Dedicated to Dr Anthony Kidman – Anti Stigma Crusaders Journal

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Pat McGorry is professor of Youth Mental Health at the University of Melbourne and the director of Origin Youth Health Research Centre in Victoria. He is a world leading clinician. He was nominated Australian of the year in 2010. Information about Pat McGorry can be obtained at the following link http://www.findanexpert.unimelb.edu.au/display/person14906

Dr. Antony Kidman is a clinical psychologist and currently the Director of the Health Psychology Unit that collaborates with the Cummins Unit, Royal North Shore Hospital, North Shore Private Hospital, Chatswood and Cremorne Community Health Centres and health care professionals. He is also a writer and writes regularly for academic journals and newspapers or magazines; and he often speaks on radio and television. He was awarded the order of Australia in 2005. Information about Tony Kidman can be obtained on the following site http://datasearch2.uts.edu.au/science/staff/details.cfm?StaffId=599

In 2011 there was an interesting show on Late Agenda (Sky News National Australia) where Tony Kidman, psychiatrist Pat McGorry and politician Josh Frydenberg were discussing mental disorders in Australia, with a particular focus on the more severe forms such as schizophrenia. Watching the show was inspiring to me because the problems that we face today became immediately apparent.

While Pat McGorry and Tony Kidman were welcoming the 1.5 billion dollars (1.5 billions for new initiative out of a 2.2 billion dollars package) promised by the Australia Government for various initiatives to help sufferers and for additional research funds, it was clear that there is need of more transparency if we are to understand how the money is spent and how exactly it helps people directly. There is also need to ensure that wastage is minimised and that the money is allocated to the most urgent causes. $1.5 billion sounds like a lot of money, but if we consider the situation closely, as I will try to do in this very short journal, it becomes apparent that we need a lot more money as a matter of urgency.

Tony Kidman made it clear that research needs to be translated into something that helps people directly (he expressed this as “translation to the coal face”). Research cannot remain a purely theoretical work because financially, we cannot afford to use precious resources in this way. We need the kind of research that can help people directly to make a difference. Today a lot of money is spent on mental health research that does not always help people directly and indeed those who suffer directly are often those who benefit the least from various research and publications. The majority of funds, under the current system, tend to benefit the professions, governments and big corporations but not so much sufferers directly.

Another problem mentioned by Tony Kidman is that, in Australia, we have a government which currently helps by giving access to therapy to the poorer members of the Australian population, particularly those on welfare. Both my wife and I use this service: my wife because she suffers with severe bipolar I, and has had a very traumatic life; and me, because I care for my wife and I also help many people online, particularly in Australia with the support of two psychologists. While I am a volunteer helper for sufferers with mental disorders, and I continue to study psychology, the stress that I experience is similar to what a psychologist experiences because I help people with severe mental disorders such as schizophrenia.

Unfortunately, the government has recently cut back the free visits to psychologists from 12 to 10 per year. And there are dangers that the cuts may continue with some negative consequences for needy sufferers like my wife, and those who have more severe forms of mental disorders. In addition, as Dr Tony Kidman proposes, people who suffer with schizophrenia may need up to 20 sessions per year.

The provision of therapy for the poorer population is s a remarkable achievement because many people have benefited, and still benefit, enormously. It is the right step forward towards some recovery. For this we must recognise the people behind Australian organizations like Head Space and Beyondblue. Professor McGorry is one of the people who are behind such organisations.

We could say that the criticism should be welcomed, but I do understand McGorry’s position on this and I think that none of the criticism takes away from the fact that his achievements are truly outstanding. Furthermore, I am sure that McGorry is aware of the tendency to overmedicate people, something that we are all becoming more aware of here in Australia.

Both Tony Kidman and Pat McGorry call for more funds, more beds, more transparency in terms of how the money is spent and allocated to various projects, more money for therapy, and the possible creation of mental health centres that they refer to as “one stop shops,” meaning that the services are more centralised rather than involving various organisations in different locations, something that proves to be time consuming, expensive and sometimes wasteful.

