public housing
28 Nov 2008
The Real Housing Crisis
In the mid 1980s, people with mental illness were moved out of institutions to be cared for in the community. But the necessary community infrastructure never materialised, writes Judy Singer
The first time Jenny, a public housing tenant in Sydney’s Inner West, met her new neighbour, Wayne (not their real names), Wayne attacked her with a broomstick.She’d heard him out the back, ranting about “f*ckin’ wogs”. Concerned for her sons who were outside, she went out to investigate. When she told Wayne to keep it down, “he went straight for my heart with the broomstick”. She ran for her life, while her son tried to hold him off with a cricket bat.
It wasn’t about race. Jenny and her family look Anglo, like Wayne. But her neighbour is a delusionary, mentally ill young man, fighting fit and raging. Thus thwarted, Wayne started smashing all the windows of his townhouse. The police came and took him into custody, but by midnight, he was back outside Jenny’s house, hurling obscenities, threatening to kill her and carve her into little pieces.
Since that night several months ago, Jenny says she has been living a nightmare. Her younger son is so afraid that he “keeps telling me to whisper when we’re in the living room in case Wayne hears”. Neighbours say the boy has lost five kilograms since the incident. And Jenny is afraid that her older son will take the law into his own hands and get hurt.
The Department of Housing has called in the community mental health team, and Wayne has been in and out of hospital since, but neighbours say that every time he comes back, “he goes straight on the rampage again”, which has included roaming up and down the street threatening passers-by with a stick. Jenny says, “I can’t eat, I can’t sleep, I’m that terrified of what he’s going to do next.”
She fears for her own sanity and says, “The police are useless and the Department [of Housing NSW] does nothing.” She is scheduled for a court hearing for an AVO, but the police have still not issued her with the documents. The police officer assigned to her case only works two days per week, and never returns calls. Jenny says, “I understand that these mentally ill men have to live somewhere, but why are they bringing them in here amongst single mothers with children? But the Department keeps bringing ‘em in, and bringing ‘em in…”
The influx of people with “complex needs”, a rubric for drug addiction, mental illness and behavioural disorders, into their communities is the dominant topic among public housing tenants these days. The Central Sydney Regional Tenant Resource Service reports that this year, inquiries involving mental health and anti-social behaviour topped the list of tenant concerns, replacing maintenance, the perennial bugbear for tenants in our often rundown estates.
Everyone has a story, and nowhere more poignant than old people terrified by violent neighbours. Joan, an aged pensioner in a nearby estate lives in fear of her neighbour — a massive, obese man who bangs on her door and accuses her of sending radio waves through the walls to kill him. Most of the older tenants will tell you that a dozen years ago they were very happy in their housing communities. But then it all began to deteriorate.
So what has changed? Over its 12 years in office, the Howard government stripped $3 billion from the states’ public housing programs. NSW, the largest public housing provider in the southern hemisphere, with a portfolio of 140,000 dwellings found itself going out backwards, with maintenance costs in the 2006-07 financial year alone totalling around $1 million each day. Something had to give and the NSW Government’s response was triage.
Their new policy “Reshaping Public Housing”, introduced in 2005 by then Housing Minister, Joe Tripodi, saw a narrowing of the eligibility criteria to “those most in need”. This was the final stage of what had been a gradual transition from the original purpose of public housing — to provide low-cost housing for low income families — to what is now known as “welfare housing”. Low income families no longer get a look in unless they are homeless. Nowadays you need to be either aged, disabled, mentally ill or addicted to get a foot in the door.
A milestone in the transition from public to welfare housing came in 1985 with the release of the Richmond Report, which recommended that people with mental illness be moved out of large-scale institutions to be cared for in the community. But the necessary community infrastructure never materialised. The state’s coffers benefited from the savings on beds, but the mentally ill were out on the streets with only the promise of care, then left to fend for themselves, often cycling in ever-decreasing circles through jails and emergency wards.
The move to deinstitutionalisation owed much to the idealism of the 1960s, fuelled by the anti-psychiatry ideas of RD Laing, and the influential film, One Flew Over the Cuckoo’s Nest which exposed the horrors of institutional abuse. These days, expert opinion is against a return to large-scale psychiatric hospitals. Vivienne Miller, co-author of the National Standards for Mental Health Services (1996), and a long time advocate of community care, says: “If you had a mental illness, where would you rather be living — in the community, or in a hospital?” She adds: “Where you have a large-scale institution, the potential for abuse is magnified.”
