A central dilemma in the mental health sector: Structural imbalance

Abstract

Mental health services provision is persistently criticised regarding resource inadequacy. Services are also subject to another dilemma, “structural imbalance”. This study demonstrates the dimensions of structural imbalance in Australia's mental health sector by recourse to the 1997 Australian Bureau of Statistics national survey of mental health and wellbeing. This study also examines the concept by reference to the Australian Government's announced COAG initiatives (April 2006), and State government responses (July 2006). The two dimensions of structural imbalance are, first, that some people with no clinical mental illness consume mental health services and, second, that other people have clinical manifestations of mental illness and (for various reasons) do not consume mental health services; the present study shows how the situations coexist. “Throwing more money” at the pre-existing structures may do nothing to address the structural imbalance problem. Remedies are discussed by reference to the reforms undertaken in the British National Health Service in recent years.

Keywords:

• Australian mental health sector
• Council of Australian Governments
• Paramedical professions
• Service provision
• Structural imbalance

Acknowledgements

This research has been supported by the Queensland Government, the Australian Government and Victoria University, Melbourne. We wish to thank Carmel Meir, Mario Gryl, Roman Scheurer and Marie Watson for assistance in the preparation of this paper. We also thank an anonymous referee whose constructive comments have improved this paper in a number of ways. Needless to say, neither the persons mentioned above, not any institutions, bear any responsibility for the views expressed here.

Notes

Source: Australian Bureau of Statistics (1998).Note. The percentages in this figure refer to the Australian adult population.