Mental health in Australia

Mental health programs in Australia, as run by Australian governments, have undergone a massive shift in the last 50 years, as community attitudes have changed. The evolution of pharmacology and other treatments, such as psychological techniques, have resulted in new treatments being made available to the public. According to the Australian Bureau of Statistics, 20% of Australians experience one or more mental health episodes in their lifetimes.[1] Australia runs on a mixed health care system, with both public and private health care streams. The public system includes a government run insurance scheme called Medicare, which covers certain mental health services. Each Australian state government has its own additional management plans for mental health treatment, however, the overarching national system and spending remains the same.[2] Australia has been noted as being a ‘leader’ in mental health policy making and management. As Australia has gone through a rigorous process towards making their mental health policies, with a rich history and a series of changes.[3]

History

Australia has a recorded history of managing mental health since the first fleet arrived in 1788. When the convicts arrived, placing all those deemed ‘insane’ into a locked area nearby. Australia had its first psychiatric facility in 1811, previously individuals with mental illnesses were placed together with convicts and criminals. With the introduction of a psychiatric facility, it was the first time the mentally disturbed were identified as separate.[4]

One of the key moments in Australia’s history with mental health, was its deinstitutionalisation in 1992. This came about after the Richmond report was released, which investigated the rumours of abuse and injustices towards the patients of these institutions. However, it did take over a decade before the change was made, even then the controversies over whether or not the change did any good remain.[5]

The first mental health care plan that was implemented nation wide was introduced in 1992, currently there have been 5 national mental health care plans. Each mental health care strategy is amended every few years, for example, the most recent plans occurred in 2012 and 2017. This highlights the governments strong awareness of these present issues and their desire to.

Current

Australia is considered a world leader in mental health reform and management, despite this the government is still working hard to improve as much as they can. Demand for rural care is also growing at a rapid rate, with an ongoing struggle for finding treatment professionals for those areas.[2]

Despite the fact that Australia has been celebrated for its sophisticated mental health management systems, there are still are wide range of issues within the systems. The Australian Medical Association reported in the 2018 mental health review that “Currently Australia lacks an overarching mental health ‘architecture’. There is no agreed national design or structure that facilitates prevention or proper care for people with mental illness.” [6] While the organisation notes that youth mental health is fairly successful, they believe that the status of treatment for adults severely lacking. The AMA argue that the Australian government lacks a structural plan for mental health management and that the future of mental health treatment in Australia is in a dangerous position.

In terms of expenditure, the Australian government spent $9.1 billion on mental health related services in 2017. This averages out to $375 per person, a rise from $359 in the year prior. The Australian government are dedicating more funds each year towards mental health related services, in 2016-2017 7.4% of the Australian governments health expenditure went towards it. The expenditure is expected to continue increasing over the next few years, to keep up with the growing trends of mental illness.[2][1] Despite this funding, critics have requested an increase in funding, claiming that the mental health budget at current is far too small. Noting that in 2015, the mental health accounted for 5.2% of the overall yearly health budgeting although mental health equated to 12% of the total burden of disease.[7]

Demographics

Pie chart displaying the proportion of the Australian population to experience a mental disorder in their lifetime[1]

  No Lifetime mental disorder (55%)
  Mental disorder for 12 months or less (25%)
  Mental disorder for more than 12 months (20%)
  Other (0%)

It is estimated that 45% of Australian, roughly 8.6 million, adults will experience a mental disorder within their life. Additionally, 3.2 million Australians have had a mental disorder that has lasted for more than 12 months. With this, the most prevalent mental disorders were: anxiety disorders, affective disorders and substance use disorders. The most common disorder found were anxiety disorders, 14.4% of Australia’s population suffer from this. And it is more common in females. Affective disorders followed with, 6.2% of Australia’s population and these are equally distributed gender balance. Substance use disorders affected 5.1% of the population, with men being significantly higher (7.7% for males and 3.3% for females).[1] Mental illness affects more than just adults, the Australian Health and Wellbeing institute reported in 2015 that 14% (560,000) children and adolescents experienced mental health disorders.[8]

In terms of other mental disorders, bipolar | disorder has been estimated to affect about 1% of the general public and bipolar || disorder is much more prevalent affecting roughly 5% of the population. Bipolar disorder to affects 33% of men in their lifetime, however, experts estimate the number is far higher due to a large portion of undiagnosed cases.[9] Additionally, mood disorders have been noted to affect females more than men, as follows with 7.1% and 5.3%.[1]

The mental health services 2018 report released by the Australian institute of health and welfare produced a wide spectrum of new statistics about the Australian population. 4.2 million people or 16.5% of the population received mental health related prescriptions during 2017-2018, 70% of the prescriptions were antidepressant medications. The state of Tasmania had the highest proportion of those prescriptions at 22% and the smallest proportion was the Northern territory at 9%.