I would like to elaborate on this a little. First we must look at the problems that we face in the world, using Australia and America as examples, because Australia does tend to follow America in many instances. It is well known that many countries try to copy America.

In Australia we have 35,000 people in our jails and of these, little more than half, or 19,000 people, are said to have a mental illness today. Yes while the professionals have large amounts of money to do research on mental illness, and while pharmaceutical corporation make huge profits in the billions, many people with mental illness are so desperate that they end up in jails. And they often end up in jail for repeated minor crimes not always for severe crimes, or because they may be experiencing emotional problems or psychosis and we do not have the ability to help them, because of lack of knowledge, funds and skills. For a country with only 22 million people, 19,000 people with mental disorders in jail is a very large figure. Nevertheless, the true number of people in severe distress, who may have problems with the law due to a mental disorder, is much higher, if we consider that Australia is quite tolerant of young offenders who often get away with repeated offences particularly if they are young. Not that they should be jailed, because jail does not solve anything, but they should be helped and the reality is that they are not. In addition, almost 65,000 people attempted suicide in Australia in 2010.

The Mental Illness Fellowship of South Australia Report informs about the fact that people with mental illness, in Australia, are the most disadvantaged social group. Lack of jobs, lack of housing and a host of many other problems are discussed by MIFA. The annual report for 2012 can be found on the following link: http://www.mifa.org.au/sites/www.mifa.org.au/files/MIFSA_AR_2012%20Final%20web.pdf

America, on the other hand, has a much larger population than Australia, and currently has 8 million people in jail. Of these people, 5 million have a mental illness, with at least 2 million having severe mental illness. This is a very large population and it is unlikely that these people will improve and that they will be helped in any way towards recovery. In addition, many people in America, who suffer with less severe forms of mental illness, such as bipolar II, anxiety, cyclothymia or milder depression, are often defined as high functioning while the reality is that their symptoms do not support the idea of a high functioning individual. These people are left to work in places were they often do not get paid, have a lower standard of living and experience tremendous financial problems. What government agencies often fail to consider, both in Australia and in America, is the stigma that prevents people from accessing adequate and supportive employment. The Australian and American statistics are clear on this: people with mental illness are the most disadvantaged group of people in the world in terms of employment, social support and standard of living. On the following links there are articles about mental illness in America:
http://www.nytimes.com/2012/02/19/health/in-chicago-mental-health-patients-have-no-place-to-go.html?pagewanted=all&_r=0
http://www.kimt.com/mostpopular/story/Mental-Illness-and-County-Jails/9HFWQOFqw02x_05gqoGGTA.cspx
http://www.healthyplace.com/blogs/borderline/2011/08/have-a-mental-illness-go-to-jail/

There are many young people, especially indigenous people, in American and Australian jails. We must ask ourselves: is there something wrong with governments’ interventions and laws? I do agree with McGorry and Kidman that we need “one stop shops with beds” that focus on recovery, whenever this is possible, especially in terms of early interventions. However, I propose “live in” mental health centers, more akin to small cities and possibly self- sufficient in terms of energy and food. The gift economy villages, with inbuilt permaculture gardens, are not only relatively inexpensive to create but have become a reality in some parts of America and the UK. http://permaculturenews.org/2013/06/05/wellbeing-gardening-gardening-for-the-body-mind-spirit/

http://www.thrive.org.uk/Files/Documents/G4L%20Resource%20Book.pdf

Having lived in a psychiatric hospital for two months, not because of having a serious mental disorder but because of being homeless and severely depressed, and because of the good heart of the mental health staff, I know that Rozelle hospital (one of the major mental health facilities in Australia with about 2000 beds) was an ideal small city within a big city that made a huge difference to the lives of people like me with a mental disorder. We could be taken away from the stigma, the ignorance, the lack of services and jobs and placed in a therapeutic environment of care, because Rozelle was an environment of care.

