MEDICUS MARCH 2016

C O V E R S T O R Y

the answer. What ‘flexible’ means to me is that good services get their funding cut at the whim of the funder. “Maybe we would be better off resourcing the state mental health services properly rather than trying to contract it all out to private services.” Although welcoming of the mapping project, A/Prof Maguire adds that GP s have lost confidence in the purchaser/ provider model because of past failures. The only way government can restore the faith of consumers, clinicians and services providers who are out there battling through the quagmire of mental health, is by acting on reform. To quote Elvis Presley: A little less conversation, a little more action please All this aggravation ain’t satisfactioning me A little more bite and a little less bark A little less fight and a little more spark… ■

old fight could ensue, as service providers try their best to defend and protect their patch. The litmus test will lie in the effective engagement of stakeholders, transparent communication and robust procedures.

GPs like Associate Professor Peter Maguire, who practises in the large Wheatbelt town of Narrogin, are unsurprisingly sceptical about the proposed reforms. “As always, the words look good, but it is the translation into reality that is the problem,” A/Prof Maguire says. “There are not enough mental health clinicians in rural areas, and there is not enough support to get seriously ill rural patients into specialised facilities.

“I am not convinced that having a ‘flexible funding pool’ is

An area of particular importance for WA in relation to the impending national mental health reform is suicide prevention. Figures released by the Australian Bureau of Statistics (ABS) earlier this month point to a national crisis – 2,861 people died from suicide in 2014, an almost 14 per cent increase from the previous report in 2009. The standardised suicide rate in WA was the second-highest in the country (14.4 per 100,000) and represented an increase compared to 2013 data. The regional statistics are especially staggering. The number of suicides in the Kimberley has doubled in the past five years, according to a report produced by the Aboriginal and Torres Strait Islander suicide prevention evaluation project in January. The government’s response over the years has been grossly inadequate. The Western Australian Suicide Prevention Strategy 2009-2013 (which came at a cost of $18 million) was heavily criticised by WA’s Auditor General. In his scathing 2014 review, Colin Murphy wrote: Inadequate planning led to delays in implementing the Strategy that reduced its impact. The roles, responsibilities and reporting requirements between the Council, the Commission and Centrecare were not adequately defined at the outset, contributing to delays and inefficiencies…Other parts of the Strategy, such as a coordinated inter-agency approach to suicide prevention, were not fully implemented. Following this shabby performance, and based on recommendations and evidence from the review and other

sources, the State Government released an ambitious plan to halve the number of suicides and suicide attempts in Western Australia over the next decade, via The Suicide Prevention 2020 Strategy, Together We Can Save Lives: One Life (2020 Strategy). The 2020 Strategy was developed by the Ministerial Council for Suicide Prevention, and the State Government committed $26 million over four years to implement initiatives and programs aligned with it. The key outcomes and action areas are linked to the prevention priorities in The Plan 2015-2025. The MHC was tasked with developing the 2020 Strategy implementation plan (including separate Aboriginal and Youth strategies). These were due to be released in mid-August of 2015, but are yet to surface. The MHC has stated that it will lead the implementation of 2020 Strategy and related initiatives through partnerships with local, State and Commonwealth Government agencies, community managed services and corporate organisations. The MHC will also oversee the commissioning of services and small grants, and ensure effective communications, monitoring of programs and facilitation of evaluations. To assist with these activities, the MHC will establish a Suicide Prevention Implementation Working Group with input from stakeholders and people with lived experience.

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