Despite the acuteness of the problem, the director general of Housing NSW, Mike Allen, says that the Department does not keep statistics on the number of people who gain public housing on the basis of mental illness. Responding to a question by Greens Senator Sylvia Hale, at October’s Housing Budget Estimates committee meeting, Allen said that numbers are not kept since there is no legal obligation on prospective tenants to reveal their mental health status.
When grilled by Senator Hale on whether he was aware of incidents such as the one described above, Housing Minister David Borger replied that Housing NSW had recruited a number of specialist support staff deployed across the state, and was successfully trialling a number of new shared access schemes, which linked housing to support services. And he added that NSW had a zero tolerance policy towards violent behaviour.
Not according to Linda, one of Jenny’s neighbours. “If I was going to go rampaging around like Wayne, I’d be out on my ear tomorrow. But with the ‘mentals’ … they’re never going to evict them”. None of the tenants interviewed for this article had ever come across any specialist support workers, though Housing NSW is currently trialling the latest of the shared access schemes referred to by the Minister, the much-awaited Housing and Human Services Accord.
The Accord, a vital component of the Reshaping Public Housing package, is intended to provide a framework for human service agencies to work in partnership with Housing NSW to support people with complex needs. However, the trial is not yet at the evaluation stage, let alone ready to be rolled out across the state.
Meanwhile, a source within Housing NSW, who asked not to be identified, said that in a problem situation the procedure was to call in local mental health support services to calm things down. If the problem occurred a couple of times, the department could apply to the Consumer Trader and Tenancy Tribunal, but there was little point. An eviction of the person at the centre of the disturbance was unlikely, because the tribunal would tend to uphold the rights of the mentally ill to a home in the community.
Like all the public housing tenants interviewed for this article, Linda accepts the justice and necessity of accepting people with psychiatric disorders into their communities. “We can’t have them sent to Leperland,” she says. “They have a right to be a part of the community.”
But while Linda affirms the rights of the mentally ill, her ambivalence is apparent. For as older residents in the complex die they are replaced by troubled younger men. Now six of the 15 dwellings in her complex, or 40 per cent, house people who receive support for having a mental illness or intellectual disability. There are also a few more who, in Linda’s opinion, have not been diagnosed.
Linda says that the worst thing is always being on alert. “You never know who is going to go off next.” She doesn’t let her children play in the adventure playground provided for the complex. “How can you explain to an eight year old that this one is mentally ill, and that one is mentally ill?” She is clearly not happy with the idea that her children are “growing up with the idea that this is the way the world is”.
So what is to be done? Sylvia Hale has the diagnosis and the cure, but it won’t come cheaply. She says, “In every sphere, services are run down. People are released prematurely from hospital because there are not sufficient outpatient resources”. It all comes down to money, and that means raising taxes, something neither the Federal Government nor NSW Labor are prepared to countenance.
Meanwhile the consensus among public housing tenants is grim. Linda speaks for all when she predicts, “Nothing is going to be done around here until someone gets killed”.
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its a crisis alright and it isn’t helped by society thinking it can push the mentally ill into public housing ghetto’s, and worse, co-opting everyone into the big pretense that nothings wrong with these people.
Collectively we need to really examine mental health issues, not just housing dilemas and infrastructure.
Perhaps as part of this dialogue it would also be worthwhile looking at introducing some basic education at school on dealing with mental illness, particularly psychosis, in others. Kind of like the first-aid/CPR/life-saving courses done in high school - hopefully the basic facts kick in when needed.
Mental illnesses of the sort described in this article are only increasing. And if the prediction rates of recreational drug-induced psychotic illnesses are correct, such situations are going to become more common.
Someone having a psychotic episode often becomes much physically stronger than they could ever be when when they are sane. It is a frightening experience and non-psychotic people are bound to feel vulnerable because it is so unpredictable. At least some basic training can help ease the sense of helpnesses in the face of the situation.
Great article Judy ;)
I agree that the community-based and general hospital mental health services established following de-institutionalisation are inadequate and that the symptoms of this (greater proportion of mentally ill people among the homeless, prison and "welfare housing" tenant populations) have been exacerbated by policies such as withdrawal of governmnent from public housing, "tough on crime" policies, and poorly resourced anti-recidivism / prison diversion programs etc.
