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Obsessive Hope Disorder: Reflections on 30 Years of Mental Health Reform and Hopes for the Future.

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John Mendoza
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The rationale for this Report is simple. It is released on the anniversaries of two landmark reports on mental health care in Australia - the 30th anniversary of the Richmond Report and 20th anniversary of the Burdekin Report. The move to deinstitutionalisation is arguably one of the most important public policy ʻdecisionsʼ of the post-war era in Australia. It has had profound impacts on our society and most particularly those affected by mental illness and their families and the mental health workforce. The Richmond and Burdekin reports did not signal the end of mental health reform. They were more likely to start the reform. The aim of this report is to examine what has followed. There have been dozens of inquiries, reports, plans, policies and strategies since 1993, some national, some by the states and territories. Despite all these plans and even the more recent high level engagement of the Council of Australian Governments (COAG) since 2006, this Report asks “How different things really are from when they were originally reported by Richmond and Burdekin, a generation ago?” While some positive changes are clear, there are still far too many reports of service issues and failures when it comes to mental health – “Too many people falling through the cracks”. Despite unequivocal commitments by all State governments in 1992 and reaffirmed in 1998, there are still hundreds of people nationally in every state jurisdiction except Victoria, languishing in institutional settings. We estimate this to be costing taxpayers more than $10 million a week. The life expectancy of people with mental illness has not improved. People with schizophrenia have the same life expectancy as remote Indigenous Australians, but there is no ʻClosing the Gapʼ strategy for schizophrenia. As we now reflect on what has changed since Richmond and Burdekin, Australiaʼs failure to lift the life expectancy of people with a mental illness is arguably the starkest indictment of our public policy failure in relation to mental health care.