Australia: Despite deaths, no youth mental facility in Brisbane

By Declan O’Malley
14 March 2016

Queensland’s state Labor government is currently conducting an official inquiry into the 2014 closure of an adolescent mental health facility in Brisbane, the state capital, which led to the tragic suicides of three teenagers.

Will Fowell, 18, Caitlin Wilkinson, 18, and Talieha Nebauer, 17, former patients of the Barrett centre, died within eight months of its closure in January 2014. Their suicides highlight the mounting human cost of the cuts to health care and other essential social services being inflicted by governments around Australia, acting on behalf of the corporate elite.

The inquiry now underway is a cynical attempt to pin the blame on the previous Liberal National Party (LNP) government for the closure—thus covering up the role of successive state and federal governments, both Labor and Liberal-National, in failing to provide adequate mental health services.

The state Labor government is also using the inquiry, which is due to report in June, to delay replacing the Barrett centre, despite previously promising grieving parents it would do so. A spokesman for Health Minister Cameron Dick has said Queensland Health would wait to evaluate the inquiry’s recommendations before deciding where and what new services would be provided.

As a result of years of neglect, the Barrett centre was the only Tier 3 mental health facility for youth in the state. Tier 3 patients are those with severe, complex and persistent disorders. The centre provided beds and care for teenagers with such serious illnesses.

When Premier Annastacia Palaszczuk announced the commission of inquiry last July, she claimed it would give the families of the dead teenagers “the truth” about the closure and its “catastrophic and heart-rending consequences.”

Justine Wilkinson, the mother of Caitlin Wilkinson, told reporters that she was not looking to the inquiry for scapegoats, but for the closure to be rectified. “I think they [the government] are going to build a new centre, that’s what they promised. But ... I haven’t heard anything more about it.”

The Barrett centre closure was ordered as part of $120 million cuts to health care made by LNP government. That government’s health minister, Lawrence Springborg, who is now the official parliamentary opposition leader, defended the decision when testifying in the inquiry.

Springborg noted that the decision to close the centre was made in 2008, under the previous Labor government. Labor leaders responded by claiming they had plans to build a replacement facility, but problems with the chosen site threw its construction into doubt.

Labor, however, is responsible for the rundown of mental health services that led to the closure. Health officials told the inquiry that the Barrett centre had been in urgent need of upgrade and refurbishment. A report in 2012 stated that the projected cost of building maintenance would be $400,000.

The inquiry has heard that mental health care in Queensland had been among the worst-funded systems in Australia since the 1990s, never rising above sixth, out of eight states and territories. During this period, Labor governments were in office in Queensland, almost continuously, from 1989 to 1996 and 1998 to 2012.

More broadly, a policy of “deinstitutionalisation” and “mainstreaming” has been implemented throughout Australia since 1993. This program consists of systematically closing down dedicated mental health facilities and placing patients in general hospitals or “community” care. The number of psychiatric beds in hospitals has plunged from around 30,000 in the 1990s to less than 7,000 today, despite an increasing population.

Under the pretext of freeing patients from antiquated and run-down institutions, many mentally-ill people have been left to fend for themselves, unable to find assistance or services. These problems have been intensified by the austerity measures implemented by federal and state governments amid the collapse of the mining boom and the deepening impact of the global economic crisis that began in 2008.

Dr Anne Brennan, a senior psychiatrist, told the inquiry she was given just four months to find new treatment options for the centre’s teenage patients in 2014 and she had great difficulty placing them. Brennan said the options for mental health treatment remain few. Supported accommodation for people with severe mental illness was “extremely limited” and “extremely poor” in quality.

Psychiatrist professor Patrick McGorry testified that a residential mental health unit was essential for young people with severe and complex mental illness, but the Barrett centre had needed updating. “It was not an ideal setting by any means, it was a very stigmatised, old-fashioned sort of setting,” he said.

McGorry added this was probably because there was a broader lack of youth mental health services across the state. “I think those long lengths of stays were a testament to the fact there was nothing else for these kids, or very little else for them.”

Mental health services, especially for youth, will continue to worsen, on both a state and federal level, despite growing need. In 2010, the federal Labor government’s chief mental health adviser John Mendoza resigned in protest over broken promises of more spending on services and facilities. He cited damning statistics, including that every day, on average, about 330 people presented to hospital emergency departments with serious mental illnesses, only to be turned away, with less than 1 in 15 referred to any other services.

Mental health problems are affecting growing numbers of people. The Australian Institute of Health and Welfare (AIHW) estimates that 45 percent of Australians will experience a commonly occurring mental health disorder in their lifetime, including depression, anxiety, stress-related and substance use disorders for adults, and behavioural and anxiety disorders for children. Each year, it is estimated that 1 in 5 adults and 1 in 7 children and adolescents (aged 4–17 years) will experience a common mental health disorder.

Yet, according to the AIHW, only about $8 billion, or $344 per person, was spent on mental health-related services by governments and private providers in Australia during 2013–14, a slight increase from $321 per person (adjusted for inflation) in 2009–10. Of this, just $2.9 billion came from the federal government. By contrast, the Australian government spent nearly $32 billion on the military last year.

Globally, mental illness is a worsening problem. Depressive disorders are today the fourth leading cause of disease, as measured by the World Health Organisation, which estimates that by 2020 they will rank second. Numerous studies also show that depressive disorders disproportionately affect the poor, who are least able to afford or gain access to services. Economic deprivation and the associated social stresses can compound anxiety and lead to depression in vulnerable individuals.

As the tragic deaths of the three Brisbane teenagers demonstrate, both Labor and Liberal-National governments are responsible for the chronic underfunding of mental health services, as well as for the worsening social conditions that are driving the growth of mental illnesses.