However, I was disappointed by Judy Singer’s portrayal of the mentally ill as violent or unpredictable. Obviously some people with serious mental illnesses such as schizophrenia sometimes display violent behaviours such as Wayne’s and particularly when they are unsupported by the health system and other services as Singer notes. It is important to remember though that people with a mental illness are in fact much more likely to be the victims of violence rather than perpetrators (see Mental Illness Myths and Misconceptions on http://www.mindframe-media.info/site/index.cfm?display=86529) and research suggests that mentally ill people have a lower rate of violent behaviour than the general community.
Perpetuating the ‘mentally ill people are violent’ stereotype serves only to embed prejudices, encourage the view that de-institutionalisation was a mistake, and work against the notion that there are more constructive ways of interacting with people with a mental illness such as de-escalating situations, reducing sources of stress, and generally treating the person with respect (from above website: "Schizophrenia is not a stress-related illness, but stress can interact with other risk factors to trigger acute (psychotic) episodes of the illness. Stress-inducing activities and events include substance use, work/school problems, rejection by others, family conflicts, low social supports and major life events.").
The statistics quoted by jk0206 are well-known, but they are too often used to shut down discussion. Unless I have some unconscious prejudices, I am not aware of saying anywhere that "the" mentally ill, as a class, were violent, and I don’t see "the" mentally ill as a class at all. What I did was raise a difficult issue, and I quoted several examples of the many that I have heard of some delusional mentally ill men who are terrorising their neighbours. I use the word "terrorise", because the neighbours report that they are terrified. I am not talking about people who suffer from depression or anxiety or any other condition included in the statistic "that 1 in 5 of us will have a mental illness one day". What I am talking about is actual incidents in which people in public housing have been threatened by their delusional neighbours, and have turned to the police,or to the department of housing, or to community mental health services, and received no help. Only last week, there was an incident reported in the SMH in which an 81 year old shot his neighbour’s grandson. People in that housing complex tell me they have been asking the Housing Department to do something about this man for years! I need to make clear that I do not blame the Housing Department. First of all, people who have a problem with their neighbours in private rental, go to the police, not their neighbours. I believe the Department is constrained by community attitudes which suggest that inside every dangerous person, there is "really" a co-operative person. And that if they’re not co-operative, it is actually the fault of the people around them. Thus, I have heard several "anecdotes" from people who say that on reporting their fears of dangerous neighbours, they have been told to try "talking it out" with them! This is in effect the attitude that JK is encouraging when s/he puts the onus back on the community for "de-escalating situations, reducing sources of stress, and generally treating the person with respect". You could almost say this was a new variant of "blame the victim". I’m now wondering whether many readers are asking themselves "What did Jenny do to provoke Wayne? What did that young man do to provoke his neighbour to shoot him?".
Finally, I accept that mentally ill people are probably less violent than other groups in the community. But mentally ill people with a history of threatening behaviour are a known risk, and isn’t it the responsibility of our institutions to reduce known risks? Yes, we can all get unlucky and fall prey to a bunch of drunken louts on a rampage, but how many of us spend every waking moment worrying about it. It’s not the same as feeling you are living next door to a ticking time bomb.
This is not an easy topic, I am keen to broaden my understanding and so I welcome further discussion and debate.
Correction to sentence in prev comment: "First of all, people who have a problem with their neighbours in private rental, go to the police, not their
neighboursReal Estate Agents.We all live in and with institutions —the community itself is an institution as are our schools and universities and the bureaucracy including local government councils.
Deinstitutionalisation was always a bad mistake. The way forward is to improve them whether they be hospitals , schools, preschools etc
It is pie in the sky to think the "community" will care for people with mental illness or with intellectual disabilities. The abandonment of Kew Cottages is a disgrace where the land values have seduced all state governments to build houses holding 6 people in separate communities. They are often locked up at night because the staff member can’t manage and the community wont. Clusters of these house on land such as Kew would be the sensible and humane way forward—in other words building a new type of "institution"
KerryL’s comment underlines my concerns. Deinstitutionalisation seems a bad idea because we have failed to establish decent community-based services for people with serious mental illnesses. However, as well as the abuse that can and does occur in psychiatric institutions (we still have some left in this country, and there are hundreds all over the world, some of which I have visited), they don’t actually help people recover from mental illness and often make things worse. I personally have met inpatients in supposedly psychiatric hospitals in Asia who have been there for 30 years and are so heavily medicated that they are barely human. This is no kind of life. So while it seems much easier to simply lock these problematic people away, doing so usually means deciding as a community that their human rights are somehow less important than ours. At the same time, leaving people who in the past would have been residents of psychiatric hospitals to their own devices and with paltry services means they often end up homeless, in gaol, or unsupported in public housing clearly is not the answer either.
