Mental illness is very common. Almost half (45%) Australians will experience a mental illness in their lifetime. One in five (20%) Australians aged 16-85 experience a mental illness in any year.
It is prevalent in our homes, schools, workplaces and communities. The potential for mental illness is in all of us. For some it is a lifelong condition.
In addition to the health and social impacts on people who have a mental illness, and those close to them, there is the economic impact – a cost $60 billion to the economy (around 4% of GDP) per year. Mentally healthy people are productive people.
Recently, bushfires and COVID-19 have compounded and distorted the incidences and impacts of mental illness, and the picture is not yet clear to what extent.
So, what do we know about mental health, and what is being done about it?
Government led mental health inquiry outcomes.
After 8200 contributions, 19 days of hearings (99 individual witnesses) and 22 days of consultations (attended by 1650 people) the Royal Commission into Victoria’s Mental Health System released its interim report in November 2019. It was preceded (by a month) by the Productivity Commission Draft Report: Mental Health – Overview & Recommendations.
The findings from the Victorian process are:
- The system has simply not kept up with the changes in the diversity and extend of the demands now placed on it. It is currently a ‘system reactive to crisis rather than a system simply in crisis.’
- The system is not responding adequately to increasing demand and changing needs and community expectations. Some believe it to be ‘nothing more than a collection of poorly integrated services.’
- Service delivery is complex with blurred roles and responsibilities.
- The Victorian Commission has a mandate to fundamentally redesign the system
- Victoria was once a leader but, initially established to look after those experiencing severe mental illness, it is not equipped to deal with the broader range of psychological distress.
- There is overwhelming pressure on emergency services, as funding does not support treatment of the number of cases presenting; and, as many experience mental health issues present in acute experiences, the crisis response from police, ambulance, hospitals, etc. is not equipped to deal with psychological distress i.e.
The key recommendations of the interim report are:
- Creation of a Victorian Collaborative Centre for Mental Health and Wellbeing to bring together different skills and expertise to drive better mental health outcomes for all Victorians.
- Establish an additional 170 youth and adult acute mental health beds to help ease critical pressures in areas of need.
- Expand the Hospital Outreach Post-suicidal after Engagement (HOPE) program into all area mental health services and linked to sub-regional health services as well as a new assertive outreach and follow up care service for children and young people, to increase the availability of support and outreach for Victorians at risk of suicide.
- Create an Aboriginal Social and Emotional Wellbeing Centre and expansion of Aboriginal social and emotional wellbeing teams across the state.
- Establish Victoria’s first residential mental health service, as an alternative to an acute admission, designed and delivered by people with lived experience of mental illness.
- Expand and support consumer and family-carer lived experience workforces.
- Address workforce shortages and prepare for reform including through the provision of more training and recruitment pathways to boost the number of graduate nurses and allied health professionals in public mental health services.
- Adopt a new approach to mental health investment.
- Establish a new administrative office.
Recommendation 9 has been achieved with the establishment of Mental Health Reform Victoria, which is addressing Recommendations 1 to 7.
It will be interesting to see if Recommendation 8 (funding) takes the form of the NDIS actuarial model.
Pam Anders speaks to VMIAC members.
“At the core of the Royal Commission’s recommendations is the design and transforming of the system that is much more led by those who have experienced the system, and those who have supported those experiencing the system,” Pam Anders, CEO, Mental Health Reform Victoria.
What needs to be considered?
Mental health policy must consider the full spectrum of mental health conditions: from emotional distress and trauma to neurodiversity and significant (chronic) mental illness.
The most common mental illnesses are depressive, anxiety and substance use disorder. These three types of mental illnesses often occur in combination. Of the 20% of Australians with a mental illness in any one year, 11.5% have one disorder and 8.5% have two or more.
Responses also needs to consider the contributing factors such as genetics, drug and alcohol abuse, early life environments, biological factors, personality factors, traumatic incidents and stress.
And then there is the settings, in which behaviours – like any other human being – reflect beliefs, attitudes, values, bias, heuristics and mental models.
Settings are important because other institutions and organisations have a responsibility to understand, identify, assess, and refer mental health incidences.
They will also likely decide the funding mix, as government reform focuses on direct interventions where there are highest risks to safety, while providing incentives for investment from other sources for treatment and prevention.
For example, Australian businesses are responsible for developing and maintaining mentally health workforces – and with good reason, they will gain from any increased in workforce productivity or reduction in insurance claims.
How we are helping.
Ellis Jones has worked with leading organisations such as Beyond Blue, St John of God, YSAS, Odyssey House Victoria, IEPA, Just Better Care, and others in community health promotion, service innovation and design, workplace mental health, research and knowledge exchange, stakeholder engagement and service marketing.
We have just started work with the National Mental Health Commission on the ground-breaking National Workplace Initiative.
Our social impact, design and communications teams are developing models and approaches in the following key areas:
- Program design and communication for business, education providers, not-for-profits and advocates activating mental health policies that encourage recovery at an appropriate pace, flexibility, prevention and harm minimisation.
- Suicide prevention campaigns and initiatives for employers, community settings and LGBTIQ+ communities.
- Co-design of services with people who have lived experience and those that support them. Developing longer term design and development programs that cycle learnings and expertise back into program design and delivery.
- Education and communication programs for health professionals: to support the pivot to consumer led design and treatment. This should be an exciting opportunity to improve diagnosis and treatment, not an undermining of the expertise and value of health professionals.
- Workforce attraction: employer branding and attraction strategies to get the right people in to the right jobs and keep them. Also, sector wide change initiatives to build a supply of vocational training graduates who can help meet the demand for services.
- Modelling prevention programs and facilities as funded, measurable initiatives that divert at risk young people to early stage counselling and support.
- Cross sector service design to match academic and treatment expertise with corporate and other organisational needs for effective prevention and de-stigmatisation.
- Provider and service specific program evaluation so that innovation does not compromise safety or quality; rather, it learns with time.
- Designing user experiences and digital gateways that facilitate exchange of information and measure health and social impacts, beyond standard application and communication metrics.
- Support emergency departments to be better prepared for mental illness presentations, creating specific departments
- Communication that everyone understands: ensuring that health promotion, service definition, and policy education is in easy English and plain language, and is designed (not simply adapted) based on cultural identity, gender and ability.
There is so much good work to do.
Talk to us about building a mental healthy Australia.