Mental health is everyone’s care

Julia Gillard, Chair of Beyond Blue speaks during the City of Sydney CityTalks event at Sydney Town Hall on October 29, 2019 in Sydney, Australia. (Photo by Lisa Maree Williams/Getty Images)

Opportunities for groundbreaking reforms that bring lasting change to our society are singularly rare, but with the release of the Productivity Commission’s draft report into mental health, we have glimpsed the possibility of generational transformation in the way we think about mental health and support people with mental health issues.

Last year, the government asked the commission to examine the effect of mental health on economic participation and ­productivity.

Its draft report finds the cost to the Australian economy of menta­l ill health and suicide is, conservatively, up to $51bn a year. Additionally, it calculates that $130bn in costs are associated with diminished health and reduce­d life expectancy.

However, it estimates reform could deliver $11.5bn in increased economic participation of people with mental ill health.

It rightly acknowledges that the treatment of mental health conditions has for too long been tacked on to a health system designe­d to treat physical illness.

It documents longstanding problems in the existing approach: a skew to crisis and acute services and under-investment in prevention and earlier intervention; a lack of affordability and patchwork access to services; a crisis-driven system too depend­ent on ambulance call-outs and hospital emergency departments; and uncertainty about the divis­ion of government roles and responsibiliti­es.

It calls for a fundamental reform­ of funding arrangements between the federal government and the states.

Half of us will experience poor mental health at some point. A million Australian adults live with depression and twice that with an anxiety condition.

On average, eight Australians will take their own lives each day; suicide is the leading cause of death for people aged 15-44.

Yet about half those who have a mental health issue do not receive the support and treatment that would help their recovery.

The reasons for this are as in­num­erable as each person is unique, but could include failure to recognise the signs and symptoms, lack of access to affordable, culturally appropriate services, or shame or fear of discrimination.

Much has been done to fight that stigma, but the Productivity Commission realises there is work to do.

We know that those who have attempted suicide are at greatest risk of trying again, especiall­y in the weeks and months that follow­. Critically, the commission has called for support for every person leaving an emergency department after a suicide attempt to receive follow-up care.

It also acknowledged that causes of psychosocial distress could lie outside the reach of the health system. These include poor or unstable housing, unemployment­ and a lack of job opportunitie­s, breakdown of relationships, drug and alcohol issues­, or trauma, especially when experienced in childhood.

We need to look at preventing mental health conditions occurring in the first place or acting early when signs and symptoms emerge. This will require ­integrating and co-ordinating services across the social, welfare, housing and justice systems and all tiers of government.

It requires support in our schools, workplaces, welfare, housing and justice systems.

Our hardworking teachers and early learning educators are in a pivotal position to enhance mental health. They may be the first to notice that a normally happy student is acting differently, is withdrawing from friends or disengaged in class.

An educator may notice that something is not right but not know what’s wrong or what to do about it. That is why the Prod­uc­tivity Commission recognised the need to invest in school-based initi­atives to help young people confidently transition from school and begin adult life with good mental health and wellbeing.

These reforms cannot be left to governments and officials alone. Including those who have mental health conditions and their carers in the development of policies and programs is essentia­l. As is the need to train and grow a workforce of people with experience of mental health challenges.

The Productivity Commission has produced a thoughtful analysis on the need for sweeping structural reform across our mental­ health system.

It recognises that we must work together and get it right, not just for economic reasons but for the millions of Australians with poor mental health, and those striving to maintain their best possible mental health.

We need to be ready and willing to listen to the commission’s recommendations and not squander this opportunity to advocate on behalf of all Australians — those who are well and want to stay that way; those who are starting to struggle; those whose psycholog­ical distress is affecting their everyday lives; those who have attempted­ to take their own lives and need support to return to hope and go on living; those who support and care for them, who love them.

This government — led by a prime minister who has declared mental health reform and suicide prevention as priorities — has the appetite for change. As does the opposition.

It is time for all those who are willing to show leadership across government, the mental health sector, schools and workplaces and at an individual level to come together and seize this chance.

The time has come to invest properly in prevention, to find new ways of combating mental ill health, to support those in a ­mental health crisis and prevent suicide.

Any change worth making is hard and doesn’t happen overnight. There will be challenges and maybe even missteps along the way but that doesn’t mean we should abandon the cause.

Too many people are depending on us.

Great reform is arduous and complex, but worth doing.

The time for reform is now.

Julia Gillard is chair of BeyondBlue.