VIRGINIA TRIOLI:
I wanted to introduce to you Dr Ruth Vine. For some time she was this state's chief psychiatrist and she's just recently, in the last few days, been appointed Deputy Chief Medical Officer for Mental Health, it is a national position and she works there with the entire team in Canberra, it's a newly created deputy role in order to recognise that during COVID-19 mental health is every bit as important as physical health. Dr Vine, good morning and congratulations.
RUTH VINE:
Thank you very much, Virginia, and good morning to you.
VIRGINIA TRIOLI:
Were you surprised to get the call?
RUTH VINE:
Yes, I was. And it's happened fairly quickly, today's day two, so I'm really eager to get in there and find out as much as I can and make a contribution and work closely with the other people in the Chief Medical Office, and also with Christine Morgan, the Head of the Mental Health Commission and Suicide Prevention Taskforce.
VIRGINIA TRIOLI:
It's a recognition, isn't it, that during this time, indeed generally, that mental health is every bit as important as our physical health during COVID-19?
RUTH VINE:
Yeah. Look, I think it's a very important recognition and I think it's a recognition that the impact is not going to be short lived, I think we're sort of seeing, if you like, rolling phases of this that the time of greater isolation and what you were just talking about, loneliness, and now I think people's apprehension is turning towards employment and the other financial impacts, and of course, for some communities it's coming on top of other major events like drought and like bushfire. And I think that the mental health response to that is very varied, you know, many people will get through this and they will use their local contacts, they will use their families, but for some they'll need more expert help, and I think it's important to have a clinical expertise around the table.
VIRGINIA TRIOLI:
It's interesting to hear Patrick McGorry- Professor McGorry of course, the former Australian of the year saying that the- noting that the mental health system was overwhelmed before COVID-19 and modelling showing that we're going to experience a quarter to a third increase in demand on top of what was not being met before. So that immediately describes a mental health system that's going to be even more overwhelmed than it was.
RUTH VINE:
It certainly describes a mental health system that's going to need to respond in the most effective and efficacious way. I think what's- quite apart from COVID, before COVID was even dreamt of, we had the royal commission starting up in Victoria, we had the Productivity Commission doing their work and now heading towards their final report, and both of those in their different ways are considering the system, the mental health system, and how it should integrate and how it should respond to the range of needs and the varying intensity of response. And so, I think there's a lot of very clever people thinking about this, Virginia, and doing good work on it.
And I'd also add that I think there are various mental health plans around, but the most recent National Mental Health Plan, that's this plan, put number one as better regional integration and better cross system communication. Because mental health, perhaps some- perhaps more than other parts of health is funded through different streams, there's a series of federal funding arrangements that some of which are national and some of which are local, and of course states and territories fund the public mental health system which often responds to- or mostly responds to those with more severe psychiatric illnesses.
VIRGINIA TRIOLI:
Given the positions that you've held in the public sector in Victoria over the last many years, you've basically seen the mental health system in Australia and in Victoria in particular collapse over the last 15 years or so. What's the chief cause of that?
RUTH VINE:
I would say I think collapse is perhaps too strong a term, I think many people do still access the system and do still have a very good outcome and a positive experience-
VIRGINIA TRIOLI:
[Interrupts] Let me jump in there just so- and explain why I use that word collapse, because of course we have a royal commission into the mental health system for that reason because it was described to have failed and failed Victorians. So, I don't think we need to dance around the language there too much, do we?
RUTH VINE:
No. Very- many descriptive terms have been used. But look, I think one of the main causes has been that- Victoria in particular, but Australia's population has grown substantially. I think the models of care that have been put into the system have often been just that, they've been a model of care for a particular initiative or for a particular part of illness and hasn't necessarily been added in a way that complements what's there, it's often been an add on rather than better integration. And I think nobody's done this through ill will, I think people have tried to respond to emerging issues.
But I think we do have an opportunity now - you know, I'm an optimist at heart, Virginia - we do have an opportunity now, I think, to bring those elements of the system together, to bring the funding streams together and really think how can this care system be better coordinated, how can it deliver what is most needed and reduce the duplication, because we do have a lot of duplication that sits between the privately funded or NBS funded and the publicly funded.
VIRGINIA TRIOLI:
Well, I think the issue of duplication is interesting here, because many people you'll speak to in the sector will immediately talk about funding and money and that there isn't enough money in there, but then others say that throwing money at the problem doesn't necessarily solve it. It requires, as you say, a much more careful recalibration of how, what is used where. Is that your view too, Ruth Vine?
RUTH VINE:
Yes, look, I was very heartened to see the emphasis in the National Mental Health Pandemic Plan - which of course was released last week - I was very heartened to see the emphasis in that on data, and it- because you don't want to drown in data, but it is really important to know who is accessing services, what the effectiveness of that is, whether there is duplication and how it's- how those health services are being experienced by people and by those who deliver those services. So, I- data's not going to solve it, but I think being better informed and being able to articulate what our data tells us is an important step to understanding how we can make our system better, as well as of course seeking more resources and seeking to improve capacity. And another very big favourite of mine is improving the workforce, getting people who want to work in mental health to really get in there, keep their skills up and value the experience and therefore provide much- provide good services. Because at the heart of providing good medical services is that- is the engagement, is the human connection that happens.
VIRGINIA TRIOLI:
Dr Vine, what's your chief top of mind concern taking on this job at a time of COVID-19? What are you most going to be turning your attention to?
RUTH VINE:
Oh, goodness, that's a hard one. I think looking at the fragmentation in the system and trying to think of ways to reduce that fragmentation and to better have the various elements. And I- that's not just the clinical sector, it's the community sector, it's the non-government sector working in a more coordinated way. If I could crack that, that would be just terrific.
VIRGINIA TRIOLI:
The dreaded coordination issue.
RUTH VINE:
Yeah, the dreaded coordination issue.
VIRGINIA TRIOLI:
Dr Vine, we'll look forward to talking to you often, I hope, about this issue. Because it's- you can hear with some of the calls we're getting this morning, and I'll read some text as well about, in particular, older Australians in isolation - it's a mental health problem just waiting to turn worse, so it's something that really deserves our attention. Thanks for joining us today.
RUTH VINE:
Thank you very much, Virginia.
VIRGINIA TRIOLI:
Dr Ruth Vine who's just been appointed the Deputy Chief Medical Officer in Australia for Mental Health.
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