sector, so thehospital and health service
providers.
We represent the non-governmentorganisations, so those
(03:36):
organisations that typically arebased more in the community,
and we also work with privateproviders to understand what
they're contributing to themental health landscape in
Victoria so that we can giveadvice to government and
advocate for policy and forinvestment that is going to
(03:58):
ensure that every Victorian hasaccess to the enablers of
positive mental health andwellbeing.
So that's about thinking aboutmental health policy.
In Victoria We've got a hugefocus on mental health reform,
but it's also thinking about theother kinds of policy domains
and factors that affect people'smental health outcomes, and so
(04:18):
we work really closely tounderstand what's happening in
the community.
What's influencing theirexperience of mental health,
what's their experience oftrying to access services like,
and how can we raise awarenessof those issues on the
community's behalf to influencechange.
Speaker 5 (04:35):
Such a really important piece, isn't it?
Because when I think about theRoyal Commission here in
Victoria, what it kind of saidwas this is a really hard system
to navigate, like, if you needmental health supports, it's
really hard to work out where togo, how to get supports when
where you need them, how youneed them.
So the role that you're talkingabout that Mental Health
Victoria plays in this isbringing everyone together
(04:57):
because ultimately, I think wehave the same shared view that
we want the best mental healthsupports for people, don't we in
the community?
Speaker 6 (05:09):
when, where and how they need them the most.
Yeah, that's right, and itmeans having a really clear
understanding of what that lookslike for the community, and
it's about you know to yourpoint.
It's about accessibility havingservices that are accessible.
It's also about understanding,particularly when you're working
in an area like mental health,where there still is,
unfortunately, quite a bit ofresidual stigma around mental
(05:29):
health, and a lot of folks willoften delay help seeking because
of that stigma.
It's also really important,then, that when we're thinking
about accessibility, that we'realso thinking about what
acceptability of those serviceslooks like.
So it is so important thatwe're having conversations to
understand Victorians and tounderstand what a mental health
(05:53):
service could and should looklike in order for them to feel
comfortable and confident to goand engage with that service.
Speaker 5 (06:02):
So I'd like to talk a bit about the advocacy that you
do.
That start there.
So I mean, I'm looking.
Obviously I'll come back to theVictorian landscape.
But on the big national stageand national scale, one of the
things that really stood out tome is the what we now call
Medicare mental health centres.
Other people might have knownthem as head to health, but NHV,
you know you actuallyco-designed this model.
(06:24):
You know of these big centresright around the country and so
through your advocacy you wereable to persuade the federal
government to invest in theseand now we're starting to see
these pop up in all sorts ofplaces in Australia and again,
really driven by what you'retalking about, what consumers
are saying, what services weresaying, but actually being able
(06:45):
to have that voice to government, which I think is a really
important part of the work thatyou do but what an impact on the
national stage that has been.
Speaker 6 (06:54):
MHV is so proud of that contribution that we were
able to make.
That was a piece of work led, Ithink, late.
We developed the model late in2018, before my leadership, so I
must acknowledge the role ofour former leader, gus Cleland,
in that work.
That was a great example of MHVworking with the sector through
(07:17):
policy networks andcollaborating, thinking about
the experience of people tryingto access services and noticing
an opportunity for improvementand spending that time thinking
about what that could look like.
The outcome of that at the timein the federal budget the 2019
federal budget that resulted inan investment of about $115
(07:40):
million over five years to trialthose centres across Australia
and of course, you know the sortof prototype of that obviously
was integrated into the RoyalCommission recommendations here
in Victoria, which is a reallypositive thing.
You know there's a similarmodel in the local mental health
and wellbeing centres, but atthe time, I think the Minister
(08:02):
set a vision that they wouldlike to see.
The government would like tosee over 100 of these across the
country and of course, nowwe're seeing, as an outcome of
the last federal budget, I thinkyou know, over 90 in Australia.
So that's a great example ofhow peak bodies can really drive
the change and be of service togovernment by being that
(08:24):
connection between what peopleare observing, what people need,
and being able to have themechanism to be able to put all
of that together and be a bitpropositional with government
with a solution.
Super important work.
Speaker 5 (08:38):
You had launched a groundbreaking report at the
time.
It was called Saving Lives,Saving Money.
It was a very powerfulstatement as to actually, if
governments did this, they couldnot just save lives, they would
actually save some of the spendand things they were doing.
