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Mental health: a commission for the whole of life

18 October 2018 Rev Keith Garner's Blog

The Federal Government’s decision to order a major Productivity Commission inquiry into Australia's mental health system is a long overdue initiative.

It is estimated 45 per cent of people will deal with a mental health condition during their life and in any year, about one million Australians. Wesley Mission’s own research has shown that around eight in ten Australians will know someone with a mental health issue.

Around $9 billion of the Federal Government’s $170 billion health budget is spent on mental health services but there has been little review of its effectiveness.

Some say this budget is too little, others too much, but it is my view is that we need to consistently measure the efficacy of mental health funding based on a clearly defined mental health strategy and tangible real-life outcomes.

The effects of poor mental health on individuals and families are enormous. Our staff and volunteers at Wesley Hospital at Kogarah and Ashfield as well as our gambling and financial counselling services and at Lifeline Sydney & Sutherland experience this impact first hand.

We also see it through our homeless services, confirmed recently by the release of a report by the Australian Institute of Health and Welfare (AIHW) which noted that 77,500 people with mental health issues used specialist homeless services.

The AIHW report also found that around four million people experienced a common mental health disorder in 2015.

Private hospitals provided 255,800 days of same day hospital care for people dealing with mental health issues – almost four times the number of days provided by public hospitals. In 2007-08 there were 1.5 episodes of residential mental health care per 10,000 people but by 2016-17 this had risen to 3.0 episodes.

In 2016-17, 276,954 presentations to our public hospitals’ emergency departments were mental health-related, which was 3.6 per cent of all presentations.

In 2016-17, one in six or around four million Australians had received prescriptions for mental health issues.

Newly-released data from the Australian Bureau of Statistics found that there were 3128 deaths by suicide across the nation last year, compared to 2866 in 2016.

Such figures are a wake-up call to not only those who work in the sector but for the entire community. Poor mental health impacts upon us in many ways: around $12 billion in lost productivity occurs each year as a result of mental illness.

There is an intricate and profound link between the mental well-being of Australians and that of this nation’s economic health and productivity. It is important that the Commonwealth Government has recognised this and is acting upon it. At Wesley Mission, we have promoted this position for many years, particularly through our Wesley Reports on mental health.

The Commission also has the opportunity to examine the contribution of those who provide care at home to a family member or a friend with mental health problems. Their care giving role affects their financial status, and mental and physical health. They are also more likely to have experienced stigma because of their association with a relative with a mental health issue.

For many caregivers, stigma remains an enduring concern. Our Wesley Report found that those who had been involved in a caregiving role for longer periods were more likely to report that stigma had affected their family, them personally, and the wellbeing of their relative.

More than 85 per cent of people caring for a relative with a mental health issue reported negative consequences for their own mental, physical and financial health. Many of these carers—particularly those in their teenage years—suffered in silence, eventually creating more serious problems for themselves, their families and their communities.

Many carers felt too ashamed to access support: victims of the stigma that surrounds having a family member with mental health issues. Carers sacrifice their time, money and even careers to ensure those they support can manage and fulfil their often challenging lives.

Mental health is about the whole of life and the Productivity Commission inexorably recognises this in its aims of the review.

My hope is that during the course of the 18 month enquiry that submissions and participants maintain a similar outlook. In the past too much public discussion about mental health and suicide prevention has seen arguments develop about the effectiveness and worth of clinical and medical based services over community based preventions and interventions.

I believe our society and indeed the sector has moved beyond this entrenched discourse to a more mature and inclusive approach to addressing mental health, well-being and suicide. The Productivity Commission has a real opportunity to take this whole of life, whole of sector and whole of community approach forward so that mental health and well-being is not just a matter for the experts but for each of us in our families, communities and workplaces.