Mental health care shouldn’t be a luxury

MENTAL illness takes a toll on your spirits, your relationships and your career but what's often overlooked is the toll it can take on your bank balance, writes Matilda Dixon-Smith.

AS a young person, relatively new to the workforce, you’re taught to cherish two little words: disposable income.

It’s that extra hunk of cash left over in your bank account after you take care of life’s niggling expenses: rent, bills, groceries, transport costs, taxes etc. What’s left, however small the pile, is yours to spend on whatever frivolity takes your fancy.

Come tax time, when we’re looking back at our past year’s expenses, it’s not uncommon to scoff at the kinds of things on which we spend our disposable cash: bespoke woollen blankets purchased on trips to the Victorian High Country; barely recalled nights out in the city with vast bills at too many bars; high-powered tools from Bunnings that are now gathering dust somewhere in the house, garage or shed — forever unused.

But when I look at my expenses, I don’t marvel at my disposable frivolity. Instead, I’m wondering how I spent nearly $10,000 in the past twelve months on my mental health.

Mental illness doesn’t discriminate on the basis of income, but it’s undeniably easier to deal with if you can afford the care you need. (Pic: iStock)

Mental health disorders are the third biggest disease burden in Australia after cancer and cardiovascular diseases. For the 20 per cent of Australians who will experience mental health issues in any given year, attending to them becomes an extreme drain not just on personal life but also on economic resources. Not only is the cost of managing your mental health in Australia astronomical, especially when compared with managing common chronic physical illnesses, the burden of mental illness can also put stress on your ability to work and sustain the financial stability necessary to pay for your mental healthcare in the first place.

Mental illness is expensive; but unfortunately, these disorders do not discriminate. It’s not just those who can afford mental ill-health reporting common disorders like depression and anxiety — it’s everyone. It’s estimated the cost of mental health is around 4 per cent GDP, or $4000 for every tax payer in Australia, and the Australian Longitudinal Study on Women’s Health reported in 2016 that financial problems are consistently connected with poor mental health.

That’s one helluva catch-22 for mentally ill Australians: a burdensome snake eating its own debt-laden tail.

A 2017 Deakin University study into the cost-burden of common mental illnesses like depression, anxiety and substance-use related disorders on society found that there was an estimated $974 million in healthcare costs and a whopping $11.8 billion in total productivity loss across Australia annually.

This productivity loss is particularly concerning, considering a large portion of that $11.8 billion loss comes from the higher rates of unemployment for people with mental health disorders. In fact, it’s tremendously hard to keep to Australia’s punishing full-time hours (and then some), or to work to an ever-changing casual schedule, while attending to your mental ill-health. So on top of the prohibitive cost of seeking help, those Australians living with mental illness must also contend with the extreme financial instability that comes with unemployment or mounting leave days.

With all these national expenses poured into lost productivity and vital healthcare, you’d think Australia, with its universal healthcare system, would’ve developed a platinum-level support system for its legions of mentally ill citizens by now.

I’m lucky to have the support of friends and family, and a job with flexibility. Not everyone is so lucky.

Not so, according to a sobering report released by the Australian Medical Association this year, which states that mental health and psychiatric care in Australia is “grossly underfunded when compared to physical health”. The AMA’s report claims Australia lacks an “overarching mental health ‘architecture’”, and says a major problem lies in the fact that “there is no national design or structure that facilitates prevention or proper care for people with mental illness”.

For any person experiencing difficulties with their mental health, there is the option to visit their GP and create a “mental health plan”, which includes 10 government-rebated sessions per year with a psychologist. Sounds great, right?

Except in any given year I visit my psychologist once a fortnight on average, meaning my ten subsidised sessions are used up well before June. On top of that, there’s the cost of seeing a psychiatrist to manage my medications — a delicate and lengthy process that became too complex for my GP to handle alone — the cost of my medications themselves, and the cost of seeing a gynaecologist to manage the interaction between my reproductive hormones and my medications.

Plus, there’s the tests to check my medications haven’t affected my physical health, the repeated trips to the doctor and the additional work I have to do outside of these medical appointments and prescription refills to keep my brain and body healthy. I take yoga, as recommended by all my doctors, so I need to pay for a membership to my local studio. And all of this costs me time away from my work; missed days away from the office for appointments, missed deadlines when I don’t have the capacity to work.

All of a sudden, it’s tax time again and I’m staring at another $10,000 bill for my mental health management, with a measly ten-session rebate from Medicare to alleviate the immense pressure of keeping my brain healthy and my life functioning. Thanks, Department of Health!

But I’m one of the lucky ones. I work flexible hours, I have a supportive partner, and I rely heavily on the financial and emotional assistance of my family to assist in the management of my mental illness. Others don’t have that luxury, and for them the treatment of mental ill-health can be a distinct struggle, even an impossibility. And there’s something seriously wrong with that reality in our “lucky country”, with our “universal healthcare”.

Because mental health doesn’t discriminate, so neither should our healthcare. Treating or managing mental illness shouldn’t be a luxury for the time- and resources-rich among us; it should be accessible to everyone.

Matilda Dixon-Smith is a freelance writer.

@mdixonsmith

Originally published as Mental health care shouldn’t be a luxury