There’s a peculiar kind of madness that grips societies when they promise progress but deliver stagnation. I’ve spent decades in the trenches of psychiatry, watching mental health reform cycle through the same broken promises like a Sisyphean ritual. Patrick McGorry, a veteran in this field, recently laid bare the truth: Victoria’s mental health system isn’t just failing—it’s being gaslit by those who claim to be fixing it. What makes this particularly fascinating is how it reflects a deeper cultural failure to confront uncomfortable truths about power, accountability, and the human cost of bureaucratic inertia.
Let’s start with the Royal Commission into Victoria’s Mental Health System. In 2018, it was hailed as a beacon of hope, a chance to finally address the rot in a system that had been neglected for decades. The commission’s 74 recommendations were meticulously crafted, backed by bipartisan support, and even included a groundbreaking levy to fund the rebuild. But here’s the rub: hope is a fragile thing, and in politics, it’s often weaponized to mask the absence of action. I’ve seen this pattern before—promises made, plans drafted, and then... nothing. The momentum dissipated like smoke, replaced by a revolving door of ministers and a government that quietly shifted mental health back into the shadows of the Health portfolio. What does this say about our ability to prioritize long-term well-being over short-term political convenience? It suggests we’re more comfortable with the illusion of progress than the messy work of actual change.
The current state of mental health services in Victoria reads like a dystopian novel. Ambulances are still stuck at the bottom of the cliff, acute units remain custodial prisons, and clinical research—a cornerstone of modern medicine—is being starved of resources. This isn’t just a failure of policy; it’s a moral indictment of a system that treats mental health as an afterthought. What many people don’t realize is that this isn’t just about funding. It’s about priorities. When a government diverts the mental health levy to prop up general hospital budgets, it’s not just a financial decision—it’s a declaration that mental health doesn’t matter. And yet, we continue to act as if the system is improving, even as patients languish in their bedrooms, on the streets, or in jail. This raises a deeper question: How can we demand accountability when the very institutions meant to protect us are complicit in their own failure?
The political theater around mental health reform is especially galling. The scrapping of regional mental health boards, the sidelining of lived experience, and the weakening of oversight mechanisms like the Mental Health Commission all point to a deliberate dismantling of accountability. This isn’t just negligence—it’s bad faith. When governments undermine the very structures designed to ensure transparency, they send a message: Trust us, even as we betray you. From my perspective, this is a dangerous game. It erodes the credibility of experts, alienates frontline workers, and leaves vulnerable populations to suffer in silence. What this really suggests is that mental health reform isn’t just about policy—it’s about power. Those in charge are choosing to maintain control over a broken system rather than risk the upheaval that real reform would require.
But there’s a way out of this quagmire. The solution isn’t more commissions or levers—it’s a radical reimagining of what mental health care can be. We need leaders who will admit failure, not spin it. We need systems that prioritize people over bureaucracy, and funding that follows the needs of patients, not the whims of politicians. The upcoming state election in Victoria offers a chance to reset, but only if voters demand it. What many people don’t realize is that mental health isn’t a niche issue—it’s a mirror reflecting the health of our entire society. If we can’t fix this, what does that say about our capacity to address any crisis? The mirage of progress must be shattered, not perpetuated. Otherwise, we’ll keep watching as the ambulance lights flicker at the bottom of the cliff, forever out of reach.
