National Mental Health Reform 2011-12
The Challenges
- Foreword
- Highlights
The Challenges- Severe and debilitating mental illness
- Better targeted and more efficient primary mental health services
- Early intervention and prevention, and mental health services for children and young people
- Economic and social participation for people with mental illness
- Addressing service gaps in state and territory systems
- Quality, transparency and accountability in mental health
- A new approach – A ten year roadmap for mental health reform
Priorities and new Initiatives
Mental illness in Australia is a large and complex problem. Nearly one in three Australians - an estimated 32 per cent of the population - will experience a mental illness at some stage in their lives. When alcohol and drug disorders are included, this rises to 45 per cent. Mental illness is the single largest cause of disability in Australia.
Analysis of the 2007 Australian Bureau of Statistics Survey of Mental Health and Well-Being shows that, each year more than 17 per cent or 3.8 million Australians experience diagnosable symptoms of mental illness, for either brief or extended periods. Unlike many illnesses with a similar disease burden mental illness affects people across their lifetime – it affects children, teenagers, parents and older people.
For anxiety and affective disorders such as depression, two-thirds of people have their first symptoms before the age of 21 years. Mental illness accounts for 24 per cent of the burden of non-fatal disease and remains the biggest risk factor for suicide.
Around two million Australians with mental illness do not receive any mental health care. And it’s the most vulnerable – people in rural and regional areas, Indigenous Australians, men, young people and disadvantaged groups - who are among the least likely to seek treatment.
The challenges are many and include:
- people with mental illness, families, carers and providers not knowing where to find the support they need;
- services that are either not connected – leading to people falling through gaps – or which overlap and duplicate resources;
- lack of early intervention and prevention services for children and young people;
- the need for more care services for people with severe and debilitating mental illness, including accommodation support services to help prevent the cycle of crisis-driven rehospitalisation and high levels of homelessness for people with mental illness;
- insufficient support for people with mental illness to participate in work or community life and who may be suffering discrimination and stigmatisation;
- inadequate support for mental health carers, who can suffer crippling isolation and are at risk of poor health themselves; and
- the need for greater transparency and accountability in the investments governments make.
- Mental health has a sizeable impact on lost productivity. This includes both those suffering from severe mental health conditions who are outside the workforce and those in the workforce with untreated mental illness.
- Mental disorders are projected to account for about 370,000 lost ‘healthy life’ years (disability-adjusted life years - DALY) in 2010, more than 13 per cent of Australia’s total burden of disease and injury
- Mental illness impacts on people in different ways and at different levels of severity, as defined by the type of condition, intensity of symptoms and when they occur.
- People who typically experience mild to moderate levels of impairment due to mental illness can still experience periods when they are severely affected. This impacts on their capacity to participate in education and employment and maintain relationships and social connections.
- About 600,000 Australians have a severe and debilitating mental illness which has an adverse impact on their ability to live independently and participate economically and socially, as well as significantly impacting their families and carers.
The good news is at least a quarter of mental health problems in adults are potentially preventable through treatment, support and others factors during childhood and early adolescence, such as being in a supportive, positive environment. Additionally, short term psychological therapies such as cognitive behaviour therapy are internationally recognised to reduce the impact and duration of common mental illness of mild to
moderate severity. Such therapies present an alternative or, for some, an effective adjunct, to pharmaceutical management.
Recently, progress has been made. The Government’s ‘Better Access to Psychiatrists, Psychologists and General Practitioners’ (‘Better Access’) initiative through the Medicare Benefits Schedule (MBS) has enabled more people with less disabling mental illnesses to receive affordable treatment. This helps to keep them engaged with friends, family and employment. The recently released evaluation of Better Access indicates
that the initiative has increased access to treatment from 35 per cent in 2007 to a estimated 46 per cent today. However, the evaluation also showed that many vulnerable groups are missing out, such as people in rural and regional Australia and low income areas, Indigenous Australians, men, young people under 25 and other disadvantaged groups.
The challenge remains to provide the right mix and level of mental health services when people need them, and to remove the barriers and stigma that prevent people with mental illness, their carers and families from asking for help.