Ideas@TheCentre
Potheads and Headspace
If it wins the federal election, the Coalition has promised to spend $1.5 billion to establish 20 Early Psychosis Prevention and Intervention Centres (EPPIC), 60 new Headspace youth mental health centres, and 800 acute and sub-acute early intervention beds.
Tony Abbott has run with the ideas promoted by the 2010 Australian of the Year, Professor Patrick McGorry, and has been lauded for helping de-stigmatise mental illness.
It is difficult to criticise an initiative that may provide better access to mental health services. Nevertheless, the second wave of ‘community-based’ mental health reform within 30 years has broader policy significance.
In the 1980s, mental asylums and thousands of psychiatric beds were closed. The rational behind de-institutionalisation was patients would receive better and cheaper care in community mental health centres.
The results have been mixed at best.
For many people with mental illnesses, ‘care in the community’ means living in putrid inner-city boarding houses, which are a disgrace to our civilisation. The critical shortage of dedicated mental health facilities means many patients suffering acute episodes receive less than optimal treatment in overcrowded emergency departments.
It’s the same old public health story in community-based services, which claim to be under-funded and overwhelmed by demand. The total absence of performance data in the sector makes this difficult to verify.
But there are reasons to believe the need for mental health services has increased.
One factor is greater tolerance and public awareness encouraging people to seek help.
Another factor is more problematic – the normalisation of the use of cannabis.
Regular cannabis smokers are 40% more likely to develop a psychotic illness. A recent EPPIC study found that 40% of young people presenting with first episode psychosis used cannabis weekly. Fifty percent did not cease cannabis use and this exacerbated their psychotic symptoms. Recurrent cannabis use is strongly associated with relapse and non-adherence to treatment.
The case for funding early intervention psychosis prevention programs is based on the claim that community-based services are more cost-effective compared to traditional hospital-based services. But the unheralded issue is government spending even higher sums to treat drug abuse-induced or exacerbated mental illness, which is preventable if users abstained.
The implication is that drug-taking is not a ‘victimless crime.’ Some cannabis users experience major mental health problems and taxpayers foot the rising treatment bill. The hidden victims are the people with conditions acquired through no fault of their own, for whom no place is available in mental health services swamped by potheads.
Dr Jeremy Sammut is a Research Fellow at the Centre for Independent Studies.
