A central dilemma in the mental health sector: Structural imbalance

Abstract

Mental health services provision is persistently criticised regarding resource inadequacy. Services are also subject to another dilemma, "structural imbalance". This study demonstrates the dimensions of structural imbalance in Australia's mental health sector by recourse to the 1997 Australian Bureau of Statistics national survey of mental health and wellbeing. This study also examines the concept by reference to the Australian Government's announced COAG initiatives (April 2006), and State government responses (July 2006). The two dimensions of structural imbalance are, first, that some people with no clinical mental illness consume mental health services and, second, that other people have clinical manifestations of mental illness and (for various reasons) do not consume mental health services; the present study shows how the situations coexist. "Throwing more money" at the pre-existing structures may do nothing to address the structural imbalance problem. Remedies are discussed by reference to the reforms undertaken in the British National Health Service in recent years.