In terms of general practice, 12.4% of all consultations were mental health related in 2015-2016. Depression is reported to be the most common mental health related diagnosis from GP consultations, estimated at 1 in 3 people. Additionally, medication was the most common treatment recommendation with 61% of encounters.[2]

Additionally, reports released by the Australian Health and Wellbeing institute found that 1 in 3 Indigenous experience high or very high levels of psychological distress. It also reported that Indigenous individuals are managed by general practitioners at a rate of 1.3 times in comparison with other Australian individuals.[10]

The prevalence of both depression and perinatal depression within the population of mothers in Australia has been noted by health organisations as rather high. With depression seen in 20% of mothers with children aged 24 months or less, perinatal depression was found in half of those 20%. These figures equate to 110,000 mothers with depression and 56,000 with perinatal depression. However, the report also found that a majority of mothers went for treatment from a general practitioner or a mental health organisation/treatment provider.[11]

Suicide
Main article: Suicide in Australia

In 2015 suicides reached a 13 year high with 3,027 Australians taking their own life. Suicide is three times more likely in men than women. As a proportion of deaths per total population it is less than 2%, although it is the number 1 cause of death of people aged 15 to 44.[12] Additionally, The Australian Bureau of Statistics reports that everyday nearly 8 people commit suicide in Australia [13]

Treatment

Australia’s approach towards mental health treatment has been praised for its approachability. The government has put forward funding for a wide range of programs and treatment options, to suit a wide range of patients. Thus there are a wide range of specified programs that meet different individuals needs and wants, this approach has been noted for its success.

In the last 10 years, Australia has made a range of improvements towards treatment for mental health. In 2006, Medicare adapted the benefits schedule to prioritise mental health treatment, which saw a large increase in the portion of treatment plans prescribed. With 1.3 million mental health treatment plans prescribed by general practitioners and 4.95 million psychologist related services.[2] Additionally, the proportion of individuals that sought out mental health treatment doubled from 1997 to 2007.

Australia’s key strategy in mental health planning comes down to: first point of contact. Mental health care providers and treaters are focused making the first point of contact the most significant/impactful. Hence, the main recommendation offered by government health organisations, is for the patient to visit their general practitioner. The aim of this is to prevent further harm or damage coming to the patient and to be able to create a personalised mental health treatment plan for the individual patient.

Government operated treatment providers

Head to Health is an online and hotline service designed to assist with individuals struggling with mental health, all responders are trained health professionals. Head to Health also has provided over 408 resources for individuals that are struggling, including websites, online programs, apps, forums and the hotline services.[14]

At Ease is an organisation aimed at helping veterans and families of veterans with mental trauma, providing assistance and resources. At Ease is managed by the Department of Veterans’ Affairs (DVA) and runs a range of online programs to meet different individuals needs.[15]

BeyondBlue is an organisation that works with individuals struggling from a wide range of mental health issues, mainly: Substance abuse disorders, depression disorders and anxiety related disorders. They are aimed at educating the Australian public about mental health and providing the skills to protect it. The mission statement of BeyondBlue is as follows "We're here for everyone in Australia – at work, home, school, university, online, and in communities across the country."[16]

Headspace Australia's logo

Headspace is aimed at aiding adolescences (12-25 year olds) with issues surrounding mental health, Headspace offers counselling services as the main point of treatment. A key focus for Headspace is early intervention, to prevent mental illness having a long lasting impact on an individuals life. Headspace is one of Australia’s leading mental health organisations, with over 100 locations across the country, all of which are either free or low cost access. Headspace has also launched a further initiative focused on aiding students, Headspace student support, noting that children and young adults should be an area of focus in mental health.[17]

Main article: headspace (organisation)

