“People recover in the context of relationships” - we’ve all experienced this. When we go to the doctor, we don’t just want someone who knows how to use a stethoscope, we want a human being, preferably one who knows us well and cares about us.

This need is especially acute in people with complex mental health needs who have so often been disappointed by authority figures and ‘the system.’ During a consultation, the individual needs to know that they matter, and nothing says that better than a health professional that is there for the long haul, with no threat of a future cut-off date.

The mental health system is highly focussed on ‘episodes of care’ (if you’ve never heard that term then you’re lucky), at the end of which a person might be stepped up or stepped down, to another provider, in another organisation, or no provider at all.

However, we know full well that recovery from mental ill-health is non-linear. Good days and bad days, good months and bad months. The idea that someone should be constantly transitioning in, and then being pressured to transition out of care goes against what it means to have a healthy community.

At First Step, as much as is humanly possible, we maintain long-term, years-long therapeutic relationships with clients. There may be periods of high acuity (frequent support from a multi-disciplinary team) and periods of little or no contact.

Of course, we want people to recover and no longer need our services but wishing doesn’t make it so. We are concerned that some areas identified for considerable (federal) government spending such as the Adult Mental Health Hubs ($400M+) will only provide short or medium-term support, which will exclude complex clients and people with histories of trauma. It’s not good enough.

In the meantime, we’ll do what we do and try to make a fair bit of noise about it to inspire others and inform government models.