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. This international gathering connected leaders in mental health, disability, and substance use by providing a space for sharing ideas, knowledge, and best practices to help spread innovation and change lives.
In this episode of Into the Fold, at the Hogg Foundation, Tammy speaks with fellow GLE attendee Dr. Hazel Dalton, senior research fellow of rural public health at Charles Sturt University in Australia. Together they discuss the mental health care systems in Australia and the United States to shed light the structural and cultural aspects that impact access to care.
Healthcare Systems
In Australia, the government helps pay for basic healthcare services, including mental health care.
“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 easier to access for most people.
In the U.S., by contrast, healthcare is heavily tied to insurance and employment. This approach can make 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. For example, peer respite centers are designed as non-clinical environments that function as “safe-havens” for people experiencing mental health crises.
“When [peer respite centers] are in place, they get used,” says Tammy. “They are a very good alternative to emergency psychiatric services.”
Australia is only in 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 emergency and mental health services, says Tammy, often due to a lack of resources and providers.
Preventative Care
Tammy and Hazel also agree that preventative care, which includes early mental health support and education, doesn’t get enough funding in either country.
“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.
“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.
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