So yes Judy Singer, this is a very difficult problem indeed. However, I am optimistic that there are solutions and drawing attention to the resulting problems from the current policy failure is critical. I appreciate that it must be terrifying for people to have a disturbed mentally ill neighbour who requires but is not receiving help, and of course trying to intervene is not appropriate when such a person is highly agitated or in a delusionary state. I merely wanted to correct the impression I still believe your article made that people with serious mental illness are on the whole more violent and dangerous than the general population, and to remind anyone reading this that if they do encounter someone who has a mental illness (not if that person is threatening or attacking them), there are options for relating to them that are not based on fear. And indeed there are constructive ways of thinking about this problem that similarly are not based on sensationalist arguments, and many good people around the country are working very hard to try to persuade government to provide the proper resourcing and coordinated action that is required to try to change things for the better.
If anyone would like to read further on this subject in terms of the scope of the problem and possible solutions, I would recommend the Mental Health Council of Australia website, particularly its reports Out of Hospital, Out of Mind (2005), Not for Service (2006) and Time for Service (2006) - see http://www.mhca.org.au/Publications/. The 2006 Senate Inquiry into Mental Health (available on the APS website) is another excellent resource - an incredibly comprehensive survey of the state of mental health and related services across Australia with some sensible recommendations about ways forward.
Ultimately, the reason things are so parlous is that people with a mental illness are among the most marginalised in society because of the incredible stigma attached to the experience of "madness", and so it’s difficult to either get the topic aired at all let alone constructively or get community support for more funding and attention to be paid to the issue. So I’m all for talking about it, I just think we need to be extremely vigilant in how we do this and take care not to add to misperceptions.
jk0206, I’m a woman with multiple disabilities - including the occasional hallucinatory mental illness- and I didn’t find the article to be fuelling the stereotypes you mention.
Yes, the stigmatizing belief that all people with mental illness are violent psychopaths is serious and common. However Singer provides clear context for her concerns here and acknowledges the need for better community healthcare - this does not strike me as a call for further criminalization or stigma in lieu of health care rights at all.
Singer raises an important issue in this statement though, re: how to discuss the aggressive behaviour that IS perpertated by a minority of people with a mental illness:
"The statistics quoted by jk0206 are well-known, but they are too often used to shut down discussion."
Exactly. While mental illness remains a heavily stigmatized topic in Australia, and suffers of the most extreme cases are more prone to violence and poverty - it remains that violent, "acting out", usually male sufferers sometimes are given precedence OVER the rights of staff and suffers who are women, children or NON violent men in health care settings.
I would personally not attend and hospitals or community care services for people with mental illness because of the aggresion of the few, and the incapacity or lack of skill of staff to deal with the gap between "stigma" and "addressing real risk". Sexual abuse and harrasment is common in both hostels and hospitals to female youths with disability by older mad males.
While such perpetrators ARE the minority by far, there does need to be a way to address this issue, without being accused of stigma by those at the distance to be able to treat the issues seperately.
It’s depressing to know that this extends to mothers in community housing also, yet worth discussion.
OK, I stand corrected re: my concerns about adding to misperceptions! I am probably a little sensitive about this as having worked / researched in this area I have been exposed to stigmatisation and abuses of power both systemic and personal. I have also had a small number of experiences of positive encounters with highly distressed people with mental health / substance abuse problems, which I suppose have given me some sense of optimism - though I fully acknowledge this is of no comparison with what people who live or work in daily contact with people with serious mental illnesses experience (part of why my experiences were positive was because I was able to give 110% of my energy and attention to them, which is of course a rare luxury). Two final points, not because I wish to shut discussion down, but because by the end of this post I will probably have said enough.
Firstly, while they are an unpopular cause I do feel for the violent men of our communities - they are the easiest of all to write off with the disproportionate and dreadful damage they cause and resources they consume. However, while they are part of our society they are our problem, and I believe we need to presume they still have some humanity within them and to think seriously about how to stop our young boys (and some girls) becoming that way in the first place, if not try to assist them once they are already on what might appear to be a dead-end path.