How did you kind of work thatout that by doing this it would
be beneficial in so manydifferent ways?
Speaker 6 (08:59):
Yeah, it comes from working really closely with
experts in the sector andworking with service providers
to be able to get really closeand understand the trajectory of
illness and, when opportunitiesare missed, what the
consequences of that are.
So, understanding what preventspeople getting earlier care,
(09:23):
understanding what might preventyou know the efficacy of that
care, understanding how thingslike geography might affect your
ability to access services andthen being able to look at well,
okay, the need doesn't go awayjust because somebody didn't
access services earlier, whereit's most likely to present
itself later in a higher costenvironment.
(09:47):
And we know from the evidencethat the longer we leave mental
illness untreated, the harder itcan be to treat and the more
distressing it is for theindividual and their family.
And by that point, what we alsosee in the Productivity
Commission often will thinkabout things like this but the
economic participation of people, their ability to go to work,
(10:11):
their connection with communitythat decreases and that
ultimately costs money.
We want Australians to be, weneed Australians to be thriving,
we need them to be contributingto community, to our economy.
And so, thinking about the costopportunity, there was, I think
(10:32):
, probably for a match made atthe time, pretty obvious that we
were spending a lot of money onthings just too late and that
we really could be doing a lotbetter and seeing a lot better
outcomes earlier.
Speaker 5 (10:44):
I think it kind of the analogy I like to give is
you know, when you've got abroken leg, you know you're not
going to go to ED and they say,oh, that's going to be fine,
walk on it for the next sixmonths, you know, and then the
surgery that you need is verydifferent.
It's the same kind of thing,isn't it?
What you're talking about hereis actually, if we have what
we're now calling the MedicareMental Health Centres a bit of a
mouthful, but if we, you know,have those and you can walk in
(11:06):
at any point and any timewithout a referral to get
support earlier, earlier what animpact that has.
Speaker 6 (11:15):
Yeah, and I think you know to draw on that.
You know that analogy of thebroken leg.
We wouldn't put a clinic abroken leg clinic on a 14th
floor with only stairs to getthere, right, so it requires
thinking about where do youlocate it?
What are the things that aregoing to make it more accessible
to the person so that when theyhave that moment that they need
(11:36):
it, it's really easy for themto get there?
Speaker 5 (11:40):
And I think, if we look at the last, you know,
crikey, it's been five yearsright since we went into the
COVID lockdown.
That blew my mind and that cameup on my Facebook feed actually
just the other day and I wasthinking, oh my goodness, did we
really do all of these things?
Speaker 6 (11:53):
Did it inspire you to make some sourdough Corinza?
It did not.
Speaker 5 (11:57):
Pip.
It got me thinking.
You know, and you know we'vehad all of that.
You know which was huge, Ithink, in Victoria that
significant lockdown, the impactthat's had on people's mental
health.
We've now got what we'recalling the cost of living
crisis.
You know, everything is skyhigh.
People are more worried thanthey've ever been, more
concerned about how am I goingto, you know, make ends meet?
(12:18):
How am I going to buy stuff formy kids?
Can't afford for my kids tojoin this club.
What are the things that I letgo?
You know, I think people'smental health, or the what's the
word I'm looking for it'sworsened.
I think that's the word I'mlooking for broadly across the
whole of the community.
In this last five years, theneed for these kind of programs
and services has never been moreimportant than it is now, in my
(12:42):
view.
Speaker 6 (12:43):
That's right.
You know it was reallyinteresting to see our
colleagues at Mental HealthAustralia, in the lead up to the
federal budget and in the leadup to the election, release a
survey that they undertook where, you know, nearly 60% of
Australians were reporting whoresponded to their survey were
reporting that cost of livingincreases had negatively
(13:04):
impacted their mental health.
If the system that provides aresponse to that also requires
you to pay money to be able toaccess to the right
professionals in a timely way inthe right place, then it's just
a barrier that begets anotherbarrier.
So these kinds of services,like the Medicare mental health
(13:27):
centres, are really importantbecause they remove that barrier
and that's never been moreimportant than now.
I think also coming out of COVIDor the experience of COVID
raised people's awareness aboutmental health and that's a
really good thing.
