As police in NSW work to establish the motives behind the knife attack at Sydney's Westfield Mall, that left six people dead, 12 in hospital, spare a thought for the families of the victims who were receiving texts up to minutes before all of a sudden, randomly, without any warning or notice their lives were gone. And spare thought too for the family of Joel Cauchi - because they have been left reeling too.  

Cauchi was an itinerant with a history of mental illness. He wasn't always like that. His family released a statement over the weekend that spoke of their devastation. They said his actions were truly horrific. They are “devastated by the traumatic events that occurred”. Their thoughts and prayers are with the families and friends of the victims and those still undergoing treatment at the time.  

“Joel's actions were truly horrific and we're still trying to comprehend what has happened. He has battled with mental health issues since he was a teenager. We have no issues with the police officer who shot our son, as she was only doing her job to protect others and we hope she is coping all right.”  

A family in shock and in pain and their thoughts are with the victims and their families, the policewoman, but they too will be suffering. And I imagine there are many families in New Zealand who would have thought, but for the grace of God go our family.  

Despite the billions of dollars that has been chucked at mental health care in recent times, there are so many people and so many families who struggle on a daily, hourly, minute by minute basis to get the care that they need or that their loved ones need. It needs to be stressed and reiterated and repeated that the vast majority of people with mental illness are more of a danger to themselves than they are to other people. It is something that they can manage, that they control, that they live with. But when things go wrong, things go wrong in a spectacular fashion, and when you look at the way the care of those who are mentally unwell has devolved, we as a community only have ourselves to blame. The decision to shut down psychiatric hospitals was based on ideological and financial imperatives. It wasn't based on best treatment. There is no doubt horrors occurred at some of these mental institutions the world over. Absolutely no doubt. But the decision to close them down wasn't based on medical reasons.  It was done out of the prevailing ideology at the time, and because they are jolly expensive to run. And when they were sold off, the last of them in the 1990s, it wasn't a carefully managed withdrawal from the institutions, they were just shut down in a haphazard, piece by piece, hospital board by hospital board kind of a way. There was no overarching plan of how those who were unwell would be cared for in the community. It was complex (shock me). It was messy, because there was also health sector restructuring going on in the 80s and 90s. There were numerous agencies, public, private, voluntary, local, regional, national, then there were the culturally based ones as well, all needing money from all different sources, all funded under different contracts, all with different expectations, all with different promises about how they would deliver. All of them lacked coordination. There was no safety net to ensure that these organisations, (some were good, some were bad) did what it said on the tin. They just got the money, we'll deal with it. Some did and some did not. Patients, families of patients, carers were caught in the cracks and inevitably there were tragic tales of poor communication, missed opportunities, poor support, lack of continuity of care and unsuitable placements. The head of one of the psychiatric institutions said at the time if we do not put the same energy, the same resource, the same money into the care of these people in the community as we have done in the institutions, then we are to blame for whatever goes wrong. And that is quite, quite true.  

When you realise that your much loved child has grown into a teenager with difficulties, they're emotionally fragile, you're worried about their state of mind, where do you go? If that's exacerbated by drug or alcohol use again, where do you go? So much is dumped on the shoulders of families. They have nobody to help them. And these are just poor young people with anxiety. The list of callers who have phoned in and said that they have done everything through the private sector, through the public sector, trying to get help for their child, who is suicidal, is enormous. Six month waiting lists in some cases. The vast majority of those with mental illness are no danger to the community. The vast majority of those with mental illness can easily get by in the community with support. But boy, we have failed the families of those who have been left to care for the wide spectrum of mental illness that exists out in the community.  

Can you imagine what the Cauchi family had done before they, in effect, had to sever ties with their son? He wouldn't take help from them, the police had been called a number of times, he was estranged from them. And the next thing they see him on the television and the very worst, everything they feared has happened. Where do we go from here?