Mental illness costs $180bn, study reveals

A million Australians with mental health conditions are going untreated each year, while the economic cost has hit $180bn.

Productivity Commission chairman Michael Brennan. Picture: James Croucher

One million Australians with mental health conditions ranging from anxiety and depression to psychosis and borderline personality disorders are going untreated each year, while the economic cost of mental illness has hit $180bn.

The Productivity Commission, in a forensic examination of mental illness, finds it is costing the ­nation about $500m a day and recommends sweeping policy changes in the health system, workplaces, housing and the ­justice system.

Calling for “generational changes’’ to address a problem that is getting worse despite increasing expenditure in the area, the report, to be released on Thursday, estimates there are 3.9 million people with mental illness, but only 2.9 million are ­accessing support and services.

Key findings of mental health report.

One in eight visits to the GP is related to mental health issues, and mental health presentations at emergency departments have risen by about 70 per cent over the past 15 years.

The system is not adequately helping many people seeking treatment, the report finds, with one million having symptoms too complex to be adequately treated by a GP and limited government-funded sessions available with mental health providers.

But their condition does not reach the threshold to access state-­funded specialised services, private psychiatrists or private hospitals because of long waiting lists or high out-of-pocket costs.

The report finds many people still avoid treatment because of stigma and, with 75 per cent of people with a mental health issue first experiencing symptoms before the age of 25, calls for a greater focus on early ­intervention.

READ MORE: Editorial — A generational change | Missing middle slip through gaps | Early checks needed to ease risks

Social and emotional development checks of Australia’s 1.25 million children aged up to three years are among 25 detailed recommendations.

Mental health costs of diminished well-being.

Productivity Commission chairman Michael Brennan said dealing with mental illness was “one of the biggest policy challenges confronting Australia”.

“Mental ill health has huge impacts on people, communities and our economy, but mental health is treated as an add-on to the physical health system — this has to change,” Mr Brennan said.

He highlighted the need for a greater emphasis on early intervention. “Seventy-five per cent of those who develop mental illness first experience symptoms before they turn 25,” he said.

“Mental ill health in critical schooling and employment years has long-lasting effects for not only your job prospects but many aspects of your life.”

Workplace, housing and education reforms to support people with mental illness are also proposed. “Mental illness is the second largest contributor to years lived in ill health,” the report finds.

“Compared to other developed countries, the prevalence of mental illness in Australia is above the OECD average.’’

Mental ill-health has huge impacts on people, communities & our economy but #MentalHealth is treated as an add-on to physical health. Change is needed, with better support for young people as well. Our draft report on Mental Health in Australia is out now: https://t.co/8sTEc961th

— Productivity Commission (@ozprodcom) October 30, 2019

The report marks the first time mental health has been examined beyond its clinical context into policy areas such as education, housing, justice and the workplace.

The report, a draft inviting public submissions, notes that one in two Australians will be affected by issues such as anxiety and ­depression during their lifetime.

“The cost to the Australian economy of mental ill health and suicide is, conservatively, in the order of $43bn-$51bn a year. ­Additional to this is an approximately $130bn a year cost associated with diminished health and reduced life expectancy for those living with mental ill health.”

The direct costs are broken down into healthcare support and services ($18bn a year), lower economic participation and lost productivity ($10bn-$18bn) and informal care provided by friends and family ($15bn).

Broader social effects such as the cost of stigma or lower social participation aren’t quantified.

The report notes that while costs have risen, “there has been no clear indication that the ­mental health of the population has improved”.

“Community awareness about mental illness has come a long way, but the mental health system has not kept pace with needs and expectations of how the wellbeing and productive capacity of people should be supported,” the commission says.

“The treatment of, and support for, people with mental illness has been tacked on to a system that has been largely ­designed around the characteristics of physical illness.

“And while service levels have increased in some areas, progress has been patchy. The right services are not available when ­needed, leading to wasted health resources and missed opportunities to improve lives.”

Today on #WorldMentalHealthDay, we make our #MentalHealthPromise to help others #seebeyondthestigma in speaking up and seeking support whenever they need it. Visit https://t.co/7SERc7a0Q5 to learn how you can #makementalhealthmorevisible. @AUMentalHealth #WorldMentalHealthDay2019

— Beyond Blue (@beyondblue) October 10, 2019

The report says Aborigines and Torres Strait Islanders are twice as likely as non-indigenous people to be hospitalised because of mental illness, and twice as likely to die by suicide.

For those up to 24 years of age, the suicide rate is 14 times higher for Aborigines and Torres Strait Islanders.

And services are far from uniform across the nation, with ­people in capital cities nearly twice as likely to access mental health services as those in ­remote areas.

The commission also calls out: thin services in the regions; too clinical an approach to mental health concerns; stigma and discrimination leading to a reluctance to seek support; and a lack of clarity between the tiers of government about roles, responsibilities and funding of services.

Among its recommended reforms, it calls for greater specialist mental health services to be ­delivered outside acute, expensive, hospital settings.

It also calls for greater investment in “long-term housing solutions for those with severe mental illness who lack stable housing”. “Stable housing for this group would not only improve their mental health and inclusion within the community, but reduce their future need for higher cost mental health in­patient services,” it says.

Workplace reform is also ­proposed.

The commission invites written submissions by January 23 in response to its draft report, and a final report will be provided to the government in May.