(13:47):
I think what it has done isit's probably shaped help
seeking, and so it's reallyimportant that we've got the
right services and theavailability and the capacity to
be able to meet the demandthat's been created, because
people are identifying, as wewant them to do earlier, that
you know, I think something'saffecting my you know my mental
(14:08):
health and I want to engage withsomebody to improve.
You know how I'm feeling, sothis doesn't get worse.
So it's really important thatthose services are available.
Speaker 5 (14:16):
You're absolutely right.
That is so not okay.
So, pip, you obviously play atMHV a huge role in advocacy and
you know I think the Medicaremental health centres nationally
are fantastic, you know, andthat advocacy is huge and you
know you're speaking on behalfof all of your members as well.
You know the hundreds of peopleand thousands of people that
(14:37):
work in mental health servicesthat see every day all of these
challenges.
Now, obviously, we're talkingabout the national level.
We've got a Labour government.
They've been re-elected.
They made some pledges as wellabout mental health services and
wanting to continue to investin mental health.
What were your thoughts aroundthat?
And obviously, the continuationof those Medicare mental health
(14:59):
centres as well.
Speaker 6 (15:01):
Yeah, look, it was really pleasing to see that
public commitment.
It was pleasing to see thatpublic commitment, I think, from
both sides of politics.
It was pleased to see the publiccommitments came relatively
early, and so what that tells usis that our politicians hear
and understand that this is anissue that matters to
(15:23):
Australians and you know, Ithink at the time about 81% of
Australians were saying it wasmental health was an issue that
they were concerned about.
When I think about theinvestment commitment, the
devil's always in the detail,right, and so I think what I'm
curious to understand is how weare going to work on the
(15:46):
enablers of those investmentsbeing successful and impactful.
So my mind, my questionsnaturally, as a recovering
bureaucrat who's worked onimplementation, my mind
naturally starts to wonder aboutthings like okay, well, what
does the workforce look like?
(16:07):
How ready are we to do this?
You know, what are the sorts ofthings that we might be able to
do to expedite rate limitingfactors like the availability of
workforce, so that we can getthese services up and running
and working effectively?
I think we've seen thisexperience in Victoria with the
(16:27):
local mental health andwellbeing services.
We have 15 of those.
Speaker 5 (16:31):
That's great, but the time that it takes.
That doesn't scratch thesurface, though, does it, pip?
Let's be honest.
Speaker 6 (16:37):
No, not even nearly.
And also, without thinkingreally carefully about those
implementation enablers.
What happens is, you know, thecommitment to stand them up goes
out there, the work starts, butactually the lead time for
those services to actually beable to deliver impact can be
(16:57):
quite long.
So it's really important, Ithink, coming out of, you know,
this election and having thatbudget commitment I mean, one of
the things that we can begrateful for is that we haven't
had a change in minister.
I think that will make things alot easier to progress.
This working with a ministerwho's already, you know,
demonstrated commitment andworked effectively in the
(17:18):
portfolio going to help.
But it is going to necessitatesome real reflection and some
real reform, thinking about, ifwe want these centres to work,
you know, what can we dodifferently to make it happen
sooner and to not experiencethat delay.
(17:38):
We heard that in Victoria,coming out of the last budget,
that there was no investment infurther locals in this financial
year because government feltthat the availability of
workforce wasn't there, and sowhen we're hearing messages like
that, what we need to see isnot just the announcement on
we're going to build thesethings and the number of how
(18:00):
many there are.
We actually need to hear.
Well, what are you going to do,though, to make this achievable
and possible and to deliver onyour promise?
Speaker 5 (18:08):
Let's go to the Victorian context then, because
you know the Royal Commissionwas quite groundbreaking here.
I mean, you know, it was brutalin some ways and hard to read
the experiences of people thathad tried, unsuccessfully, to
get mental health supports andsome of the really tragic
stories where people had diedwaiting to get.
(18:30):
You know that you can'tsugarcoat that waiting to get
the treatment and supports andthings that they needed.
So I mean it's really, reallyimportant we're about to come
into a state budget, you know,and the Royal Commission made a
number of recommendations, andthat they also included a levy
which taxpayers are paying.
You know, let's be a little bitcontroversial now to actually
fund these mental healthprograms and services.
(18:50):
You know, so, as the peak body,you know, you've been
incredibly vocal at a federallevel and you know that
investment in those Medicaremental health centres which
you've co-designed is huge.
