Hard to say. But his new approach to mental health care will make it very hard for those who are. Unless you’re cashed up, of course. Let’s look at the social implications of the 2010 budget mental health services slash…

For a long while, I detested the political cliche ideology of choosing between two devils. I saw it as a functional excuse for disengagement, and the catchcry of a people who had no capacity to relate politics to individual power in a collectivist society. But, alas, today I have now officially given in. What an election this is shaping up to be, huh? In the right – far right – corner, we have the evangelical supermoron who makes Howard look progressive. Seemingly a little less in the right corner – but closer than you’d probably hoped, three years ago – we have Kevin Rudd. Rudd The Dud, etc. And he is. And I’m trapped, really, because even though I’ll give my votes to the Greens, we’ll end up with one of these men. I’m forced to hope it’s Rudd. But that pains me, when I consider what he has done to an area very dear to me – mental health. I’ve strayed away from this passion of mine – and, at one time, both a study and career – but find myself returning of late. Crusader Aaron™ is stirring again. I’m back, kiddies. And, this time, we’re going to wander a little away from the pop culture at the core of most of our journeys in recent years on this site, and take things on in a slightly more direct fashion. We’ll still look at how culture embodies the things we talk about – reflects them, projects them, whatever the case may be. But there is something very wrong with this world. Something is going very wrong with us. And I’m going to use this space to have a few discussions about this, because, well, somebody needs to. Or more need to, at very least. We’re not coping. And Kevin Rudd’s budget has not only failed to address this, but, quite horrifyingly, chosen to exploit and ride one of the biggest problems of this issue – that it does not have a voice. Thanks to this budget, it will also have no money.

Promises, Promises…

What Rudd promised us, all that time ago, in what was a brilliantly executed fusion of right and left wing ideals that devilishly trumped the polarised nature of contemporary post 9-11 society, was that he would deliver a “historical reshaping of mental health services”. Oh, hang on. You know, now that I think of it, he was telling the truth. Wasn’t quite what most of the people close to this issue had in mind, though.

In this week’s budget, that “historical reshaping” of the Australian mental health climate showed itself to be heading towards that American social model that terrifies the life out of any leftie and hangs ominously in the not-too-distant future on every social services debate. That model is to basically have no model – to push the service into not being a service, but a commodity. Mental health as a commodity is a frightening thought in today’s world, but it’s where it will go with “reshapings” like these. And the thing is, the mental health area (along with dental – and I’m not discounting that issue, but let’s face it, mental health is slightly different to having a nice set of teeth) is affected by this model much more than any other, because, at the end of the day, what’s wrong with it in the first place is that it’s just so bloody expensive.

It’s really about the idea of rights – that is what is at the heart of this. The word “socialist” has made a strange comeback in the mainstream cultural discourse; it’s strange to think that everyday people – and conservatives – now throw a word around that was once considered ludicrously over-the-top for everyday use (it has negative implications, and is hardly ever used by those it is referring to). My problem with it is that it’s mostly a misused term, or completely misunderstood. But for the purpose of contextual meaning, what the term is really getting down to is the  battle of ideology over human rights. Rich and/or successful people (and success doesn’t always have to mean money, but in 9 cases out of 10 that’s what it boils down to here), who have attained what it is they have worked to attain, have an annoying tendency to wish to deny the things they have attained from others who have not been so successful. I think this is what we see in the papers, and on the talkback shows, when Mr Soandso gets his knickers in a knot over those bloody lefties and their notion that Mary Hardship down the street is entitled to the things he has worked for, “without having worked for them”. It’s sour grapes, because it’s threatening the affirmation that Mr Soandso has received for having attained it, and it renders probably a fair amount of pain and sacrifice in attaining it as potentially for having been for nothing. That’s the fear. That’s the gripe.

That’s not to say that there isn’t something logical in the idea that it is right that people reap the fruits of their labour, but it is a blurred subject in many areas, and difficult to resolve as an ethical power struggle.  It does appeal to a very innate human instinct of “fairness”, and we can even see the idea in a strange reversal of the power dynamic of the successful resenting the unsuccessful, such as class resentment issues. Coming from a lower class background, I’m familiar with the resentment of rich kids who had a life I did not have for seemingly no autonomous reason of their own. It bothered me as a kid, and I didn’t quite understand the fairness in that. Why did Johnny Snobs get the Reebok pumps and not me? What did he do to get them? Be born in a rich family and have parents who were bankers? He’s an asshole. I’m a good person. How is that fair? Shouldn’t I be the one to be awarded the glory of Reebok pumps? This is the basic mentality, and I see this, somewhat ironically, in the gripes of the all the Mr Soandsos who ring up 2GB et al, and whinge endlessly about the bloody socialists and their ridiculous ideas that people should get “somethin’ for nuthin””. Of course, Mr Soandso is probably Johnny Snobs’ father, and thinks that his son is perfectly entitled to his pumps over me, because he was successful enough to provide them for his family, and mine weren’t. So, it’s a little more complex than we take for granted, but the problem always comes back to the same thing – money.