KidsMatter is a mental health organisation focused on preventing problems and supporting children's mental health wellbeing. Their vision is as follows "every learning community is positive, inclusive and resilient – a place where every child, young person, educator and family can achieve their best possible mental health."[18]

LifeLine Australia is Australia's main suicide prevention hotline and is a registered charity, providing support services and accepting calls 24/7. Lifeline receives a new call every minute from somewhere in Australia, individuals call Lifeline about a range of mental health problems including: Anxiety, stress, depression and suicidal thoughts. The main Lifeline number is: 13 11 14 [19]

Mental health disorders within Health Direct serves as a portal providing information about Australia's mental health services and general information about mental illnesses. The main Health direct portal helps guide individuals towards different help services and resources. Under the Mental Health disorders sub-category, Health Direct links to a range of other Australian organisations designed to cover a wide range of patient needs.[20]

National Mental Health Commission is an organisation that reports on the current status of Australia's mental health support system. The National mental health commission is Australia's first, their key goal for the organisation is to identify what is working and what is not within Australia's mental health services. The National Mental Health Commission's mission statement is as follows "is to give mental health and suicide prevention national attention, to influence reform and to help people live contributing lives by reporting, advising and collaborating."[21]

OzHelp Foundation is a non-profit organisation aimed at industry and workplaces, that is focused on preventing mental illness and improving mental wellbeing of employees. The mission of the OzHelp Foundation is as follows "OzHelp continue to strive towards improving the mental health and wellbeing of people in the workforce and the wider community."[22]

See also

References
  1. "National Survey of Mental Health and Wellbeing: Summary of Results". ABS.gov. Retrieved 13 April 2019.
  2. Gallagher. "Progress of mental health system reform in Australia". Health.gov.au. Retrieved 12 April 2019.
  3. Senate Committee. "Select Committee on Mental Health" (PDF). BPD Community. Commonwealth of Australia 2006. Retrieved 20 April 2019.
  4. Dax; EC (1989). "'The first 200 years of Australian psychiatry". Australian and New Zealand Journal of Psychiatry. 23 (1): 103–110. doi:10.3109/00048678909062599. PMID 2649057. Retrieved 20 April 2019.
  5. Burdekin; Hall; B; D; Guilfoyle (1993). "Human rights and mental illness: Report of the national inquiry into the human rights of people with mental illness". Retrieved 9 April 2019. Cite journal requires |journal= (help)
  6. AMA. "Mental Health - 2018". Australian Medical Association. Australian Medical Association. Retrieved 7 June 2019.
  7. AIHW. "The Australian Burden of Disease Study 2011". AIHW. AIHW. Retrieved 7 June 2019.
  8. AIHW. "Mental health services in Australia". AIHW. AIHW. Retrieved 7 June 2019.
  9. Eyers, K; Parker, G (2008). Mastering Bipolar Disorder: An insider's guide to managing mood swings and finding balance. Sydney: Allen & Unwin.
  10. AIHW. "The health and welfare of Australia's Aboriginal and Torres Strait Islander peoples: 2015". AIHW. Retrieved 7 June 2019.
  11. AIHW. "Perinatal depression: data from the 2010 Australian National Infant Feeding Survey". AIHW. AIHW. Retrieved 7 June 2019.
  12. "SUICIDE IN AUSTRALIA". Australian Bureau of Statistics. Retrieved 1 May 2019.
  13. Australian Bureau of Statistics. "National Health Survey: First Results, 2014-15". ABS. Canberra: ABS. Retrieved 7 June 2019.
  14. "Welcome to Head to health". Head to health. Retrieved 20 April 2019.
  15. "Helping veterans and their families lead happy and healthy lives". At Ease. Retrieved 20 April 2019.
  16. "Beyond Blue Home". Beyond Blue. Retrieved 20 April 2019.
  17. "Headspace information & support". Headspace. Retrieved 20 April 2019.
  18. "Kidsmatter". Beyond Blue. Retrieved 20 April 2019.
  19. "Lifeline". Lifeline Australia. Retrieved 20 April 2019.
  20. "Mental Health Direct". Mental health disorders. Retrieved 20 April 2019.
  21. "Mental Health Commission Home". Mental Health Commission. Retrieved 20 April 2019.
  22. "OzHelp Home". OzHelp. Retrieved 20 April 2019.
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