How is Mental Health Victoriaworking with all of its members
to, you know, to hold thisgovernment to account for all
the things that the RoyalCommission recommended and the
(19:10):
government said it would do?
Speaker 6 (19:12):
Well, I think.
Firstly, mental Health,victoria.
We strongly support the mentalhealth levy, but we think the
need for transparency around theallocation of the revenue
that's generated by that levy isreally important.
This is an additional tax onVictorian business, and
(19:36):
Victorian businesses have aright to understand how that
money is being spent.
Speaker 5 (19:43):
I think you're right, pip.
No one would disagree thatspending money on mental health
is bad.
I think anyone and everyonewho's stopped them in the street
, they would all say, yes, Ithink this is a great thing to
do, but where is it?
Where is it going to be andwhat does it look like?
I would be asking, that's right.
What?
Speaker 6 (19:58):
are the outputs and what are the outcomes?
So there's a difference betweenspending money and spending
money well.
And so thinking carefully abouthow the allocation of that
really precious resource isallocated is really important,
and also working really closelywith the community and with the
(20:21):
sector to understand really well, before those allocations are
made, whether that investment isthe right investment.
Is it the right time?
Are we approaching it in theright way?
That's really important.
So we're not wasting money,we're not missing opportunities.
Speaker 5 (20:39):
I think everyone listening to this podcast would
100% agree with you.
So, pip, what do you think theVictorian government should be
doing?
You're obviously listening toall of the mental health
services, whether they'reclinical, whether they're
community-based.
You're also listening to peoplethat access those services, to
consumers, families, carers.
What are you hearing?
(21:00):
What do you think if you couldtalk to the Victorian government
on both sides of parliament,all sides of parliament,
government?
What are you hearing?
Speaker 6 (21:11):
Well, look, we're lucky enough to have the
opportunity fairly frequently tospeak to people on all sides of
politics here in Victoria aboutthese issues, and I would
comment that on both sides ofpolitics there is an interest
and a commitment to this as anissue.
My messaging, you know we're atyear four now, post the Royal
(21:34):
Commission, and my messaging toboth sides of government has
really been about the importanceto exercise situational and
contextual leadership.
The Royal Commission wasundertaken at a particular point
in time.
It had a terms of referencethat was not exhaustive, it had
(21:55):
a limited scope, it was quiteretrospective in its analysis,
and so it was, you know,learning from things that had
happened in the past.
And one of the things obviouslythat wasn't apparent, you know,
to those working on the RoyalCommission was that we were
going to go through COVID.
That significantly, you know,context changing situation here
(22:20):
in Victoria.
And so my message to governmentis very much that we need to be
working really closely with thesector and with the community
to understand new and emergingissues, to not think solely
about reform and sort of take atick box approach to
(22:41):
implementing particular projectsin silos, that we're at a point
here in Victoria where we'veinvested over $6 billion into
this reform so far.
Speaker 5 (22:53):
That's a lot of money , isn't?
It that is a huge amount ofmoney.
Speaker 6 (22:57):
It is huge, and so it's only right that we're
starting to that.
We need to have answers tothose questions about are we
seeing any impact?
Have we put the investments inthe right place?
Are there steps, perhaps, thatwe missed that we need to go
back on?
Are we paying enough attentionto the parts of the sector that
aren't the focus of reforminitiatives to be able to
(23:21):
anticipate changes in whatthey're able to do or the demand
that they're experiencing orthe health of those particular
parts of the sector?
So my messaging to governmenthas, or to both sides of
politics, has been about reallyneeding to take some time to
(23:42):
work really intentionally withthe community, with the sector,
with peak bodies, to make surethat what we're doing is right.
We could continue to spend alot of money and a lot of time
and not see the change or theimpact of the change that this
Royal Commission and that thisgovernment promised us.
Speaker 5 (24:01):
When I think about reforms as well.
We've.
Obviously I can't talk aboutthe end.
You know anything withouttouching on the NDIS.
We're about to see huge changein the NDIS around what's called
foundational supports, and soat the start of the NDIS, you
know, a number of people who hadwhat you know is defined as a
psychosocial disability foundthemselves in the NDIS system
(24:21):
rather than in the mental healthservice system.
Just for our listeners,psychosocial disability and
mental health, right, are theythe same or are they different?
Like what's the?
You know the differentlanguages and different terms.
