National Mental Health Strategy
Using Bacchi’s (2009) framework provide a clear analysis of your chosen policy using the
following headings to provide an outline for your essay
- what is the problem
- what pre-suppositions or assumptions underlie the problem?
- how has the representation come about?
- what is left un-problematic in this problem representation?
�write in essay format
�use the above headings to provide a framework for your essay
�write succinctly with clear academic expression
�there should be a minimum of 15 references for your assignment
�do not use dot points, or any other form of truncated expression
�do not use graphs or attach appendices
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Bacchi’s policy analysis “what the problem represented to be?” is a policy analysis approach,
which focuses on how policies represent the societal problems and the impacts of these
problems. This approach provides a theoretical framework. The WPR approach is practically
applied in this study to provide eloquent description of National Mental Health (NMH) policy, as
well as highly demonstrate the policy impacts on areas such as welfare, unemployment, drug use,
crime, education and mental health disparities in the Australia (Bacchi 2009).
This framework is chosen for this assignment because it is based on Foucauldian strategy
grounded in structuralist theory to draw on the work of government and to a lesser extent applies
the feminist perspective. The approach indicates that policy problems are manifested as social
constructions. According to this approach, the government establishes policies that do not react
to the existing problems; instead, the policies established are the source of the problems. In this
context, Bacchi’s argument does not imply that the issues to which the policy are applied for are
not real, but rather terming the issues as problems and trying to fix them makes it necessary for
the policy to be interrogated. This approach is challenging as it tasks one to treat the policy idea-
NMH policy in this case- as problem representation, reflect on the origins, the purposes as well
as effects of the problem. This approach demands a larger extent of reflexivity which recognizes
that “we are all immersed in the conceptual logics of this era, and thus we must interrogate our
own assumptions of NMH policy (Bacchi 2009).”
- What is the problem
The National Mental Health Policy is an Australian government initiative established to
improve the mental status of the Australians. The strategy was endorsed in 1992 which aimed to
promote the mental health of the Australians, prevent new prevalence of the disease and reduce
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the economic impact on the affected individuals, their family members and the society. Since its
inception, the strategy has improved the mental health. However, mental illness is still a public
health burden (Australian Government. 2013a). Research approximates that one in every five
Australians suffer from mental illness. It is identified as the third leading cause of disability as
well as burden in Australia, and it causes about 27% of the total years lost because of disability.
Approximately 4% of the population suffers from major depressive disorders, 14% with anxiety
disorders, 3% by psychotic diseases such as schizophrenia and 5% mental illness associated with
substance use. The prevalence rates of mental disease decrease with age with its peak amongst
young people of 18-24 years of age. Women are more affected than men. Research indicates
health disparity between the Aboriginal and Torres Strait Islander people suffering with mental
diseases as compared to other Australians (Crosbie 2009; McGorry 2011).
This indicates that the recent National Mental Health Policy reviews have not met the
mental health needs of the Australians. There are complex systems and contradictory range of
services, which leaves those in need of mental health and support struggling to get the services
needed to maintain good health. In the recent past, the Australian government has had four
mental health plans that have not been that successful. It is time to seek for and apply
interventions that are culturally competent and comprehensive to NMH policy. Therefore, the
‘problem’ represented is poor implementation of the NMH policy that causes decline in quality
of mental care of the Australians (Australian Government. 2013b).
- What pre-suppositions or assumptions underlie the problem?
The analysis of NMH pre-suppositions here focuses mainly on the several government
level reforms which begun in 1992. The inception as well as the first 5-year plan of the NMH
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policy marked a major turning point for mental health care in Australia (Australian Government.
2013). The subsequent major reforms led to publications of 5 yearly government policies that
outline the priority areas for reform and investment. The first plan (1993-1998) focused on
community problems, which arose due to deinstitutionalization. The next plan (1998-2003)
expanded the policy to include mild and moderate mental issues, which provided emphasis on
early intervention and prevention (Howlett, 2012). The next plan (2003-2008) focused on better
integration of healthcare systems including legal and ethical services. Critics argue that NMH
policy lost its track in this third plan as it attempted to address all the challenges raised in the
first and second plan without addition of any resources or guidance on the most effective
approach. The fourth approach 2008-2013 focused on strengthening of work agreements,
accreditation as well as delivery of quality care to people minority and the indigenous
Australians. This shifted the focus towards early intervention and preventive strategies (Jones
2010; Howlett 2011).
