Boosting Victoria’s mental health funding will save lives and money: Report

Early intervention in psychosis in Victoria has a return on investment (ROI) of $8.60 for every $1 invested.
 
That is among the most striking findings of a new KPMG report for Mental Health Victoria analysing the state’s chronic underfunding of its creaking mental health system, which receives the lowest funding per head of population of any state or territory.
 
‘Victoria has the dubious distinction of having the lowest per capita expenditure on mental health in the country, with access to services at 39% below the national average,’ the report states.
 
The report – Saving lives. Saving Money: The case for better investment in Victorian mental health –  found that two decades of underspending is taking the state’s system to crisis point, and is linked to a spike in homelessness.
 
Up to two-thirds of young adults with a mental health condition are turned away from the care they need, according to a lecture by Professor Patrick McGorry given last year.
 
Mental Health Victoria Chair Damian Ferrie told newsGP that GPs, who undertake the majority of mental health maintenance in the community, often have nowhere to send people on the brink of becoming very unwell.
 
‘GPs need to be able to refer someone who is developing psychosis or to get support in managing them. The most common thing GPs say to me is that patients have to be actually critically unwell before they can get access to clinical services,’ he said.
 
‘If someone presents with acute depression and/or suicidal ideation and/or suicide attempts, they often need more help than small clinic can provide. Where can a GP send them?’
 
The report focused on how fixing the mental health system would save both lives and money.
 
‘Around 900 Victorians are diagnosed with schizophrenia each year. Ensuring they received assertive early intervention would cost around $8 million but deliver almost $70 million in long term savings,’ the report states.
 
Mr Ferrie said the decision to focus on the business case for mental health was a deliberate one.
 
‘We were not making the headway we needed to get the government to properly invest in public mental health,’ he said.
 
‘So we said let’s look at this from a business point of view and see what it looks like. KPMG’s economists came back to us and said getting a ROI of $8.60 is extraordinary.
 
‘We are calling for investment right across the network. We are 204 acute psychiatric beds below the national average. Hospital CEOs tell me they’re using general beds for people who are mentally unwell.’
 
The report frames mental health spending as a win–win for the government and for patients, with an upfront investment leading to many positive social and economic outcomes.
 
Mental Health Victoria is calling for a $543 million cash injection into rebuilding the state’s mental health services – a sum which, the report claims, would lead to a $1.1 billion saving.
 
The report states that strong investment in mental health has huge spin-off benefits in terms of avoidable emergency department admissions, reduced demand for hospital beds, reduction in homelessness, a reduction in crime and incarceration, improved productivity and greater workforce participation.
 
The recent Victorian budget included a major investment in mental health, with $705 million allocated for more acute beds and to build separate emergency departments for people with mental health or drug problems.
 
Mr Ferrie said the new funding is very welcome, but there remains a gap between Victoria and the rest of Australia.
 
‘We’re coming from a low rate, so even with that injection we’ll still be 13% below the national average spend per head of population,’ he said.
 
The report comes as NSW is set to announce a $700 million spend to begin a state-wide rebuild of mental health infrastructure, including ‘step-up step-down’ beds and new specialist mental health units.
 
The Mental Health Victoria report also found that targeted assertive outreach programs after someone is hospitalised for self-harm are particularly effective at preventing suicide, and come with a ROI of almost $2 on every $1 invested.
 
Mr Ferrie said underinvestment in the mental health system means a much greater impact on emergency services, from ambulances to emergency departments.
 
The report states that mental health admissions in emergency departments have shot up by almost 20% in the four years to 2016–17, with one new admission every 10 minutes.

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