In Conversation with Christine Morgan

Christine Morgan is the CEO of the National Mental Health Commission and is Australia’s first National Suicide Prevention Adviser to the Prime Minister. She has been tasked with bringing together the Vision 2030 for Mental Health and Suicide Prevention and reporting to the Prime Minister on the effectiveness of the design, coordination and delivery of suicide prevention activities in Australia. Christine is dual winner of the 2019 Australian Mental Health Prize, which recognises Australians who have made outstanding contributions to either the promotion of mental health or the prevention and treatment of mental illness.

Christine, congratulations on receiving the Australian Mental Health Prize. So that our readers can get a good feel for the work that you have been doing, could you please summarise the focus of your current work?

Of course. I wear two different but related hats at the moment. As CEO of the National Mental Health Commission it is my job to support individual and community voices to be heard when it comes to the Australian Government’s future plans for mental health and suicide prevention. This includes the development of Vision 2030 for Mental Health and Suicide Prevention and the supporting roadmap.

As the National Suicide Prevention Adviser, the Prime Minister has given me the momentous task of reporting directly to him on the effectiveness of the design, coordination and delivery of suicide prevention activities in Australia and advising on what a whole-of-government approach should look like.

In this role, I am working closely with government ministers and departments, community leaders, experts from a wide range of intersecting fields and people with lived experiences of suicide, to develop well-rounded advice that can help reduce the number of people who die by suicide as well as the number of people that experience suicidal distress.

Please tell us about the aims of the Vision 2030 for Mental Health and Suicide Prevention.

The development of Vison 2030 started with a national conversation across Australia known as the Connections Project — connecting with over 3000 people to hear about their experiences of the current mental health system and their hopes for a new system. We held Town Hall meetings in a range of communities as well as meeting with stakeholders and running an online survey. The Commission has been consolidating this feedback to inform the Vision 2030 for Mental Health and Suicide Prevention, which will be presented to the Federal Minister for Health in December this year.

Vision 2030 for Mental Health and Suicide Prevention is a long-term commitment and plan for mental health and suicide prevention in Australia that will cover research, prevention, early intervention, treatment, recovery and multisector approaches to psychosocial wellbeing. It will outline the goals and objectives for mental health and the systems or services which may meet these. A collaborative process will be used to develop a roadmap that will identify agreed long-term strategies in investment, coordination, development and performance measurement that will be required to achieve the Vision and meet goals and objectives for mental health in Australia.

What are the main barriers to mental health in Australia, both in terms of people receiving support and treatment, and facilities being able to provide what they need?

As part of the Connections Project, I was humbled and inspired by talking with the community to really hear at the local level what is happening, what is working and what needs to change. While analysis of the information from our Town Hall meetings and national survey is ongoing, we can already see that individuals and communities experience a range of barriers when it comes to mental health in Australia. Some of the most common challenges I heard about, which have been reinforced in the recent Productivity Commission Report on Mental Health, include stigma (systemic, societal and sometimes individual), lack of access to and availability of services, lack of awareness of supports available and limited connection between services.

What is also clear is that while we can find some common themes, people and communities are diverse so have very diverse needs that require tailored responses. It follows that our service system cannot be one size fits all. Rather, services need to be person-centred, holistic and designed and delivered locally.

What needs to be mapped out before Australia can work towards preventing suicides?

The Prime Minister has set the goal of ‘Towards zero suicides’. This acknowledges the significant impact suicide has on our community and the value we place on the life of every Australian regardless of age, gender identity, sexual preference, cultural background or where they live.

As a country we are already working towards this goal with a number of organisations and communities delivering prevention initiatives. I would like to acknowledge the passion and commitment of all of those who work hard every day to contribute to suicide prevention in this country.

That said, we need to do more work on developing a whole-of-government, whole-of-community approach that ensures services and programs work together so that people who reach a place of despair get immediate and effective support. We also need to consider the broad range of issues impacting on people’s lives and consider all the touchpoints we have through different services and government agencies where we have an opportunity to make a positive difference before people reach a point of despair.

This is all part of my work as the National Suicide Prevention Adviser. I am carefully considering what such an approach should look like by working across government and the community and with experts and those with lived experience.

We are in a place where we have unprecedented interest and investment in suicide prevention. I want to capitalise on this and drive positive change.

What structures need to be in place to improve mental health in Australia?

Recently, the National Mental Health Commission released its National Report 2019 on Australia’s mental health and suicide prevention system and it included a number of recommendations to improve mental health outcomes. A key focus of this report was the Commission continuing to recommend a whole-of-government approach to mental health and suicide prevention.