And why are some people in theNDIS and some people not in the
NDIS?
And I don't know if that'ssomething you can answer, that's
just a very technical question.
Speaker 6 (24:41):
It is a technical question, but it's a good
question because I think it's aquestion that you know there
will be a lot of Australians whoare needing to access services,
who will be facing the dilemmaof trying to understand why they
fit in a particular part of thesystem or not in another, or
perhaps nowhere.
I think my sense of this isthat, you know, the ambitious
(25:02):
design of the NDIS looked torespond to permanent and
enduring disability and thatconsiderations of enduring
mental health issues and theirimpact on a person's ability to
live their best life would alsorequire some responsiveness.
(25:22):
But I think the design aroundthat for people with mental
health, with psychosocialdisability, in the NDIS probably
could have done with a bit morethought.
And so, post this review of theNDIS, we are seeing those
changes and I think when I firststarted thinking about, or when
(25:43):
I first started interactingwith, the implementation of the
NDIS, what struck me as beingsignificant was that there is a
difference, fundamentally, insome of the philosophies that
underpin, you know, the NDIS andthe disability sector and the
mental health sector.
So in mental health, we think alot about recovery, we talk a
(26:03):
lot about recovery.
We believe that you know people, it will take different amounts
of time and different inputs.
But you know, we genuinely dobelieve that people recover from
mental illness and indisability.
When somebody has a permanentdisability, of course there's a
different framing around that.
So I think there was, rightfrom the start, there was sort
(26:25):
of some foundationalincompatibilities in the way
that we think about these things, and what that meant is that
then trying to design responsesor trying to design
accessibility criteria becamereally complicated.
We do know that there areindividuals who have enduring
(26:47):
mental health issues from whichthe impact is significant and
journeys with them over time,and that's where the thinking
around this being a psychosocialdisability comes in.
This condition, this experiencethat I have, limits my ability
to be able to participate insociety.
(27:07):
It might limit my independence,it might mean that I require
support and I might requirethose things over a long period.
So it's a nuance.
There's, you know, there's very, like you said, very technical
and sort of philosophicalunderpinnings to those
constructs.
There has been, you know, somemisalignment, I think, in those
(27:31):
concepts and how they've beenapplied.
That has resulted in thesituation that we're in at the
moment, where there is someuncertainty around.
Well, how do people with youknow mental health issues,
enduring mental health issues,experiencing, you know,
structural or socialdisadvantage because of that.
How do they fit in to thesystem?
Where do they fit?
And we're working wherever inand across Australia, we're
(27:55):
advocating to governments toprovide some clarity on the
future of that.
There is uncertainty acrossAustralia, and that's another
stress for people.
It's a stress for providers,and particularly for groups of
people who, when we think aboutthe origins of mental illness
and we think about people'sexperiences of trauma and where
(28:17):
trauma plays out inrelationships, and so we've got
folks who've been engaging withNDIS services through
psychosocial supports, who havebuilt up relationships, and
that's not necessarily easy,because relationships haven't
always worked out well, you know, for folks who who've got an
experience of trauma.
So these changes are reallysensitive, and we have to think
(28:41):
about what impact these changeswill make and how we can work
with people to support themthrough any change.
The way that we approach this,though, needs to be informed by
clarity on what the future lookslike, and, unfortunately, at
the moment, we don't have that.
Speaker 5 (28:57):
It's probably quite hard to get lifelong mental
health supports, pip, you knowin.
You know in the mental healthservice system.
So where the NDIS has kind ofstepped in, you know, supports
for those day-to-day functionsof living for people who have a
lifelong mental illness havebeen wonderful.
But I think that the change andchanges are happening
everywhere is that, you know,with foundational supports some
(29:18):
of that will change and will nolonger be part of the NDIS too.
I mean, I guess that's the sortof stuff that you're probably
hearing from your members, pip.
Speaker 6 (29:26):
Yeah, and concern about you know, obviously there
have been changes in you knowthe funding arrangements for
these kinds of services thatoccurred when we made that
transition to the NDIS.
So there are real questionsaround, not just what it's going
to look like, but who's goingto be providing these services,
(29:47):
where are they going to be?
They're big questions, bethey're big questions and
thinking about.
Are the services going to besuitable and appropriate to
support people over that longerperiod around maintaining
stability in their mental healthbut also being able to make
(30:11):
progress towards their personalgoals around?
