VICTORIANS living with the most serious mental health conditions – meaning those that are chronic, complex and severe – have been overlooked by this week’s State Budget, says the Victorian Branch of the Royal Australian and New Zealand College of Psychiatrists (RANZCP).

The Victorian Branch of the RANZCP said while it welcomed the 2023-24 State Budget’s $776 million of investment for continuing and new mental health initiatives, there was a disappointing lack of investment in frontline services for public patients with chronic, severe and complex mental health issues.

Too many Victorians are still having to rely on frontline community and bed-based services not yet equipped to provide the support needed.

The Branch congratulates Minister for Mental Health, the Hon Gabrielle Williams MP, for her commitment to women’s mental health. The Victorian Branch has previously called on the State Government to ensure equitable access across the State to women’s-only mental health facilities. The $10 million investment in this Budget for inpatient services is a good start, especially as it includes a focus on women’s safety. The Victorian Branch would welcome further commitment to Prevention and Recovery Care (PARC) services for women.

The Victorian Public Mental Health and Wellbeing system is responsible for supporting some of the most vulnerable Victorians and is undergoing a once-in-a-lifetime reform following the Royal Commission into Victoria’s Mental Health System (RCVMHS). That reform has focused on a system with lived experience at its centre.

RANZCP Victorian Branch Chair, Dr Astha Tomar, said: “It is heartening to witness lived experience leadership embedded in the Mental Health and Wellbeing Division, and throughout mental health and wellbeing services – in addition to the development of the new legislation, strategies and frameworks, and new governance entities.”

The Victorian Branch of RANZCP commends Premier Andrews’ commitment to transforming the mental health and wellbeing system, including implementation of the RCVMHS recommendations, and continued investment to improve the mental health and wellbeing of all Victorians.

The Victorian Branch also welcomes the Government’s recognition of the ‘missing middle’ – those not sick enough to access clinical care, or too sick to be treated outside hospital – and the need for access to care where people live.

But “equitable access to quality care in the mental health and wellbeing system is critical,” says Dr Tomar. “The access to services must not be limited by mental health or co-existing conditions, nor social, financial or postcode inequity. 

“It is reassuring that the restructure of the mental health and wellbeing system envisioned by the Royal Commission is continuing to deliver services in the community, which aligns very much with what the community wants, and our Branch views. “

However, she said more needs to be in place to address the specialist clinical needs of those Victorians already struggling with a severe mental illness – estimated at over 200,000 Victorians. (RCVMHS Final Report estimated that 3 per cent of people living in Victoria experience ‘severe’ mental illness – equating to over 200,000 people).

Dr Tomar stressed that the needs of the severely mentally ill – whose care is primarily delivered through the public health system – were not a focus of this Budget.

 “The Victorian Branch is hopeful that the continued reform focuses on Victorian communities’ access to the best possible clinical care – particularly those struggling with a severe mental illness. (And) that this is met in a timely way - together with a strong strategic plan and capacity building investment around it,” she said. 

Dr Tomar also said that the Government needed to do more to ensure we retain psychiatrists and other specialist clinicians in the system, because workforce shortages impacted quality of care and safety. She said a clear strategy was required, underpinned by an analysis of workforce gaps, that addresses workforce retention, distribution and recruitment of specialists including psychiatrists.

 The Victorian Branch acknowledged that COVID-19 had a significant impact across the entire health system, but said the mental healthcare system was not-fit-for-purpose prior to the pandemic, and two years on from the Royal Commission’s Final Report, the picture in Victoria remains largely unchanged, especially in frontline services.

ENQUIRIES: For more information, or to arrange an interview call +61 423 444 907, or email media@ranzcp.org.

The Royal Australian and New Zealand College of Psychiatrists is a membership organisation that prepares medical specialists in the field of psychiatry, supports and enhances clinical practice, advocates for people affected by mental illness and advises governments and other groups on mental health care. For information about our work, our members or our history, visit www.ranzcp.org.

In Australia: If you or someone you know needs help, contact Lifeline on 13 11 14 or www.lifeline.org.au or the Suicide Callback Service on 1300 659 467 or www.suicidecallbackservice.org.au.

In New Zealand: If you or someone you know needs help, contact Lifeline NZ on 0800 543 354 or www.lifeline.org.nz or the Suicide Crisis Helpline on 0508 828 865 or www.lifeline.org.nz/suicide-prevention.