Victoria's new leadership offers a chance for renewed mental health reform

Following the recent change of leadership in the Victorian Government and appointment of a new Minister for Mental Health, Simon Katterl (@SimonKatterl) calls for a reset of Victoria's mental health reforms, which have fallen short of expectations. In this post, he discusses a number of flailing areas of the reform agenda and explains where they could improve. Simon is a mental health and human rights advocate, consultant and writer, and has lived experience of mental health issues. 

Last week Jacinta Allan and Ben Carroll were appointed as premier and deputy premier of Victoria after the resignation of Daniel Andrews, with Ingrid Stitt becoming the new Minister for Mental Health. Always moving policy quicker than politics could keep up, Andrews has led the nation on key reforms around LGBTIQ+ rights, family violence and treaty-making. But on mental health, the complexity has bogged the government down.

Now that Allan, Carrol and Stitt are in the driver’s seats, they will need to initiate an urgent reboot.

The Royal Commission into Victoria’s Mental Health System was established in 2019 with much fanfare. People were, and are, desperate for change. Ultimately the Royal Commission would hand down 74 recommendations from its interim and final reports, stating that this represented a “new road” for mental health reform.

There was no question that the former premier believed deeply in this cause. Speaking with a clarity, precision and moral urgency that few political leaders can emulate, Andrews stated ‘Building a quality mental health system from the ground-up won’t be easy and it won’t be quick. But when the cost of not acting is measured in lives, we can't afford to fail.”

But since the handing down of the final report, many of us worry that we are not seeing change: we are seeing more of the same.

Despite now more than 14 000 human rights complaints without adequate enforcement, the Victorian Government has emulated large parts of the previous Mental Health Complaints Commission in the “new” Mental Health and Wellbeing Commission. The result has been that the new Commission is continuing to pursue, with taxpayer money, measures to keep mental health service performance secret via the courts.

New laws may look good, but they are not self-executing. Despite relatively minor changes arising from the new Mental Health and Wellbeing Act, the sector has not been properly briefed on how to meet their legal obligations. With low support for staff and low enforcement of the law, we will continue to get low performance. People using the system will be most harmed, but so will their families.

The types of services available are mixed. While there are exciting reforms such as new lived experience-led services (2), other initiatives feel like carbon copies of the past and others. People using the mental health system and staff are reporting that “local services”, meant to address the “missing middle”, reflect much of the paternalistic “doctor knows best” culture of the old system.

Much of the old continues and grows, while the new is unfunded. Many in the sector were shocked when a new lived experience agency, recommended under the Royal Commission, was not funded in the last budget. It leaves people in the system anxious that real change is not on the horizon.

In some respects, a refreshing of leadership may enhance our system’s transformation. We are at an inflection point where the injection of much-needed cash into the system will either grow a system that has been known to be harmful, or rebuild and transform a new one built around principles of respect, equality and human rights.

True partnership with people with lived experience – including Aboriginal Victorians and other under-served communities – will be crucial. To date, this has been difficult.

Andrews’ swift political pragmatism made mental health matter. But that sharp eye for political risk management has always cut into opportunities for real, and sometimes messy, partnerships with those in the community. The mess is often where the good stuff happens. With mental health now on the map, the next step is charting a shared journey.

Another step is to take up the opportunity to grapple with, and respond to, harm in the mental health system. Rather than entrench us in the past, a restorative justice process will create the trust necessary to chart that shared journey to a better future. That offer comes from people with lived experience.

As Andrews predicted, the reform process isn’t proving easy. The road to hell is paved with good intentions…but so is the path to success. New leadership can help us get back on track.

 Content moderator Sue Olney