Why money is important in how the issue of mental health works, and where it all goes wrong, is that all these services, in today’s world – logically, in a capitalist society that runs on labour for money – cost. Nothing is for free. And this blurs the idea that there are some things – some services – in life that are our “right” as human beings, outside the capitalist machine we all live in, because someone has to pay for them. Administering these rights requires the work of everyday people performing the jobs involved in these services, and they need to be paid to do this part in the service, so that they can go on and live the functional capitalist lives they’re entitled to, whilst the people who do not have the money to provide this income – because, for whatever reason, they have not been as prosperous in their own capitalist lives – get these services anyway. But who pays the labour involved in this service, then?

Government must. The idea is that government must pay for things when they are “rights”, things that exist outside the system of fairness of Mr Soandso or my pining for Reebok pumps. So it’s all about what is and isn’t a right that deserves to exist outside the idea of inequality at the heart of capitalism: that not everyone gets the same life because you reap what you sew. There must be some socialism inside a capitalist system, some kind of division at least, or we have a world that is frightening to contemplate. We are dangerously heading towards that world, though, and America is closer than anyone. The safety of many of the rights of our society that have been maintained within the capitalist system are being taken away. Education has successfully been changed drastically (and Howard played a big role in that, of course – but the problem with the myschools website is that Rudd doesn’t seem to care about equality of social disadvantage in education either), and many other areas have started to go. This time round, we are faced with the battle over mental health.

So, the question is simple: If a human being suffers to poor mental health, do they have a right to be treated? Is that something that should exist outside of the capitalist system of entitlement to the successful who have prospered in that system? Does someone’s bank account balance relevantly connect to their ability to not suffer from poor mental health?

This is the question because, if you toss mental health outside the government system, it’s ludicrously expensive – much more so than most “medical” situations. Firstly, most medical situations are relatively simple and require just the one – with maybe a checkup – point of action. You hurt your knee, get an infection, whatever the case may be, you go to a doctor, pay the money to see them (the consultation alone is much quicker than seeing someone in mental health, so it’s cheaper), pay for your prescription, and maybe do it once more to check that it all went to plan. You cannot compare this to mental health! It’s ludicrous to. It’s more akin to major medical problems involving hospitalisation and surgery – except in the biomedical sphere of life, that is the minority of circumstances, and in the psychological sphere of life it’s nearly all circumstances. Consultation for psychology is an ongoing process of many, many appointments, and even the medicine, unlike most biomedical pharmaceutical treatments, are ongoing (for a minimum of six months – generally, longer). It’s really expensive to have a psychological problem and do something about it.

So what we’re looking at with Rudd’s emerging system is a world where the lower end of the socioeconomic spectrum can’t and, therefore, won’t. And it would suit the Mr Soandsos on this topic to consider – since empathy generally doesn’t motivate Mr Soandsos particularly – some consequences of this that you won’t see thrown around in this debate enough. We already have a society increasingly plagued by poor mental health. On the whole, our mental health is starting to fail us – that is not a prediction, it is now well and truly a statistical reality. One in six Australians are currently either diagnosed or treated for mental health problems, and with the number of people who don’t seek help (and anyone involved with the area will tell you that most don’t – and this isn’t just about financial elements, it’s also connected to the social stigma we still battle on the topic, plus a range of cultural problems), add them to that statistic and then… you know… stop and think about it for a second. Turn your mind away from this screen and consider it. We’re looking at a world – our world – where perhaps not much less than half of us are not psychologically functioning properly in some way. I’m going to write soon about various factors going into this – because something has to be causing these spikes, and looking at this is fascinating – but for now, just consider that as a reality that needs to be addressed. This is not the time to be slashing the mental health system to pieces. It’s not just despicable on greater empathetic or ideological levels, it’s technically out of step. It’s functionally moronic. Surely, the government should be addressing the parts of the machine that suddenly seem to be breaking down? This one is about to do the opposite. And it isn’t just even leaving it how it is, at a time when it needs to be stepped up. It’s taking away from it. Fuck you, Kevin Rudd.

