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Royal Commission into Victoria’s Mental Health System

Case study:

Jo Farmer

Jo Farmer

Jo, aged 29 years, has lived experience of mental illness and of caring for others experiencing poor mental health.

First having experienced depression and anxiety as a pre-teen in Scotland, Jo has received numerous diagnoses, among them depression, anxiety, bipolar disorder II and binge eating disorder. Jo describes herself as currently well enough to function in her everyday life, although her mental health conditions remain ever-present.

Now living in suburban Melbourne, Jo has witnessed services being overstretched and ill-equipped to cope with the continually growing demand. The result is that only those who are most unwell are seen.

At present the system has insufficient capacity for prevention and early intervention services.

Low capacity within the public system results in people experiencing an exacerbation of their condition whilst waiting for treatment. In rural areas, I have heard of people in acute distress who were required to be sedated for extended periods, to be safely transported to a hospital hundreds of kilometres away.

This is problematic for those who do require treatment away from home, since community and social connection are vital for recovery.

Jo notes that living in a rural part of Victoria is not the only obstacle to service accessibility and thinks the area mental health service model creates a ‘postcode lottery’ for access to care. She has noted responses she has received while trying to obtain a consultation with a treating psychiatrist:

‘I’m sorry but you do not fit our service eligibility requirements.’

‘Unfortunately, I am not currently taking new clients.’

‘My next available appointment is in three months.’

She believes her doctor was only half joking when she said:

‘Your binge eating disorder cannot be treated under our current eating disorder trial as we are only accepting clients with a diagnosis of bulimia. So, I guess that means you have two options: try being sick after binging. Or we wait until you develop diabetes and then you can get help.’

The Commission also heard from service providers, young people and carers that demands on headspace had resulted in higher thresholds and long wait times.

At my headspace, many young people are far too hard for GPs and private psychologists — but the waiting time for our services is huge.

Our experience is they (headspace and [child and youth mental health services]) handball from one to another. The bar is really high, but we don’t even know what the bar is. They have suicidal ideation, but they are still not sick enough to get help.200 In the end we went to headspace and I had to wait six weeks for someone to see her and then she could only have 10 sessions.

I was too complex for headspace — even Orygen didn’t really want to take me.

According to headspace, wait lists are preventing young people from getting the help they need when they need it:

[As] more young people with complex mental health and social problems and/or moderate to severe mental health conditions are seeking help at headspace […] these young people are often prioritised due to their high-risk profile, which extends the waiting list for young people with more mild to moderate mental health problems.

Source: Interim Report, November 2019