Health_Inequalities_Mental_Illness

Dear Minister of Health, I would like to draw attention to the implications of Australia’s mental health, and implore the government to allocate more funding due to the serious and potential impact of mental illness on not only the individual that is affected but the people around them. How this condition has contributed significantly to the burden on Australians Prevalence of the Condition From the results of the 2007 survey, conducted by the Australian Bureau of Statistics (ABS), one in five Australians aged 16-85 experienced one of the common mental illnesses such as anxiety, mood and substance use disorders, within the last 12 months. This graph shows areas which need to be addressed in particular anxiety and other 12-month disorders. Prevalence rates of mental illness vary across lifespan but from the graph taken from the 2007 ABS survey, the prevalence of mental illness for young adults in the 16-24 age range (26%) is one third higher than the average for the overall adult population. Similar results are shown in the 1997 ABS survey, which highlights the need for early intervention services that target younger Australians. However, mental illness also includes low prevalence conditions such as eating disorders and severe personality disorders. In addition to schizophrenia, bipolar disorder and other psychoses were not counted in the 1997 or 2007 ABS survey but are speculated to affect an additional 2-3% of the adult population. From the ABS survey, the graph shows the major disorders and it is clearly shown that anxiety has the highest prevalence with the highest rate in 35-44 year age group. Of the 2.5 million people aged 16-24 years that were in the survey, 13% had a 12-month substance disorder. Due to a general prevalence in anxiety orders amongst ages 16-54, this graph highlights the need for early intervention. Mental illness is shown in this graph to significantly appear in people who have a disability. It’s clear that a vast majority of people with a disability are more likely to experience a mental disorder than people with no disability. 43% of people with a disability have experienced some form of 12-month mental disorder, almost five times the percentage of people who have no disability at 15.8%. From the 2008 National Aboriginal and Torres Strait Islander Social Survey, information on psychological distress was collected based on five questions from the Kessler Psychological Distress Scale. A high score indicates feelings of anxiety or depression on a regular basis whereas a low score indicates little or no incidence of these feelings. 31% of Indigenous adults aged 15 years and over had high or very high levels of psychological distress – more than twice the rate for non-Indigenous Australians. Rates of high or very high levels of psychological distress were higher in women (34%) than men (27%). These findings illustrate a need to reduce the burden of mental disorder on Indigenous Australians and find why they may be experiencing these feelings. Socioeconomically disadvantaged people are likely to experience a mental disorder due to a number of factors like education. From the AIHW report on Australia’s Health 2008, mental and behavioural make up 10% in the lowest fifth of the population with the greatest overall level of disadvantage. This may be due to a number of reasons such as lack of education and poor lifestyle choices because of a low income. Although it may not appear to be much, mental illness can lead to other dependence on alcohol and smoking in their attempt to reduce stress and by providing aid to those that are affected, we can encourage lifestyle changes that will ultimately benefit their health. Approximately 34% of the Australian population live in rural or remote areas and males are 1.4 times likely to suffer depression or psychological distress than males living in the city. This is explained by a lack of access to health services and lower socio-economic status. The harsh conditions people in rural areas live in provide an environment that fosters mental illness bec ause of the struggles they may have to endure. Costs to Individual and Community From the 2007 Survey of Mental Health and Wellbeing in Australia, the graph illustrates the effect of mental illness and physical conditions on affected people’s day to day lives. It is clear that both chronic physical conditions and mental disorders by themselves take out a significant number of days in a person’s life, but it is more evident when they are experienced at the same time. From the graph on days out of role, people with mental health problems are effectively disabled in their day-to-day functions. Results From the 2003 ABS Survey of Disability, Ageing and Carers, the prevalance of psychiatric disabling conditions was estimated at 5.2% of the Australian population in 2003. About half of those with psychiatric disability required help with self-care, mobility or communication activities. More recent results from the 2007 Survey of Mental Health and Wellbeing show hat 6.5% of respondents with a previous 12 month mental disorder had severe core activity limitation and a further 11% were mildly affected in their day to day lives. In addition 12% experienced a schooling or employment restriction. Overall, nearly 30% experienced some degree of limitation or restriction. These limitations or restrictions can