I’m looking for help
I’m trying to help a loved one
Collaboration and pooled resources are need to tackle one of our health system’s most wicked problems, writes Hope CEO Merinda March.
There has been much debate and discussion about if, how and where our WA Government should begin spending the much-publicised budget surpluses of the past few years.
When I looked at our most recent State budget, it was heartening to see continued investment in our mental health services (particularly services for acute mental illness). I absolutely applaud the commitment to employ more Aboriginal mental health workers and I look forward to visiting the new Head to Health hubs when they are operational.
But this budget – like so many of its predecessors – has once again failed to make any real provisions for a group of people who are in desperate need of services. Our young people.
In 2020-21, the Australian Bureau of Statistics conducted its National Study of Mental Health and Wellbeing. It revealed that two in five people aged 16 to 24 years met the criteria for a mental illness in the 12 months leading up to the study.
Yet a significant proportion of these young people fall into “the missing middle”. If you’re experiencing mental distress or illness, it’s the place you never want to be.
A wicked problem
The missing middle refers to young people whose mental health needs are too severe or complex for our GPs to manage alone, but not acute, severe or complex enough to meet the criteria for specialist treatment within our Child and Adolescent Mental Health Services.
It is only when they deteriorate to the point where their mental illness results in self-harm or suicide attempts that these young people have chance at getting support. For many young people the support that does come is too little and much too late.
Too ill, but not ill enough. A wicked problem that our woefully underfunded health system does not have the capacity solve.
This is a problem I and some of my colleagues deal with both personally and professionally. As a parent it is a maddening quest trying to find a mental health professional available to support my child. Even with all the resources I have access to, the support can be sporadic.
Searching for support
Professionally, Hope Community Services deals with young people across a range of settings. From the justice system to our alcohol and other drug services to our family and domestic violence services, we see just how desperate our young people are for support.
We also operate two of the 21 headspace centres in WA, which are essentially early intervention mental health services for young people aged 12 to 25. We are one of many headspace centre operators across the country.
Our goal is to provide mental health services (such as counselling and psychology) alongside other practical services that will support young people to get their overall mental health back on track.
More and more we are seeing the missing middle turn up on our doorstep. Some are already on the excruciatingly long waitlists; others have turned up at emergency departments, only to be provided minimal care then sent home with no follow-up support.
When they come to us, we of course provide them with the best support we can, but our staff are also stretched and our resources are also limited.
Collaboration can deliver results
At present headspace centres are funded exclusively by the Australian Government, with no top up funding from the WA Government. This is a situation unique to WA.
Each State has a bilateral agreement with the Australian Government that covers mental health and suicide prevention, however WA is the only state whose bilateral agreement does not cover headspace centres.
When Victoria signed their bilateral agreement, the result was $45 million dedicated to creating two more headspace centres and enhancing services at existing centres.
Importantly, written into that agreement was an express commitment to fund extra services for those young people who fall into “the missing middle” category.
We need that kind of cooperation here. With investment from the State Government, existing headspace centres would be able to expand their services, getting more counsellors and psychologists on the frontlines where they are needed.
Importantly, headspace also offers a telepsychiatry program which is crucial when a diagnosis is needed to access medications and services that will help that young person avoid a crisis.
Rather than investing in new infrastructure, and risk duplicating services, the State Government should be looking at ways to work with headspace.
Pooled funding and joint strategies to expressly tackle the missing middle is the best chance we have at preventing these young people ending up in crisis and in our emergency departments – the very worst places for them.
