In June of 2024, several Hogg Foundation staff members, including Tammy Heinz, senior program officer and consumer and family liaison, attended the Global Leadership Exchange (GLE) in the Netherlands. The international gathering connected leaders in mental health, disability, and substance use, providing a space for sharing ideas, knowledge, and best practices to help spread impactful innovation.
Tammy recently spoke with fellow GLE attendee Dr. Hazel Dalton, senior research fellow of rural public health at Charles Sturt University in Australia. Their comparison of the mental health care systems in Australia and the United States sheds light the structural and cultural aspects that impact access to care.
Healthcare Systems
Basic healthcare services in Australia, including mental health care, are funded by the government.
“We have what’s called a Medicare Safety Net. It’s a base level of funding where primary care and access to specialists is subsidized and mostly free to users,” says Hazel. “This makes healthcare easy to access for most people.”
In the United States, by contrast, healthcare is generally provided by private insurers through employers. Unfortunately, this system often makes accessing care more difficult, especially for lower-income individuals and those without employer-provided insurance.
“My son, who has a job making minimum wage, doesn’t have private insurance through his employer,” says Tammy. “When he went to the emergency room recently, they immediately asked him how he was going to pay.”
Peer-Led Services
In both countries, peer-led initiatives are often scarce and underfunded despite their effectiveness. For example, non-clinical environments like peer respite centers function as “safe havens” for people experiencing mental health crises.
“When they are in place, they get used,” says Tammy. “Peer respite centers are a very good alternative to emergency psychiatric services.”
The United States and Australia are just entering the trial phase of using safe haven spaces to provide calm, supportive places outside of hospitals for people in mental health crises.
Rural and Remote Healthcare
Rural healthcare is another shared challenge.
“Australia does have telehealth,” says Hazel, “But we also have the opportunity costs if you live further away. Cracks in the ideal start to show up.”
Rural areas in the U.S. also struggle with limited access to mental health services and providers, says Tammy.
Preventative Care
Tammy and Hazel agree that preventative care, which includes early mental health support and education, needs more funding in both countries.
“Australia does not spend its fair share on mental health,” says Hazel, which is reflected in the limited resources put toward mental health promotion.
Tammy describes a similar situation in the U.S, where urgent needs and crisis care is prioritized.
“The big money goes to the things that have to happen right now,” she says.
As a result, programs that help prevent mental health issues before they become crises or that promote community-centered services are often neglected.
Increasing Inclusivity
Tammy and Hazel’s conversation underscores the broader social and political factors that influence mental healthcare.
Indeed, both the United States and Australia need to do more work addressing systemic issues before they will achieve truly inclusive and accessible mental health frameworks. Only then will mental health care be within reach for everyone in need.