There are concerns proposed changes to the way Western Australia funds mental healthcare could lead to services falling through the cracks and not getting the attention they deserve.
Currently, there is no single part of WA's health system responsible for mental health, with the Mental Health Commission (MHC) given the bulk of the task and other areas responsible for smaller sections.
It is an issue a recent independent review into the health system identified as leaving mental health services "fragmented [and] operating separately from one another".
In response, the review recommended the Department of Health be given responsibility for mental health as a whole – with a new directorate set-up to take responsibility.
Concerns over loss of close scrutiny
The major concerns being expressed are that because mental health issues need to be treated differently to physical health issues, that nuance could be lost if both were managed by the same body.
One senior figure who spoke to the ABC said the reason the MHC was established in 2010 was to allow for closer scrutiny of mental health spending, and to change the way mental health issues were managed.
They worried if mental health fell within the remit of the much bigger department that close scrutiny could be lost and mental health could struggle to compete for attention and money when up against other areas of the system.
Opposition health spokesperson Libby Mettam shared those concerns.
"It is a significant challenge for the mental health sector to attain a voice when it comes to obtaining relevant funding for one of our state's most vulnerable sectors," she said.
"This is about diminishing the voice of an independent body that has a prime focus on mental health outcomes for WA patients."
Addressing the issue in parliament, Health Minister Amber-Jade Sanderson rejected that idea.
"Regardless of what the review says, or what changes may or may not happen, now or in the future, with delivery of those services, the priority is the delivery of those services … and ensuring access to those services," she said.
Ms Sanderson said government would continue to closely scrutinise all spending to ensure money was being spent in the right places.
'Devil in the detail'
Australian Medical Association (AMA) WA boss Mark Duncan-Smith was also supportive of the proposed shift.
"We feel that a new structure where there is better transparency, better responsibility, better coordination and better collaboration between all of the parties involved in mental healthcare delivery, will result in better outcomes for mental health," he said.
Dr Duncan-Smith said while the "devil would be in the detail", he would like to see funding remain consistent, no matter who was managing mental healthcare.
"The AMA's position is that all money that would normally go to mental health should remain with mental health," he said.
The report suggested that if government were to take responsibility for funding services away from the MHC, its role would "shift to providing independent oversight".
That would include holding WA Health, and individual health services, "to account for the performance of the mental health system, including through conducting inquiries on the request of the minister and reporting to Parliament".
"The MHC should maintain responsibility for primary prevention, reducing stigma and promoting consumer inclusion and engagement," it stated.
The wide-ranging report made dozens of other recommendations not relating to mental health, including for different parts of the system to work more closely together.
It said better collaboration would help "make best use of capacity across the system and direct patients to the best care options that can meet their needs the soonest".
Some of the 55 recommendations also addressed making it easier for staff to work in different parts of the health system, and the need for a stronger Aboriginal voice.
Mental health chief departs
The findings of the review were released on the same day it was announced the head of the Mental Health Commission, Jennifer McGrath, would be leaving her role effective on Wednesday.
A media release said Ms McGrath had decided it was "the right time for her to step down and allow for new leadership for the next phase of maturity" of the MHC.
Ms McGrath will now become a deputy director-general within the Department of Local Government, Sport and Cultural Industries.
Ms Sanderson said the government would consider the findings of the independent report and consult with stakeholders before making any decisions about implementing the review's recommendations.