So… a society as a combination of two factors: we have more people falling down to poor mental health, but also a society where more people cannot address their mental health. What do you think that’s going to be like? C’mon. Doesn’t take an Einstein.

Mental health and homelessness

This then connects to a range of other areas. Homelessness, as many more people need to realise, has a direct relationship to mental health. Yes, yes, “homeless people are all crazy”, that’s the thing we all “know”. But what most people don’t consider is that the chicken and the egg is not the way round they think it is. Homeless people are those who have not been able to create even the most basic semblance of a normal, functional life in any manner, whatsoever. We tragically ignore them – because we so dislike unpleasant thoughts, no less – but their stories are severe. There are few things more severe in life than than those of the homeless, and what is says about human beings, the world they operate in and how this world operates. And you don’t just fall into such a hole for no reason. I often hear people remark, “But there’s the dole, there’s welfare, there’s government housing, how can anyone get to that state in our world?” But the situation isn’t about the technicalities, such as these. It’s about people who are so destroyed they are unable to even get themselves into any kind of system at all, letalone function within it. Even being on welfare, and getting a life, a home, food, whatever, takes functionality (actually, they’ve made it so difficult, these days, it requires more than ever!). It’s not that these people are functioning in some sort of bizarre fringe system of their own – they’re not in any system, they are in a complete void. They’re not just without a home – the term is drastically selling it all short. They’re without anything. That’s how fucked up they have been at one point of their lives. And mental health is largely about direction – almost no disorder or “state” exists in a stable manner, it moves, it interacts with environment, and it tends to get better or worse because of this. Once someone is in so bad a state that they literally fall outside of our world altogether, however are they going to get up again? And they will become even worse – if that’s possible – until they are literally shattered human beings (and the psychological shattering will quickly become a physical shattering). There is nothing more brutal. We walk past them every day, and we just shut it out – but we are walking past something that is utterly brutal.

When I lived in Darlinghurst, many years ago, I got to know some of the stories of the area’s homeless. In particular, there were two staples: Sheryl and Harry. Sheryl’s story was incredible. She was a successful doctor. She had a family, a life, she’d done pretty well for herself. Until her latent schizophrenia was triggered. Who knows how long that spiral took, but she became so incapable – her condition, we can safely presume, so severe – that she fell outside the system and onto the streets. She lost her home, her family, everything. She mentally did not have what it takes to have any of them. She didn’t have what it takes to have anything at all. And she was in one of the unfortunate situations (because this is often one of the sad variants in who does and does not become homeless) of not having any support network around her (presumably, her family abandoned her completely). She fell. And a few years later, there she was, not even having the mental capacity to ask anyone for money, sitting in shop doorways of Oxford Street, in an endless throw of anxiety and paranoia, muttering threatened defenses at passers-by, sitting in her own urine, the bottle of metho never too far away (and what do you think metho does – apart from quickly kill you – to an already shattered mind?). She is not just the story of the homeless. She is the story of the “mentally ill”.

Harry was, granted, higher up the capability spectrum (but that’s still a bad concept to place on anyone who is homeless). I’d heard stories – and he’ll concur these – that he was sent to Vietnam, but I always questioned his age, and suspected that he was rather the son of a Vietnam ex-veteran. I’ll never know. Regardless, something to do with post-Vietnam trauma (whether it was his own, or whether he was indirectly the victim to someone else’s) led to a breakdown, a kind of psychological implosion. This led him to falling outside that system. He would swing from severe highs to severe lows – both as insane as each other – and go from miming disco classics with a clown wig, up and down Oxford Street, to storming around in the throws of his paranoia and anxiety (his delusions) in military uniform, announcing the end of the world at the hands of war. There was something so eccentric to Harry’s insanity – so theatrical, in a way – that he became the “favourite” homeless person of Darlinghurst, and many people would gather round to “enjoy” his antics, looking on with actual smiles on their faces. They “enjoyed” him. But, in his mind, he honestly believed the world was about to end and that we would all be killed – until his body wore out and the vodka took its toll and he curled up on whatever bench, or box, or whatever it was, that he slept on. I don’t think he was enjoying that much. He was once another human being, in the same world you and I live in. Then, that fateful moment eventuated. Harry is not the story of homelessness. He is the story of “mental illness”.

