After 15 years, lack of data on Mental Health Crises is intentional
Posted by Dave Bath on 2009-11-14
Unsurprisingly, the "Responding to Mental Health Crises in the Community" (2009-11-11) report from the Victorian Auditor General didn’t get a mention within a few days (at least) in either the old or new RSS feeds of all Victorian Premier and Ministers media statements.
Before having a brief look at the Auditor’s report on this topic (it ain’t pretty), it’s worth noting that very few of the auditor’s reports get a mention in the "All Media Releases" from the Victoria. Three, according to searching within Google Reader, in a little over a year, had the word "auditor" in them… which suggests that only three were viewed as supporting the government, or even slightly spinnable. There’s an opportunity for some interesting metrics, or even mashups there… looking for auditor reports and corresponding government/opposition media releases, especially the ones where the government avoids even the spin attempt.
The auditor examined the Department of Health, four Area Mental Health Services, Victoria Police and Ambulance Victoria to assess whether:
- agency responses to mental health crises are coordinated;
- agencies are adequately prepared to respond to mental health crises, and respond appropriately;
- agencies can show the effectiveness of their responses to mental health crises.
Mental Health Crises (MHCs) are those unfortunate situations where the one-in-five Victorians affected by some form of mental illness (including endemic depression, surely an indicator of government performance as important as any other) can become a risk to themselves or others.
Basically, while there are some in the police, social welfare, and health agencies trying to do make things better, for most things relevant to the problem, there are either no well-defined metrics, or where there are metrics defined, they either aren’t collected, collated or disseminated.
There’s a rule in performance management: if it ain’t measured, it can’t be managed.
For politicians, there is another rule: if it ain’t measured properly, any problem can be denied and/or responsibility avoided.
Even before the summary of findings document starts giving the dot points for conclusions, the auditor has this to say:
Presently however, responses to mental health crises are not consistently meeting the standards set out in the Mental Health Act 1986 or in agreed interagency protocols.
There is a lack of information showing the effectiveness of triage and CAT services, and police and ambulance responses to mental health crises. This prevents quantitative analysis and robust performance monitoring, allowing service gaps to go unaddressed
So, the auditor cannot figure out what is going on because there are no figures to work from… how convenient for the politicians!
DOH lacks useful data about triage and CAT service responses to mental health crises. CAT services have run for 15 years, but DOH does not know the number of urgent referrals received, how services respond, their timeliness or the outcomes.
Until agencies have access to robust information about response effectiveness, they cannot identify successes or areas to improve in their own crisis response operations, nor can they review their joint performance to identify system-wide issues.
It goes on, there is insufficient awareness of long-standing, recently introduced, or planned protocols, and no data available on how those protocols are performing anyway.
Remember the adage I mentioned? "If it ain’t measured, it can’t be managed."
After 15 years of both Liberal (Kennett) and Labor (Bracks and Brumby) governments without measurement, there has obviously been no real intent to manage. If there is a single objective being met, it is that the politicians have ensured they cannot be measured. Even with incompetent governments, 15 years is enough to get a measurement system in place so that an auditor would have enough figures to get a grip on what is happening, whether things are getting worse or better. The auditor has been as effectively blocked from investigating as if all the books had been burnt, while the auditor’s hands were tied and eyes gouged out.
It looks like the lack of figures must be intentional, malicious rather than negligent… and one in five Victorians are the target of that malice.