Rozelle hospital was located on beautiful grounds and it was a combination of a number of buildings erected in the 18th century that had been transformed into a world renowned mental health facility where people were helped to recover, if not fully, then partially. What was different about that place is that it protected sufferers from the stigma, it gave them a safe environment, helped them gain respect for themselves and from others and contributed to the study of mental disorders. Many volunteers helped there and students of psychology and psychiatry used to visit there quite often. Unfortunately, Rozelle is no longer a psychiatric hospital today because the government decided to use the facility for other purposes, given that it is such a historical and valuable site. For me it was a disastrous move because it not only eliminated a rare Mental Health Centre, that offered accomodation and protection to many vulnerable people, and by so doing saved their lives, but a model that could be studied to create other similar Centers.

We need Centers where there are beds for those who need them, where people can find a safe environment; where sufferers can be helped through creative projects; where people can be educated about their disorder; where sufferers can learn some skills such as growing vegetables, harvesting fruits, producing food, using computers and doing all sorts of productive and interesting things. Permaculture gardens are a well-known way to provide food and therapeutic activities for sufferers. Well established Permaculture gardens can feed entire cities with little effort and maintenance: http://permaculturenews.org/2010/10/08/how-to-build-a-permaculture-vegetable-garden/
In short, we need little cities for the mentally ill within the big city. Such centers would focus on recovery and the aim would be to help sufferers develop resilience and skills to survive in what is a very unfriendly and ignorant society, when it comes to support and understanding of those with mental disorders. Even work should be possible in such centers, and this could contribute financially to the wider society.

Governments may well say that this would be a very costly exercise and that such centers would need millions to be built. “It is an impossible endeavor.” the governments would say. Yet, if we consider the health care costs and the cost of having people with mental illness in jail, we soon find that we would actually save millions in the long run. Not only would government save millions but we would help people with mental illness to become outstanding citizens, who not only help their communities, but also contribute to society in many ways. The special Centers for Mental Health could also become models for a better society. The key to the creation of such Centers is Voluntary work. Volunteers could make such project a reality. I already work as a volunteer helper and I know I make a huge difference to the lives of many sufferers.

I am not calling for institutionalisation of the mentally ill. I am calling for the provision of Advanced Centers for Mental Health where people are helped to recover in some way through early intervention programs and other available initiatives. This alone would be a tremendous wealth to Australia and something that is very possible to achieve.
In terms of energy and food, such Centers could be self-sufficient because we have the technology. The presence of health professionals could be a voluntary effort of psychologists, psychiatrists, doctors, nurses, student of psychology and various University students who offer a couple of hours per week. I know that my therapists and doctors (GPS) would be able to offer some of their time. After all, I am here as a volunteer, giving up to 20 hours per week of my time to help my community. I write this journal, I study psychology to help the people become more competent, and I help sufferers as a volunteer, with the support and guidance of two psychologists. If I can do it, given that I am a full-time caregiver for my wife and that I have a mental disorder, so can mental health professionals donate a couple of hours of their time to help their community.

We have the space, we have the professionals to make this happen, we have the knowledge and we can get the money if we look at the situation closely. What is preventing this from happening is an old ideology that will cost us so much more in the long run. It is a lack of vision and the usual insistence on what attracts votes now, not what is good for us in the near future. In the comments, Judy writes that society is not able to provide a supportive and stigma free environment. That is why we must protect sufferers while we help them build resilience and learn how to function in a problematic society. It can be done but it cannot happen within an ignorant society.
Politics and life are based on the here and now and we have lost the ability to prepare for the future. Will Australia follow in the steps of America, which today does not have good support for the mentally ill? We hope that America changes its ways and this may be possible with the help of Barack Obama, who has a good heart and who probably has a good idea of what needs to be changed. But even Obama is up against on old ideology and change will not be easy if at all possible.

The problems are tremendous, but it does not hurt to dream and have vision. My dream is to see small cities within cities for those with mental illness where focus is on recovery and the shaping of outstanding citizens. Where our young people are given a good chance and hope for the future that our society has taken away from them. People with mental illness can become outstanding citizens with support. I am an outstanding citizen in many ways and today I help my society, I help Australia and I help the world. What I do may be little and what I can change very limited. But I am here doing it. This has been possible because of the support that I received in the past and Rozelle hospital was central to my recovery.