Coronavirus: Youth mental health a seed for national wealth

Modelling shows ‘at least 10 per cent of the lost productivity that we now face will be because of mental ill-health’.

Because of the swift and effective action of the Morrison government in response to COVID-19, Australia has saved thousands of lives. That action was based on sophisticated predictive modelling and expert medical advice.

Now, as we move to the next phase of the pandemic, the government has at its disposal similar predictive modelling and expert advice on the potential loss of lives from suicide and the long-term loss of productivity that will result from mental ill-health.

The new challenge is not only to place the same value on saved lives from mental ill-health and suicide but also to protect against longer-term productivity losses. Those productivity losses are particularly due to the catastrophic impacts of the COVID-induced economic and social shutdown on the life opportunities of young people. They are not protected against these effects by more community awareness campaigns or expansion of national helplines.

Before the lockdown, Scott Morrison had already highlighted the prevention of youth suicide as a priority for his government, and emphasised his wish for new thinking. After the COVID-19 crisis, he needs to ensure those same young people do not suffer the lifetime consequences of underemployment and mental ill-health as many young people in Europe and the US did following the global financial crisis in 2009. The extra losses to their economies are still evident today.

National Mental Health Commission inaugural chairman Allan Fels repeatedly highlighted to the Gillard, Abbott and Turnbull governments that mental ill-health resulted in a 4 per cent loss to the national economy. He pushed hard for prime ministers to see this as lost “mental wealth” and for enhanced mental health to be a focus of long-term economic reform. Last year’s draft report of the Productivity Commission calculated the annual costs of mental ill-health to the economy as $43bn to $51bn, with an additional $130bn cost due to diminished health and life expectancy.

This was all before the coronavirus pandemic, when unemployment was 5.2 per cent, about 600,000 people were in the jobs network and the economy was growing slowly.

Now that unemployment is almost 10 per cent, 1.5 million people are on JobSeeker and the economy will contract by at least 8 per cent, we need to see growth of our “mental wealth” as a key part of the national equation.

Our most recent dynamic modelling of the COVID-19 disruption is that at least 10 per cent of the lost productivity that we now face will be because of mental ill-health. This will then contribute to many more years of low productivity in those most affected. As we frequently say in mental health: we don’t get well to go to work, we go to work to get well.

The beauty of dynamic modelling, in economics and health, is that the likely impacts of various scenarios can be openly and honestly presented to decision-makers. Fortunately, the Morrison government has already taken important steps through the size of the investments in JobKeeper and JobSeeker. If these programs connect with those most affected, particularly the young, casual workers, post-school students and vocational trainees, and those living in outer-urban areas, then they will have significant benefits to our national “mental wealth”.

There are many gaps and many unknowns. Beyond the next few months, the return of substantial casual or full-time work in those regions most dependent on tourism, hospitality, retail, building services and higher education is uncertain. A key lesson from the GFC was that the best option for many young people who could not find work was to move to longer-term skills training in the vocational sector or to begin higher education. But to do this now, at scale, will require direct, sustained government support, not only for students but also for the industries they work in.

As highlighted by the Productivity Commission and numerous previous national reports, the mental health services sector is chaotic and frequently disconnected from the employment support and education sectors.

Consequently, numerous government programs are ineffective, poorly targeted and do little to deliver expected health or productivity gains. This waste results in part from the reluctance to model the likely impacts of programs before implementation or to monitor their delivery on the ground. While much is well-intentioned or a direct response to sector advocacy, very little uses any 21st-century methods in design, delivery or monitoring. Once initiated, these ineffective programs are rarely stopped.

Despite the reluctance of those in the mental health sector to conceptualise these personal forms of ill-health in such harsh dollar terms, there is greater urgency to be clear about the size of the challenge. It will not be enough simply to recognise we are all more anxious, to conduct more surveys or to suggest that if we all pull together the economic impact will be largely diminished. There is no sugar-coating the size, scope and extent of the likely mental ill-health and linked productivity challenges we face.

Ian Hickie is co-director, health and policy, at the University of Sydney’s Brain and Mind Centre.