Second, related to that, and reiterating a theme emerging in my previous post, I am totally supportive of discussion - but I think as well as talking about the problems we need to keep focussed on ideas for solutions, as otherwise it’s all too easy to get bogged down in feelings of pessimism and hopelessness… I’ve already provided some tips for reading on ways forward (as well as lots of coverage of the problems!) but to wrap up, here’s one more - Orygen Youth Health Director Patrick McGorry’s vision of how things could be different as laid out at the end of a speech he gave in 2004 titled "Every me and you: Responding to the hidden challenge of mental illness in Australia". For the abridged version see http://uninews.unimelb.edu.au/news/1302/, especially the last section under the subheading "Dream Scenario".
And what is that scenario like for the person experiencing mental health problems him or herself? Also from McGorry:
“I got help early, and when I needed it, and so did my family.
Our insurance paid for the help we received.
We were able to see doctors and others who were smart, well trained, and knowledgeable.
We saw people who (liked and) respected us.
People respected my privacy.
No-one ever locked me up or made me take medications against my will.
The people in my family understand that it’s not all my fault, and not all their fault.
No-one hassled me about how sick I was or whether I deserved to get help.
I just got it.
And when I talked, people listened."
Positive for them, positive for all of us, and worth a try. By international standards we are an incredibly wealthy country with pretty good mental health service infrastructure and personnel, increasing levels of mental health literacy, a still-intact social safety net, and myriad other private and non-government services including some truly excellent programs and initiatives. Compared with the situation confronting the cause of mental health in some countries, we have a very solid foundation here in Australia from which we can and must continue to work.
Hi JK. I’m also interested in positive solutions, so I’m wondering if you can see a solution that will give "Joan" or "Jenny" and her son a good night’s sleep free of fear.
Both Catherine James and jk0206 fall for the ninetenth-century fallacies: that there is a rational way of dealing with the irrational; that the mentally ill are only victims; and that those who are not mentally ill but who are victims of those who are are just collateral damage in the wider cause of deinstitutionalisation.
The mentally-ill-as-victims notion isn’t working for anyone, and only when we convince government that it’s a false economy will they do something. But do what? Damage limitation does not just apply to the mentally ill, and we need a way of thinking that goes beyond RD Laing and Foucault.
"some basic training", Catherine James? Judy has described a clearly intolerable situation and you think the answer is "some basic training"? Does this extend to kids on play equipment?
It’s also unfair because not all mental illness involves violent psychosis, as jk0206 observes. That said though, jk gilds the lily a bit:
Even when they are supported by the system the lash out. It’s part of the job for mental health workers. Not all incidents are recorded in detail sufficient for research or ministerial PR.
That research should have picked up the fact that police classify violent incidents diffrently when mental illness is involved, as opposed to the temporary illness induced by alcohol.
So if you do anything that may cause stress to anyone, and they lash out, you only have yourself to blame? One of the features of psychosis is that those affected can become violent due to random, or even non-existent, factors - which flies in the face of jk’s cool rationality.
Whereas Judy Singer’s ‘Wayne’, he’s fully human isn’t he; and the families who cower before him, that’s the life. I accept your point that there are people who are trying to get extra support, but if you operate from an antediluvian set of perspectives it should surprise no-one - least of all yourself - that you’re going to get ignored.
After all that experience, you should have learned the difference between an article that mentions mental illness and violence and one that reinforces it. Singer’s article no more demonises the mentally ill than it does to "fuckin’ wogs". You have no excuse for blithely ignoring and talking past the real and immediate concerns of judysinger’s post of 04/12/08 11:19PM.
We need a new way of thinking about this, and neither Catherine James and jk0206 could be bothered. This means that your James Q Wilson broken-window three-strikes-yer-out treat-the-symptoms-only becomes the only answer available. If you’re genuinely tired of failed reaction, get to work.
Hey awelder, I accept my comment is no where near as informed or researched as Judy Singer’s or the other thread contributors, so please take what I said with a grain of salt if my ignorance offends you. I was not blithely ignoring anyone, least of all Judy’s plea for a positive solution; I simply did not feel I could further contribute to the conversation.
But seeing as you’ve so passionately named and shamed me, for the record my comment was not intended to be a solution to the problem described by Judy. I was talking from a personal experience similar to the one described in Judy’s article. "Basic training", in the context of the article perhaps seems a little left field, but it was more intended as an overall big picture comment to see if we could have more education around understanding different mental illnesses and how to cope with them given the extent of the mental health problems that are on our doorstep.
