Building the mental health workforce will be one of the keys to overhauling Victoria's 'catastrophically failing' mental health system, according to the interim report of the Royal Commission in to Victoria's Mental Health System.
Rural and regional areas suffer a pronounced shortage of mental health professionals despite having rates of mental illness and suicide far higher than metropolitan regions.
In 2017, there were 13.9 psychiatrists per 100,000 people in metropolitan Melbourne compared to 5.2 in inner regional areas like Ballarat, and just 1.2 in outer regional areas.
"Workforce shortages in rural and regional areas are exacerbated by recruitment and retention difficulties that are unique to these areas-for example, education and training opportunities being largely based in Melbourne, personal factors such as living away from family, and limited incentives," commission chief Penny Armytage wrote in the 680-page interim report.
Nationally there is a shortage of psychiatrists which is forecast to increase to about 350 by 2030, and in February 2017 the Department of Health and Human Services reported an average mental health nurse vacancy rate of 10 per cent in Victoria, although some services reported a 20-30 per cent vacancy rate.
As a result, waiting times for people referred to psychiatrists and other mental health professionals are often long - even for those in crisis.
And specialists feel the pressure themselves, with those working in the mental health system, including psychiatrists, reporting feeling traumatised by an under-resourced system.
"Psychiatrists and other mental health workers are facing moral distress: a desire and knowledge to do the right thing, but system constraints make it impossible to do so," the report stated.
Building the mental health workforce through funded graduate positions, postgraduate scholarships and psychiatry rotations, supported overseas recruitment, leadership development and improved data was one of nine recommendations made for urgent action in the landmark report which Premier Daniel Andrews responded to at the new Sebastopol Men's Shed on Friday.
Mr Andrews said free TAFE could be expanded to include some mental health professions.
"One key lesson, one key finding - we have to acknowledge the system is failing desperately, shamefully failing hundreds of thousands of Victorians every year. We can't settle for that, we have to do more, have to do better. It's time we take mental illness seriously," he said.
Conceding that overhauling the system would take many years and billions of dollars, Mr Andrews committed to acting immediately to start the process.
"This debate and reform journey will take a long time and at various points in that process we will talk about hundreds of millions, talk about billions of dollars," he said.
While visiting the men's shed, Mr Andrews announced a further $900,000 for eight new Men's Sheds and 15 upgraded Men's Sheds throughout Victoria, acknowledging the difference the sheds made to the mental and physical health of thousands of men.
The Royal Commission found too many Victorians needing mental health treatment couldn't find suitable support, while those who do access the system find it hard to negotiate and many only receive treatment when their illness has reached crisis point.
State mental health minister Martin Foley said the mental health outcomes in regional and rural areas, particularly for men, were grim.
"Our mental health system catastrophically fails Victorians. It is not fit for purpose in the 21st century. It is a product of generational underinvestment - telling people we really don't take their mental health seriously," Mr Foley said.
"The Royal Commission points to the fact that in rural and regional Victoria people have worse mental health outcomes ... suicide and self harm rates in rural and regional Victoria are significantly higher 30 to 40 per cent higher than in metropolitan areas."
Mr Andrews said the state's response to the Mental Health Royal Commission would probably be the biggest feature of next year's budget.
When asked if a specialist men's health clinic could be on the table, as advocated for by a group of Ballarat medical professionals, Mr Andrews was uncommitted.
"We wouldn't rule that out. We need to listen to experts - whatever they believe will work and will save more lives," he said.
A group of Ballarat medical professionals and campaigners have been advocating for the creation of a specialist men's health clinic which, they believe, would help curb premature deaths - whether through suicide or ill health - and their devastating effect on families and the wider community through early intervention and linking men to the right treatment.
It would be free and accessible within business hours. A nurse or medical professional with an interest in mens health and knowledge of existing services would be on hand.
A Ballarat Health spokesperson welcomed the release of the interim report.
"The report highlights the unique challenges faced by our community in rural and regional areas in accessing mental health services," a Ballarat Health Services spokesperson said.
"We will review the interim report alongside our ongoing development and improvement of our mental health services to meet the needs of our growing population."
If you or someone you know needs support:
- headspace Ballarat 5304 4777
- Lifeline 13 11 14
- Mensline Australia Line 1300 789 978
- Kids Help 1800 55 1800
- Suicide Call Back Service 1300 659 467.
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