Mental health commission needs authority to speak freely: Fels

Professor Allan Fels says the National Mental Health Commission he used to chair has lost the confidence of the sector and must be given the authority to speak freely about how billions in government money is being spent on the struggling mental health system.

As mental health experts express alarm over rising suicide rates and call for broad reform ahead of a federal government roundtable on Monday, Fels warned there was little evidence about whether government funding for mental health was being used productively.

Allan Fels, who chaired the National Mental Health Commission from its inception in 2012 until 2018, says: “There’s not a lot of confidence that the commissioners, acting as a commission, can speak freely and uninhibitedly.”Credit:Alex Ellinghausen

“[The commission] should specify desirable outcomes such as measures of improved mental health, and then require the provision of information about how well those measures are being met,” he said.

But he said it was failing to do so because it was not truly independent and lacked the legislated authority of entities such as the Productivity Commission or the Australian Competition and Consumer Commission, which Fels led for 14 years before chairing the mental health commission from its inception in 2012 until 2018.

“There’s not a lot of confidence that the commissioners, acting as a commission, can speak freely and uninhibitedly. That is the key point,” Fels said.

“The original concept [was] to set it up as an independent body that would hold the Commonwealth government to account and as a result enjoy the confidence of the community, especially the mental health community.”

Fels said that had gradually changed since the mid-2010s as its independence was downplayed and it took on a more advisory function.

The commission, which has $24.7 million in total resources this financial year, sits within the federal Health Department and its chief executive reports to Health Minister Mark Butler. CEO Christine Morgan, who was appointed in 2019, was also national suicide prevention adviser to former prime minister Scott Morrison until 2020.

As Butler seeks to restore the mental health sector’s confidence following an outcry over his decision to halve the number of Medicare-funded psychology sessions late last year, Fels said giving the commission statutory authority to independently scrutinise government “would be one useful step”.

“The government is still on trial,” he said. “I am concerned at the present environment which repeats history. Periodically, mental health has a brief rise to being very high on the policy priority list of governments and then it is very soon overtaken.

“There is an ongoing need for the Commonwealth government to lift its game on mental health, both in treating it as a priority and to get a better organised system, and the pressure from the commission [if it has the right authority] can make a difference.”

The Productivity Commission’s 2020 report into mental health also recommended the mental health body be given statutory authority status “as a priority reform”.

Butler’s office declined to comment, referring questions to the Health Department.

“The commission continues to provide important independent advice, and undertake national monitoring and reporting activities to improve Australia’s mental health and suicide prevention system,” a Health Department spokesperson said.

The commission also declined to comment, saying it was a matter for government.

Fels said giving the commission statutory authority was a low-cost change that would contribute to a much better system.

“But there remains persistent opposition, principally from the bureaucracy, to independence. I think the department does not want to expose the government or itself to independent review,” he said.

Beyond Blue chief executive Georgie Harman, who was the commission’s deputy chief executive between 2012 and 2014, backed Fels’ view.

“Over the years, [the commission’s] remit has broadened, and I think it has lost that incisive source of truth about how the system is actually performing,” she said.

“I want a single source of truth about … where the failures are, what’s improving. It’s in a unique position to do that with authority and independence.

“The government needs to consider its independence and legal structure. If you’re not established in statute you don’t have legislation that defines and protects your role.”

Crisis support is available from Lifeline on 13 11 14.

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