We don’t know how many people died because of a deliberate policy decision of the Coalition government, and we never will.
What we do know is huge harm was caused by the intentional and proactive decision to aggressively and relentlessly pursue vulnerable people for substantial sums of money, much of which was not actually owed.
Every one of the deaths resulting from Robodebt were preventable.
The findings of the Royal Commission into the Robodebt scheme paint a chilling picture. Countless families are now experiencing the pain of the untimely loss of an irreplaceable person because it did not occur to their government that its actions might cause harm. Or worse, perhaps the government did know, and it didn’t care.
When governments make decisions they are normally expected to carefully consider the implications of the proposed decisions, as a part of good governance, risk management and sound bureaucratic processes. Financial risks must be taken into account, alongside any obvious financial benefit. Legal issues are painstakingly considered, starting with the constitutionality of the decision, a review of other Acts of parliament, and ultimately any obligations that arise from international treaties. Wherever relevant, environment impacts are considered.
Shouldn’t it also be that when there is an impact on the public, as a matter of ordinary administrative process, governments consider the impacts on mental health and well-being as well?
The consequences of government decisions on the mental health and wellbeing of people can be small or, as in the tragic case of the victims of Robodebt, catastrophic. Mental health impacts should be assessed, understood and considered before major policy decisions are taken. The public should be able to access these deliberations through Freedom of Information requests, and diligent Senators should be able to quiz Ministers and public servants about them through the Estimates process.
In short, governments should be systematically accountable for the choices they make that have direct or indirect consequences for the mental health of individuals or the population at large.
And in a better system, accountability wouldn’t stop there. Across all portfolios, governments have an opportunity to improve or harm the mental wellbeing of its people. Beyond health, it extends to housing, education, social services, workplace relations, environment, law and order, finance and defence.
With an orientation across the whole of government towards considering mental health — both the opportunities to improve and risks to harm — we could see extraordinary improvements to Australians' lives, better outcomes against other policy objectives, and a lower cost burden on the treasury.
Economic policy is a hidden lever for change. The worsening state of youth mental health is due in large part to the effects of recent decades of economic and social policies which have made the lives of many young people deeply insecure.
Integrating health services internally and with other domains is another policy setting we must expand. Effective mental health services will reduce homelessness. Conversely, affordable housing as a basic human right services will improve risk and outcomes for mental illness and homelessness.
Better understanding of mental illness and changes in police values, training and procedures could make policing safer for police and citizens struggling with mental illness.
If every Minister, through every department and agency, adopted a population mental health strategy and applied that as a lens to their work and processes, we would see immeasurable improvements to mental health and wellbeing. It would cause huge improvements in ways that we can’t — from the vantage point of the mental health crisis in which we currently live — currently imagine.
A new mechanism is required to deliver such a reform. The National Mental Health Commission is under review at present. If it were made a statutory authority with full independence and a mandate to report on mental health to the Prime Minister across the whole of government, such a mechanism could provide immense benefit to Australia and all Australians.
By Chris Gambian, Executive Director of Australians for Mental Health, and Professor Patrick McGorry AO, Founding Board Member of Australians for Mental Health.