I know the fear that comes with having someone close to you who is mentally ill of the psychotic sort. It is not a fear based on demonising anyone but it is a natural fear stemming from the fact that no one, not even the ill person, is in control of the situation. Adequate medical care can help, but sometimes there is a buffer period where the medication needs time to work.
I did not condone institutionalisation in my comment, and nor do I lament de-institutionalisation. On the contrary, I suggested more education of the wider community (because it would appear we are going to live with these situations more rather than less). I do not regard mentally ill as "victims" just as I do not regard someone with cancer as a victim. They are both unwell, and require care. It may one day be ourselves at the receiving end of such care.
If I can contribute anything further, I would only wish to add that our solutions should strive to keep the golden rule in mind: "if it were me in their shoes, how would I want to be treated?" But other than this, I really don’t know what short-term solutions can help Joan, Jenny, or anyone sleep better at night with their respective situations, short of removing themselves from what they feel threatened by. However, even if this was possible, I know it’s not really a solution as it would simply become someone else’s problem. These situations are long term problems that require long term solutions. I’m genuinely sorry I cannot help more.
I don’t know if I’m supposed to be the moderator since I started
this thread, but I’ll step into the role, just to affirm that
we are dealing with a very difficult dilemma, and I admire the
passion with which participants are expressing their viewpoints,
all of which express important truths. The question at issue,
as I see it is:
How society responds to this question will arise from the quality
of debate like this one, so keep it going, folks.
I must say I was particularly impressed with "DeployTheIdiots".
It takes a great deal of character to speak up for a truth that
may be misused by those who will seize upon what you say to turn
it against your "own" people. Whether it’s public housing
tenants who allow that not all of us are angels, or to use a
common example, Moslem women who speak out against sexism in
Islam, you risk becoming a poster boy/girl for people who want to
use you to malign your people. So good on you for speaking up for the nuances!
I have just returned to this thread after a week or so to discover it has continued a little further. Catherine James, a mental health first aid program has been developed by Betty Kitchener and Anthony Jorm - if you are interested in learning more see http://www.mhfa.com.au/mhfa_manual.pdf especially pages 38-41 which is an overview of first aid for people with psychosis (note that the first two points of advice if the person is threatening others is not to intervene and to call the police - though request a plain clothed officer if possible). Awelder, I’d be glad to hear more about ideas you have for new ways of thinking about things as you suggest, because I agree. What do you see as some possible answers, and how do the suggestions that are out there in the debate on these matters (including in places such as the resources I have pointed to) fall short?
As you observe Judy Singer, the dilemma you have raised is very difficult and invokes passionate responses, particularly for those with direct experience. However, with respect to all, we need to focus on what practically should / can be done if we want to move the debate forward - and perhaps even improve the current situation. More resources would be a great place to start, as our current system is so depleted that we cannot base judgements about care in the community on it. But at a more detailed level, there are many things that can be done.
The 2006 Senate Inquiry for example makes 91 recommendations about improving mental health and related services in Australia (nos 37-39 relate specifically to housing). While the inquiry was conducted under the previous government, the ideas contained in the recommendations have been raised a number of times and are therefore worth discussing. Let’s take a few, some of which relate to issues raised in this thread.
Recommendation 1 - which influences all others: Matching expenditure on mental health (currently about 6%) to the disease burden (9-12%).
12a: Federal govt to increase the number of funded places and financial incentives in accredited medical and allied health training courses to meet future mental health workforce demands (workforce shortages are a huge issue and only getting worse).
13a: Establish more staffed step-up, step-down treatment services so that people with psychotic disorders have somewhere to go as they begin to get unwell and after the worst period has passed, rather than not being able to get into hospital until they are acutely unwell and after they have caused great distress to everyone around them (these services are very scarce, have been proven to work, but are expensive and therefore require government to push their establishment).
13c: Ensure safe environments for consumers in all mental health service settings including gender and age-group separation (currently not guaranteed as deploytheidiots points out).
20: Federal government allocates recurrent funding to ensure prevention and early intervention programs in the education system are ongoing and evaluated.
23: That state / territory governments and mental health service providers significantly increase the use of assertive community treatment and active case management to support people with severe adn prolonged mental illness to live in the community.
37: That all levels of government ensure the full range of short, medium and long term supported accommodation is available to those with a mental illness who need it (possibly drawing on successful pilot programs involving coordinated service delivery - disability support, accommodation and health).
These are just a few of the issues and possible ways forward. What do people think?