The greatest peril, however, is that community mental health is being desperately neglected. Twenty-five years ago, in common with a process around the world, mental institutions were closed across Australia with a new and positive ethos that people are best cared for, in the community, not in hospitals. And Community Mental Health Services were then born. Alas, recent years have seen a decline in these services, at precisely a time when mental health issues are increasing dramatically.

A few years ago I briefly chaired a community consultative committee for Northern Sydney Mental Health - the affluent area from the harbour to the Hawkesbury. With a budget of $70 million and 1000 staff, the system was in trouble. Eighty per cent of presentations were for ‘co-morbidity’ - people presenting with both mental health and drug/alcohol/substance problems. We are not alone in having large problems in mental health.

Everywhere the debate seems to be about more hospital facilities, but the greatest need is to save the acute services of very serious cases. All evidence points to mental health being secured in the community, in family, among friends, with love and support.

My very great concern is that economic pressures will contribute to greater alienation and community distress in the next few years. We cannot just depend on government services, we must as individuals, families and neighbours shift to be more caring and supportive, providing each other with self-esteem and positive sense of place.

D. Argall,

Nowra 2541