This is consistent with what I have heard from individuals and communities as part of the Connections Project as well as emerging findings from other inquiries such as the Productivity Commission’s inquiry into Mental Health.

We must look at the whole person and ensure factors which impact individuals’ mental health and wellbeing, such as housing, employment, education and social justice, are addressed alongside the delivery of mental health care.

What are the major hurdles to pushing forward with mental health reform?

The breadth and depth of mental health reform required for positive change presents many challenges. Some can be tackled in a systematic fashion as we determine the Roadmap to Vision 2030. However, one major hurdle that I’d like everyone to consider is discrimination and the deep-rooted stigmas around mental health. Stigma is a word I have heard repeatedly during the Connections Project and throughout my professional career in the mental health sector. But what does it mean and how can we combat it? What are the attitudes and behaviours that need to be addressed to reduce systemic, societal and self-stigma in our lives? As well as putting steps in place to call out and reduce stigma in our mental health system, I ask every Australian to consider their views and values when it comes to mental illness and mental health. We all have a role to play in building a safe, inclusive, compassionate community when it comes to mental health care.

What would you like our health system to achieve in terms of providing treatment and support for Australians with mental ill health?

There are so many outcomes I’d like to see achieved; however, they all come back to one overarching objective: a system that provides immediate and effective support for every Australian, their families and carers when they need it.

As well as this, during the Connections Project, I heard loud and clear that we must recognise the social determinants of mental health and suicide, and look at possible policy approaches as well as interventions that can address the risk factors for suicide and mental ill health.

It is clear we need to have a mental health system that supports people to live well with mental illness, as well as other health and psychosocial risk factors such as alcohol and other drug problems, relationship issues, legal issues, unemployment, homelessness, disability, bullying, loss of a loved one and the impacts of chronic health conditions.

While our health services, community organisations and funded mental health and suicide prevention programs certainly have a critical role to play, we must consider the broad range of issues impacting on people’s lives and consider all of the touchpoints where we have an opportunity to make a positive difference.

You have done incredible work with The Butterfly Foundation as its CEO and Director, gaining recognition for the mental health needs of those with eating disorders. What are the key messages that Australians should be aware of in terms of the mental health needs of those with eating disorders?

Thank you, the recognition gained and progress made with eating disorders treatment in Australia has been a collaborative effort involving support from sector leaders, organisations and the Australian Government alongside the invaluable expertise shared by those with a lived experience and their carers.

One of the key messages that I often shared in my previous role as CEO of the Butterfly Foundation was that eating disorders are serious and complex neuropsychological illnesses with life-threatening consequences that require a multidisciplinary approach to care; they are not a lifestyle choice. In addition to this, as with all mental illnesses, eating disorders do not discriminate — they affect all Australians regardless of age, location, gender identity, cultural background and sexuality. Most importantly, recovery is possible and there is help available.

As of 1 November 2019, the new Medicare Benefit Scheme item number for eating disorders has been active, enabling access to increased psychology and dietetic sessions. This has been a long time coming and something I am proud to see implemented. There is still much to do in this space, but this is real progress that will save lives.

Are there good examples that we can take from other parts of the world in terms of approaches to mental health and suicide prevention?

Mental ill health and suicide are not issues specific to Australia so I’m keen to work collaboratively both nationally and internationally. We may all be working in different contexts but are facing the same issues so there is an opportunity to learn from each other.

Recently I took part in the International Association for Suicide Prevention Conference (IASP) World Congress which saw researchers, people with lived experience, service providers and others come together to share lessons learned and emerging evidence when it comes to best practice in suicide prevention. Countries like Finland and Denmark have achieved significant reductions in suicide rates in recent years. There have been large promising school-based trials in Europe and other promising cross-portfolio work in countries like Scotland that I think we could explore further. But, the other thing I learnt from attending the conference was the high regard that international colleagues have for some of our work in Australia. I think there are strengths we can build on as well as new opportunities and different ways of working that should be considered.

We cannot afford to be complacent or act in isolation. This is a global issue that requires global action.

For more information about the National Mental Health Commission, visit www.mentalhealthcommission.gov.au.

If you, or someone you know, is currently going through a tough time, we encourage you to reach out for support. You can contact your local GP or the below support lines:

Lifeline 13 11 14

Suicide Call Back Service 1300 659 467

Kids Helpline 1800 551 800

MensLine Australia 1300 789 978

Family Drug Support 1300 368 186

Butterfly National Helpline 1800 334 673