Australia Mental health advocates say Victorians being able to reach local support 'a gamechanger'
Avoca fought hard to keep medical services in town, but now it's facing another GP shortage
Less than a decade ago a rural community in western Victoria fought to keep a medical centre in town, but now it's a case of deja vu with a sudden shortage of general practitioners. Until a few weeks ago, three doctors worked out of the one full-time clinic in Avoca, a few hours north-west of Melbourne. Now it is down to just one, and the remaining GP is only available for face-to-face appointments one day each week. The ABC understands the change at Tristar Medical Group occurred in the past few weeks.
Donna's car is an essential tool to manage her mental health.
The mother, who lives on the fringe of Melbourne, has been navigating the mental health system for more than 25 years for herself, and more recently her son.
She spends hours driving to and from appointments for her family, due to the scarcity of services on the ground.
"Being willing to sacrifice almost an entire day to get support from another service is also incredibly time consuming and exhausting," she said.
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She now uses her experiences to support people like Lauren McGovern, who suffers from severe anxiety and depression as well as post-traumatic stress disorder (PTSD).
In the past, Ms McGovern has found herself homeless and at risk of violence, circumstances some support services were able to help her escape.
She considers herself fairly lucky as a result, but has also seen and felt the gaps that exist in Victoria's mental health system, including the "missing middle" services to support people before a crisis escalates.
"They're just hard to find, it's hard to get in contact," she said.
"I know people that are out there, that are struggling and can't get access to mental health support services, and I know how much it can help, and not seeing that available to them can be distressing."
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Karenza Louis-Smith also encounters the tyranny of a thinly spread sector every day, in her role as CEO of mental health service Ermha 365 in Dandenong South.
"The further down you go, the further away from Melbourne, the thinner and thinner and thinner the services become," she said.
Systemic mental health challenges 'magnified' in outer suburbs
In its sweeping report tabled this week, Victoria's mental health royal commission recommended 60 new community-based services be created, to ensure that Victorians can access most services locally.
On Wednesday, the Victorian government announced six locations where it would be "fast-tracking" the sites, which are designed to be "front doors" for anyone in the community to get support.
Premier Daniel Andrews said the purpose of the sites was to provide more support locally, to address mental health issues before they escalated.
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"This is all about community treatment, and keeping people well, keeping people safe … giving people their fundamental human rights and the dignity that comes from being well and being supported as close to home as possible," he said.
Bringing more services to local communities is key to Ms Louis-Smith, who said the lack of integration across Victoria's mental health system was "magnified" in the outer suburbs, where people had less choice about the services they used.
"Having what you need, when you need it, without having to wait … gamechanger," she said.
Bringing more services to Melbourne's outer suburbs is also a key focus for Bronwen Clark, from the National Growth Areas Alliance.
"For Melbourne's outer suburbs, where more than a quarter of Melbourne's population lives, that is really important," she said.
"Because people have been arriving in new suburbs very quickly and it's taken years, if not decades, for mental health services to follow."
Regional communities say more services will offer choice to patients
In the state's north-east, acting chief executive of Benalla Health, Andrew Litschke, welcomed the announcement that his community would be prioritised for services.
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Benalla Health offers counselling services to the community, but most other services are provided as an outreach program through a partnership with Albury Wodonga Health and Murray Primary Health Network.
Mr Litschke said greater access to services was needed not just in the mental health sector, but for rural and regional health more broadly.
State secretary of the Health and Community Services Union Paul Healey agreed.
"The further you get from the Melbourne GPA the less likely you are to be able to access services," Mr Healey said.
"We've gone from a service system that actually treated people before they got really unwell to now just being a reactive system where they treat the most unwell and then move them along without actually ever helping people recover."
Mr Healey said bed-based services in regional and rural areas sometimes required patients to move away from their support network.
"This is about trying to pull all the bits of the system together and to actually give people lots of options," he said.
"So that when you're a patient you can actually have a choice in what you do and how your treatment is."
In Gippsland, mental health advocacy group Barrier Breakers welcomed the news that community mental health health obligations would be removed from the Latrobe Regional Health (LRH) hospital.
The region has more than double the state average of people presenting to hospitals with intentional self-harm, with only one acute mental health ward in the vast region.
There has been a series of issues in LRH's Traralgon acute mental health ward and a government-commissioned investigation found allegations of workplace bullying and sexual harassment in its community mental health service.
Derek Amos from mental health advocacy group Barrier Breakers said his members had been lobbying for the chance to use community services for decades.
"Such hospitals have other priorities … when it comes to mental health unfortunately it appears to rank as a poor country cousin," he said.
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