impact on the education and employment they receive, thus reducing quality of life and severely harming their health From the report by Professor J.Kulkarni, 12.4% of Australians have severe depression – 2.7 million Australians. Of this group, the potential earnings lost are around 173 billion dollars per year. Hospitalisations for depression cost patients over $20,000 per patient per year whereas mental illnesses like schizophrenia can cost $24, 000 per episode. Only 1% of the Australian population suffer from schizophrenia. These figures show how serious the cost of mental illness is and highlights immediate action to help patients push through these figures. Like any other person with a disease, they require care and support to help them overcome it. Mental illness is no different. The patients’ family and friends may take time off from their own time and possibly their work hours to provide the care and support the patient needs. However mental illness can affect people’s relationships which can hinder this care and support. Direct costs to the individual involve payments for medication, clinic visits, or hospitalisations. Indirect costs to the individual are incurred through reduced labour supply, public income support payments and reduced educational attainment. The potential there is for this burden to be decreased It is important to apply social justice principles in addressing mental illness as mental illness is a problem that’s not so easily solved in one moment. It is often long term and requires time and effort to fight against mental disorders like anxiety and depression. Also the diversity behind mental illness requires collaboration between all forms of government and the community. The AIHW Mental Health Services in Australia 2007-08 report describes a number of initiatives and activities of Australia’s mental health care service. The National Action Plan for Mental Health 2006-2011 has an action area dedicated to promotion, prevention and early intervention. For promotion, prevention and early intervention, the policy aims to: - building resilience and coping skills of children, young people and families - raising community awareness - improving capacity for early identification and referral to appropriate services - improving treatments services to better respond to the early onset of mental illness, particularly for children and young people - investing in mental health research to better understand the onset and treatment. Governments have originally committed $454 million additional funding to initiatives under promotion, prevention and intervention, but are increasing to $514 million. The table below shows the amount of funding going for mental health across Australia. Action Area 1 - funding commitments 2006-11 and allocations 2006-07 (millions) | |Funding commitments 2006-11 |New funding allocated | | | |2006-07 | | |As reported in the |Subsequent new funding |Total funding | | | |Action Plan July |commitments |commitments 2006-11 | | | |2006 | | | | |Australian Government |158.4 |0.3 |158.7 |17.6 | |New South Wales |102.2 |19.5 |121.7 |32.0 | |Victoria |80.3 |10.0 |90.3 |13.1 | |Queensland |6.9 |9.4 |16.3 |0.5 | |Western Australia |60.7 |12.6 |73.3 |11.3 | |South Australia |39.5 |7.6 |47.1 |4.1 | |Tasmania |2.0 |- |2.0 |0.2 | |Australian Capital Territory |3.3 |- |3.3 |0.5 | |Northern Territory |1.0 |0.3 |1.3 |0.5 | |Total |454.3 |59.6 |513.8 |79.8 | However in comparison to the allocation of funds to Action Area 2 involving integrating and improving the care system it is not effective. Although the money spent into improving the current care system helps treat people better, there would not be a need if people are learning to cope with stress and traumatic events in life. More funding into promotion, prevention and intervention is need along with the funding to improving the health system to provide an overall groundwork in addressing Australia’s mental health. Mental illness can be prevented by reducing the prevalence of risk factors that contribute to the onset of mental illness and prevent longer term recovery. This includes addressing rates of use of illicit drugs that contribute to mental illness in young people. From the ABS 2007 Survey of Mental Health and Wellbeing, of the people who misused drugs in the past 12 months shown in the graph, 63% had a 12-month disorder and almost half (49%) had a substance use disorder. It is clear, that people affected by mental illness may resort to drugs or alcohol to manage their mental problems. Prevalence of drug use in Australia, 2004 [pic] The National Action Plan for Mental Health 2006-2011 outlines their concerns about the high level of drug use associated with cannabis and methamphetamines because of the mental health problems associated with their use. In collaboration with the National Drug Strategy, the government aims to reduce substance abuse by raising awareness about the consequences of its use. Tobacco use leads to a wide range of problems such as cancer and cardiovascular disease. The link between smoking and mental illness is complex, as mental illness is also a risk factor for smoking. People may smoke due to a number of reasons including using it as a tool to manage stress. Alcohol is particularly concerning as people who are diagnosed with alcohol dependence are more likely to develop mental problems and people with mental health problems are also