You know what living ameaningful and contributing life
looks like.
It's different for everybody,but for somebody who's
experiencing a psychosocialdisability, having support that
can work alongside them over alonger period is really
(30:31):
important.
Speaker 5 (30:33):
I think you know, across all of this conversation,
the thing that still strikes meis how complicated and
difficult this service system is, how hard it is for people to
navigate consumers, carers,families, sometimes even for
service providers and how is allof this stitched together?
And I think a lot.
You know what.
I think that you know, pip,we're lucky, you know, to A a
have you on the podcast.
I mean, you're a tremendousadvocate and mental health,
(30:55):
victoria, you know, really leadsthe way.
I think, when it comes toputting these pieces together to
inform policy, practice andthinking.
It's such a crucial rolebecause otherwise we just have
this bowl of spaghetti that noone can kind of, you know, work
their way through.
Right, it's just so difficultand so hard and I think people
listening will feel like crikey.
(31:16):
There are all of thesedifferent bits and how does any
of this stitch together andchange?
You know the role that you'replaying here is huge in this,
pip.
So you know we were obviouslylucky enough to have you as a
guest on a panel at our 2025Complex Needs Conference, where
you were talking a lot aboutcomplexity and service system
complexity and having tonavigate those parts being, you
(31:38):
know, really difficult.
And you know, I've seen youobviously speak at other events
and you've recently again justpublished some thoughts with
other peak bodies as well andI'm probably going to get the
name of this one wrong, becauseagain I stumble over words the
royal australian and new zealandcollege of psychiatrists, and
you've released a position paperon the role of mental health
(31:59):
services in the delivery of drugand alcohol treatment and care
and support, which again is ahuge thing, isn't it?
People will often say whichcame first, the drug and alcohol
problems or the mental healthchallenges, and then when you
put those things together, it'syou know, it's quite difficult.
Speaker 6 (32:15):
It is, and we're humans, right, we're complex
beings.
We're never simple tounderstand, and one of the
challenges that lots of peoplein the community face is not
knowing the right place to go toget help.
What if you know if I've gotthis particular need?
What if I've got two needs?
And, equally, for people tryingto provide services as well,
(32:37):
who will be talking to peopleand identifying?
Oh gosh, you know, look, itsounds like there are some
mental health issues here, but,you know, a significant
contributor is, you know, thesubstance use that's occurring.
And so you know, in order todeal with one, well, we need to
deal with the other.
But the systems are separatedand there's really complicated
(32:59):
and maybe not so complicated,but there's some boring policy,
funding and governance issuesthat contribute to those systems
being separated into the silosthat people experience.
That makes finding the rightcare at the right time a lot
harder.
(33:19):
And I think in Victoria at themoment, we have been trying to
raise awareness with you know,the government and with the
Department of Health as stewardsof our system, that, while
we're really happy to be seeinginvestment in new types of
services across the state, thenature of the implementation,
(33:42):
the way that it's working hasprobably created more confusion
for people, not knowing where togo, not knowing which service
is right for them, and ourposition paper on the alcohol
and other drug system and themental health service
contribution to that system wasreally Mental Health Victoria
(34:03):
and the College of Psychiatristsas leaders in the sector, as
representatives of the mentalhealth service system, to be
able to say to government weneed to be more intentional in
our planning about this.
We need to remove unnecessarybarriers, we need to be really
(34:24):
clear about what we're talkingabout in our vision for
accessibility for people whoexperience co-occurring mental
health and alcohol and otherdrug needs, and make it seamless
for people to walk through thatsystem.
One of the challenges thatpeople face is that you don't
(34:46):
come prepared with a detailedmap and knowledge of
accessibility criteria orrequirements for mental health
services.
We're not born with it and sooftentimes when people are
needing to access those services, unfortunately it's occurring
at a point of crisis and youknow crisis situations um are
(35:10):
not the right time to be tryingto learn new information, and so
having you want.
Speaker 5 (35:16):
You want the response then?
Speaker 6 (35:18):
though, don't you when you're in that crisis, you,
you can't wait.
Speaker 5 (35:20):
You know that's right , it's the same.
Back to the broken leg, isn'tit?
You're not going to sit andwait.
You need that leg x-rayed.
You need the plaster cast orwalking boot, you need it sorted
now.