The assumptions of the NMH policy and its reforms is that it has facilitated the
establishment of programs that indicate promising results for the Australian social and emotional
wellbeing as they facilitated community governance, reconnection and restoration of community
health and well being. The assumptions hold that the policy programs offer holistic approach,
focus on each recovery and healing process, empower people diagnosed by mental illness to help
them regain a sense of control to their lives. This will continue promote human rights and
autonomy (Australian Government. 2013c).
- How has the representation come about?
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Despite the government commitment to mental health in the last two decades, there are
complex and contradictory health care services which leave the vulnerable people struggling to
find quality mental care. Research indicates that most of the Australians have more than one
chronic condition and mental health. The Australians have longest life expectancies, which
indicate that more people continue to experience moderate disability and chronic disease (Kruk
2012).
The programs have failed to take account of cultural values, aspirations, lifestyles and
differing needs as well as the diverse complex economic and social circumstances. The programs
developed often lack adequate frames and funding to support and address all the health needs in
a holistic manner and within the community context. The expectations of the programs within
the short term are inflexible and often designed to deliver without consultation or engagement
with the community. This poor engagement of the policy stakeholders lead to lack of cultural
understanding, systemic racism and reliance to the ineffective approach of “one size fits all”
(Connors et al. 2012).
- What is left un-problematic in this problem representation?
Using the current NMH policy, it makes it difficult to evaluate the mental health
outcomes. While the government excels at glossy, rhetoric policy documents as well as promises,
its commitment to reduce health disparity of mental health lack focus to follow through and to
ensure sustained healthcare. The overall examples include inadequate resourcing of health
resources to commensurate the population exact needs. The current evidence based research is
not translated into policy and practice. Consequently, the government makes inefficient and
wasteful funding models, models that are competitive and not cooperative (Smullen 2015).
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This presentation indicates that mainstream structures as well as practices to improve
mental health in Australia are deeply entrenched to the non-mainstream problems faced by the
Australians including poverty, unemployment and substance use. The lack of cultural competent
policy strategies highlights cultural misunderstanding about mental health causation and
treatment, which ends up compromising health (Boxall & Buckmaster 2009; Roberts 2011).
The effect of this representation results into inequitable healthcare regimens between the
regions, ethnic groups (with the indigenous Australians suffering the most) and ineffective
mechanism to implement the indigenous health frameworks, market-driven health care and poor
communication. The policy focus on establishing models of care that prioritizes on body
systems, treatment and cure rather than the prevention. The policy focus on short term systems
that focus on education and promotion of health that targets lifestyle diseases; which is not
adequate approach to substitute for whole government initiatives to address the social
determinants of health. Failure to effectively address the exact Australians problems, interrogate
practices and policies that have long term negative consequences for the Australians (Althaus,
Bridgeman, & Davis 2012)
Conclusion
Therefore, while some of the policies meet the issue by developing frameworks that
improve performance as well as accountability in mental healthcare services, the providers
attitudes, practices, poor communication, mistrust of the system and lack of cultural
understanding which makes the progress to be slow must be addressed. Recognizing these
catalysts critically reflect on interpersonal issues such as poverty, poor housing, poor education,
and unemployment will ensure that the government makes huge strides in the right direction.
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References
Althaus, C, Bridgeman, P & Davis, G 2012, The Australian policy handbook, 5th edn, Allen and
Unwin, NSW.
Australian Government. 2013a, Mental health services in Australia reports.
Australian Government, 2013b, National mental health committee publication.
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Australian Public Policy. 2013, Mental health policy — stumbling in the dark?
Bateman, J. & Smith, T. (2011). Taking Our Place. International Journal Of Mental
Health, 40(2), 55-71.
Boxall, A.M., & Buckmaster, L. 2009, Background note: options for reforming Australia’s
health system. Canberra, Australia: Parliamentary Library,
Carol Bacchi (2009) Analysing Policy: What’s the Problem Represented to be? Pearson
Education. Available as e-book.