We are already seeing spikes in the rate of homelessness. They correlate with the mental health crisis. Now put that in the context of Rudd’s vision of this society. These cases may be the minority – they may be the most extreme cases possible. But they still paint a picture. The crossroad is great. Intervention – and opportunity to intervention (and I’m talking, as well, about self-administered intervention) is everything. The difference could very well be the difference between any one of the happy, functioning people I know who at one stage of their lives were anything but, and… well… Harry and Sheryl. Mental illness doesn’t change by itself – it changes because of what is done to it. Rudd is now seeing that less can be done. Unless you’re rich. If you’ve got the money, then it can come down to whether you have the support network around you, etc (but economically successful people tend to, it goes with the turf). That is not fair.

Mental health and the elderly

I’d say the one hope we have in this for media exposure and some degree of public outrage is the impact this has upon senior citizens. We’re already seeing this – many of the articles today focus on the issue as one for the elderly. It’s a misrepresentation (and hence, does annoy me, admittedly), but at least it gets it into press with a marketable interest factor. There are systems in place within the mental health industry (pissweak as they are, mind you) for the elderly, and these are affected by the budget cuts too, but what you have to understand is how this issue does incorporate them, and I don’t think people do enough.

We are psychologically a pretty backward society. We’ve evolved, and I hope will continue to, but, on the whole, we’ve a long way to go, when you compare our connection to physical life to our connection to psychological life. That makes a grand kind of sense, really, because the physical life is much simpler – it’s mechanical, systematic, tangible. Our species has grasped the physical first, and this then has affected our culture (and it’s connected to the patriarchal grip, but that’s another article). We herald football players over academics, people who do things with stuff over people who think about things. We marvel at men who conquer mountains more than those who conquer intellectual confounds. And we do this because its easy to project upon these things, even to see them as remotely attainable for us all. We grasp the physical life. But we grapple intensely with the psychological. And as a result of this, we tend to see old age – a taboo, as it is, pumped full of our own projections of fear – as a physical phenomenon. We “die” physically. We fear it. We see death in old people. We comprehend it as purely a physical phenomenon.

But it’s not just physical, it’s psyhcological. The body doesn’t just decay in old age – so does the mind. And these things are actually much more complex and more difficult to treat. When you can no longer walk, you get a wheelchair. But what do you get when your mind starts to fail you? Not much, as it is! But you’re about to get even less – unless you go into that nursing home with access to ample funds (and for most, just being in a nursing home drains any finances; letalone then paying to address the issues you’re facing, once you’re there). And I’ve seen families fork out for those wheelchairs, but we have very little understanding of the psychological reality of these people, nor their needs. In the end, their psychological needs are less considered than those of the rest of us – when, in reality, their needs, across the board, are greater. With the state our nursing homes are mostly in, as it is, even the facilities cannot adequately recognise and treat many of these needs – it comes down to the social workers who go into these places, as well as the homes of the elderly who have not been placed in institutions, and work with them. What does the budget do? Take funding away from social work – including the social work assigned to the elderly.

Lynne Harris, a social worker that deals with the disadvantaged elderly, has come out to bat for them in the press. “I cant begin to tell you what is going to happen,” she fears. “Alot of these people do not have family, and unless we can go in there and assess them, and work with the GPs, nothing happens. In aged care, there is so little funding for people with mental health disorders – it’s just not there. So taking away the social work services will really diminish it.”

Robbing from the mute

This is not fair. It really isn’t. And what’s so despicable about it is that it steals money from this area with a great deal of obviously calculated safety, knowing that this issue does still not have the social voice behind it. These people do not have the voice – obviously. They are people just trying to deal with even the most basic aspects of their lives, letalone mount fights against government policy. And the elderly don’t have a voice at the best of times, letalone those suffering from mental health issues. And to the mentally healthy, we still see a culture of tabooism and social stigma that means we see very little discussion, because we’d all prefer to put our blinkers on and presume it will never happen to us. In truth, it happens to more and more of us, all the time. And the ultimate twist of the knife? It happens in higher ratios to lower socioeconomic groups who, obviously, are going to be psychologically more fragile and susceptible to distress, because their lives are harder to begin with. You’re taking it away from the very people who need it the most. That. Is. Not. Fair.

These are just some of the issues connected to this debate. If you have a situation you’d like to talk about of your experience of mental health, or if you’d like a soapbox to vent, you can use the comments board below! But, unlike many of the other articles, this time we are talking about a political issue, so make sure you’re also writing to your local member, or whoever you can get hold of, and (my personal approach) take to their airwaves! Go on. Mr Soandso needs somebody to pull him into line. And so, I’m sorry to say, does Kevin Rudd.

You can sign the online petition on this issue at http://www.gopetition.com.au/petitions/reinstate-allied-health-professions.html and make sure you answer our mental health poll on the right hand menu of the screen!