Speaker 6 (35:42):
But if you have to spend I don't know eight hours,
you know, on Google or textmessaging people or calling the
wrong places to find out whereyou fit in a system, all that's
going to do is exacerbate thecrisis that you're in and make
you feel more isolated.
So we've been talking a lotwith both sides of politics
about the importance ofsupporting system navigation,
making it easy for people tofind their way around.
In Victoria at the moment.
(36:03):
We are really happy to see thegrowth of those community mental
health providers, but we have alandscape that has local mental
health and wellbeing services.
There are head to healthclinics, there are mental health
and wellbeing hubs, medicaremental health locals.
(36:26):
How does the average Victorianunderstand where they're meant
to go?
And what if you're in a part ofVictoria where none of those
things exist at the moment?
Where do you go?
Where do you fit where?
Where are the answers to thesequestions?
Who helps you?
And I think, for me.
As you know a former clinician,but also somebody who's, you
(36:47):
know, worked in theadministration of mental health
I know personally that not aweek goes by where I don't get a
text message from somebodysaying oh, oh yeah, can you help
?
Speaker 5 (36:58):
Can you help my daughter, my son, my sister?
Speaker 6 (37:02):
Yeah, yeah, and I'm disappointed to say that it's
not always easy actually toprovide the answer no it's not,
and if I can't answer thosequestions easily and make those
connections happen, then who can?
Speaker 1 (37:17):
I don't know who can what?
Speaker 5 (37:17):
chance have they got Pip?
What chance have they got?
Exactly happen, then who can?
Speaker 6 (37:20):
like I just I don't know who can exactly.
Yeah, so we have a, you know.
So investment is great, butinvestment and funding and
announcements are very, verydifferent to reform.
And, yeah, the those importantthings you know are often can be
, you know, more difficult tomeasure or perhaps, you know,
aren't as exciting to announce,but they're things that are
(37:41):
actually going to make adifference and we are really
calling on the Victoriangovernment to think carefully
about the investment, about whatthe right next steps are to
make sure that they areimproving things for Victorians
today.
Yes, we're four years in.
We need to start seeing thosethings changing.
Speaker 5 (38:02):
I 100% agree.
I just want to kind of end bysaying what a phenomenal role
Mental Health Victoria plays.
People will be listening.
They'll be wanting to know moreabout your services.
How can they become members tofind out more about the really
important advocacy that you'redoing, the way that you're
bringing all of the parts of theservice system together to
(38:23):
facilitate reform and facilitatechange?
How can people find out moreabout your work?
How can they get in touch?
How can they even join thiswork?
Speaker 6 (38:32):
Well, people can reach out to us.
They can access our website,follow us on LinkedIn for some
of our commentary.
We've got information on thewebsite about you know the work
that we do, who we work with,how we do it.
There's also the ability tosubscribe to our e-news.
We put out a newsletter everyfortnight and that's not just
(38:56):
limited to our members, sothat's something that we
encourage anybody to access sothat you know you can be a part
of the conversation.
You can hear about the thingsthat we're talking about, and it
gives people the opportunity,if they think that we're missing
something or they want to makea contribution, to be able to
join in and be a part of thatconversation.
Speaker 5 (39:13):
I love it and we'll include all of the information
in our show notes as part ofthis episode.
What an awesome job you do.
I know you don't have a hugeamount of money as an
organisation.
Mhv you well and truly, youknow, do such a huge amount of
work for our community.
You're fearless advocates.
You are in there always talkingabout mental health and, you
(39:35):
know, looking to get the rightsupports for people.
So you know, I think, on behalfof every consumer, carer,
family member in this state, ahuge thank you, because I think
that message about saving livesis such a big thing and
sometimes this is what it is,this is what it comes down to.
So, yeah, please keep doing allof the things that you do at
(39:55):
Mental Health.
Victoria I mean, emma, we'rehuge supporters.
We love your work.
We are completely biased,obviously, because we've chosen
to be members as well of such areally important peak body.
I just really want to end onthat note.
So a huge thank you for joiningus, pip.
Speaker 6 (40:09):
Thank you so much for the time and for the
conversation.
Speaker 2 (40:12):
You've been listening to Get Real talking mental
health and disability, broughtto you by the team at Irma 365.
Get Real is produced andpresented by Emily Webb, with
Corenza Louis-Smith and specialguests.
Thanks for listening and we'llsee you next time.
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