Panel speakers: Dr Ken Thompson, Mary O'Hagan and Frank Quinlan
Each speaker was individually introduced and present their views on the topic: Grand Designs to Better Lives. Dr Ken Thompson was first to present the US perspective on systematic change. Ken discussed the historical context of deinstitutionalisation and the last act of federal involvement in 1963. While there were goals to have many mental health centres offering services to all communities, these plans foundered over uncertainty about who would fund or even run the centres. President Ronald Regan was said to have disconnected funding from federal level to State level, with responsibility for management uncertain between State and communities. Ken suggested mental health services and education were both vulnerable to funding cuts. He concluded on a more positive outlook for US health services, stating that the US was now addressing a system re-design that would increase the quality of services, while decreasing cost. Their aim was a Primary Care System focusing on prevention and early intervention.
Mary talked about grand design from New Zealand's perspective. She was proud of the closure of mental hospitals in the 1990s, and discussed how it was one step in a long journey. Mary explained how the closures stimulated an inquiry into mental health and developed two outcomes; the Anti-discrimination Campaign which is still going strong, and the Mental Health Commission which was able to give the government a concrete report of needs, statistics and measurable data which led to increased funding for mental health. The commission ended in 2007. All of this led to support for a recovery approach which aimed to shift cultural ideas about disability and mental health. Mary stated she felt it is a struggle to create sustainable change, and that the struggle was halted in 2008 when politicians let mental health slip from their priority list. She went on to say that the grand design, or real system change required knowledgeable political support, political advocacy, strong leadership and a clear vision for the future. Mary concluded with reading a few pages from her book, Madness and Me; a memoir. She said that the recovery rolution is at risk of remaining unfinished. She asks us to envision a world of tolerance and acceptance for all.
Mr Quinlan opened his presentation by paying respect to original land owners, and saying that mhaustralia was developing an action plan with Reconciliation Australia to help address concerns arising from the stolen generation. Frank stated that it no matter how good the plan is, it matters most to act on it, and the actions produced outcomes beyond the scope of the plan for reform. Part of Franks characteristics of a high performing system were full and meaningful participation for consumers and the people who care for them, mental health promotion, accessibility, effectiveness, efficiency and accountability based on measureable consumer and carer outcomes. He stated basic concepts were not in contest, but something in the implementation of them was impeding progress. He argued that governance and funding, reporting and accountability, service models, building sector capacity, explicit goals and monitoring progress were all essential to success.
Post by Jeremy Hancock and Ashley Pelton