at risk of experiencing problems related to alcohol. The graph from the results of the 2007 Survey of Mental Health and Well-Being describes the mental illness of the 2.8 million people who drink and Awareness needs to be raised on the misuse of alcohol and other related drugs. The Fourth National Mental Health Plan recognises that intervention in children and young children is important to prevent the development of mental illness and negative behaviours. It works with schools, workplaces and communities to deliver programs to improve mental health literacy and enhance resilience. The plan recognises a range of strategies to improve mental health such as improved living conditions, supportive, inclusive communities and healthy environments. Schools are important for improving awareness about mental health but are also important for developing resilience and coping skills. KidsMatter and MindMatters are programs that address issues in school. National intiatives such as Beyondblue have improved understanding and awareness on the illnesses and how to access treatment and care. Workplaces are also important settings for building resilience and fostering coping strategies. The plan recognises that different stages will require different service responses. For example, children will need to develop resilience and be socially encouraged, whereas older people will require strategies to tackle their mental health whether by medication or therapy. Although the plan is focused around the early stages of life, it also addresses the workforce who may come into contact with people at all stages of mental illness and recovery; even individuals who may be suicidal. The plan recognises that these groups will need to better understand and recognise mental illness and how to react to individuals during an acute episode of illness or suicidal behaviour. This will improve intervention and bring better outcomes for individuals and their families. It is especially important amongst workers in the police, ambulance, child protection workers, correctional services staff, employment support offieers, pharmacists, residential aged care workers and teachers. Organisations such as beyondblue and Lifeline have developed programs to provide greater awareness and understanding of mental health issues. ASIST or Applied Suicide Interactive Skills training is a two day interactive workshop that helps people recognise when someone may be at the risk of suicide, explores how to connect with them in ways that understand and clarify that risk, increase their immediate safety and link them with further help. The Aboriginal Mental Health and Well Being Policy 2006-2010 addresses that similar strategies used for non-Indigenous Australians may not be well suited to Indigenous Australians. Partnerships with Aboriginal communities are being formed such as the Sydney West Area Health Service and Daruk Aboriginal Community Controlled health service formed in 1997. Reports indicate some positive things have come from the partnership such as training and resources are shared and suicide prevention training. The policy recognises that because of colonisation, Indigenous Australian culture exhibit effects of disempowerment, and collective distress characterised by increases in rates of suicide, offending, substance abuse and mental distress and disorder. By involving Aboriginal communities and promoting Aboriginal self-determination, this can give the ATSI people a sense of empowerment. This involves: - provision of choices to Aboriginal people - involvement of Aboriginal people and communities in the planning and delivery of mental health services - promotion of Aboriginal Community Controlled Health Services as sites of primary mental health and social and emotional well being service delivery. - Aboriginal Community Controlled Health Services working together with specialist mental health services to ensure people with more complex mental health problems receive appropriate services. - Employment and progression of Aboriginal people in mental health services in clearly defined career paths. As such, much of these strategies apply social justice principles and plans aim to improve equity for non-Indigenous and Indigenous Australians and eliminate the stigma associated with mental illness. Mental illness is a big thing. From all the information that is gathered, it is clear that mental illness should be a priority issue as it stems from other causes like drug abuse and disabilities. However as much as there is being done, more needs to be done to raise awareness. A national organisation such as beyondblue has aimed in the past to advertise getting people through mental illness. However, fewer and fewer advertisements seem to be appearing at the present moment leaving many people unaware of mental illness. Current government spending has been centred around treating the present effects of mental illness which I think is when the government needs to realise that mental illness is a long term illness and governments and organisations need to remain committed for the long term by putting more money and effort into protection, prevention and intervention to prevent the likelihood of most forms of mental disorder. From this letter, it is clear that mental illness should be of a high priority and hope that the governments respond swiftly to this present and future matter. From, Bryan.