Mental Health Archives - thegoodwills.com

Adopt a duck in mental health week

It’s Mental Health Week, aptly coinciding with a self-diagnosed bout of post-viral depression. Those of you who suffer the ‘Black Dog’ will know that a flu or virus can tip you into a depressive cycle. She Who Also Gets It commonly says: “Don’t be depressed – it’s boring.” Fine for her to say if she’s OK.

(Read to the end then come back and watch this 43 second video by Bob)

As my Ma would have said (and maybe yours too), ‘misery loves company’. Statistically-speaking, about 40% of my readers will have suffered from some kind of mental health episode in their lifetime. The other 60% will probably let this FOMM go by (“Why doesn’t he write something nice and fluffy, grumble, grumble, or at least say what he thinks instead of quoting other people?”)

The latest data from the Australian Bureau of Statistics (ABS) tells us that more than 40% of Australians aged 16-85 years have experienced a mental disorder at some time in their life. One in five (21.4% or 4.2 million people), had a 12-month mental disorder. Anxiety was the most common group of 12-month mental disorders (16.8% or 3.3 million people). Young people were most at risk with 39.6% aged 16-24 years reporting a 12-month mental disorder.

Note: 12-month disorders are categorised as including anxiety, mood, impulse-control and substance use disorders.

The latest national study into mental health and well-being was released in July. Among its findings are that 3.4 million Australians aged 16-85 years (17.5%) saw a health professional for their mental health in 2020-2021. Of these, 57.4% had a 12-month mental disorder, 17.7% had experienced a mental disorder at some time in their life and 24.0% had no lifetime mental disorder. (To quote the quintessential Aussie singer-songwriter Kasey Chambers- ‘If you ain’t worried now, you’re not paying attention..’Ed)

That latter cohort (the 24%) are probably those referred to in this World Health Organisation (WHO) report. The WHO said that in the first year of the COVID-19 pandemic, global prevalence of anxiety and depression increased by 25%.

“The information we have now about the impact of COVID-19 on the world’s mental health is just the tip of the iceberg,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This is a wake-up call to all countries to pay more attention to mental health and do a better job of supporting their population’s mental health.”

The WHO’s Mental Health Atlas showed that in 2020, governments worldwide spent on average just over 2% of their health budgets on mental health. Many low-income countries reported having fewer than 1 mental health worker per 100,000 people.

Australia stands out from the crowd in terms of investment. Government spending on mental health-related services in 2019–20 was estimated to be around 7.6% of total government health expenditure.

The Australian Institute of Health and Welfare says $11 billion was spent on mental health-related services in 2019-2020. Of the $11.0 billion, State and Territory governments spent 60.0% ($6.6 billion). The Australian Government’s $3.8 billion contribution covered Medicare-subsidised mental health services and prescriptions.

Australian Government spending on prescriptions equates to about $22 per person. Anti-psychotics (48.1%) and antidepressants (32.5%) accounted for the majority of mental health-related subsidised prescriptions.

That may well be, but I pay something close to full price for mine, mainly because my doctor told me not to accept the generic version. On the other hand, I paid $6.90 for the antiviral meds prescribed when I tested positive to Covid-19. The full price on the packet was $1,130, Now you see why Australia is so lucky to have Medicare.

Ah Covid, that was almost a month ago. I still have a cough and after walking the dog on the river circuit, I have to take some Ventolin and lie down. Multiple research reports have emerged which discuss the serious implications of ‘long Covid’ and lingering symptoms such as lung problems, fatigue and ‘brain fog’. Clearly there is much work yet to be done to establish the long-term risks of having had Covid-19.

And yet the collective Australian government response to Covid seems to be aligned to President Joe Biden’s recent claim that the pandemic is ‘over’. We shall find out after today, which is when Australian State and Territory governments agreed we should no longer be required to quarantine after testing positive. My view of it is simplistic. As of today, 10.3 million Australians have had Covid and 15,399 died with Covid – more than people killed on the roads in 2020.

Perhaps it was coincidence that the US health administration also eased its quarantine recommendations. The Center (US spelling) for Disease Control and Prevention said in August it was no longer recommending that adults and children quarantine at home after having been exposed to Covid-19. The CDC instead recommends those exposed wear a mask for 10 days and take a test on day five. The CDC is, however, saying that Covid is ‘here to stay’, recommending that people who have tested positive to the virus isolate for five days.

Greta Massetti, chief of the CDC’s Field Epidemiology and Prevention Branch, said the changes reflected data indicating 95% of the population has some protection, either from infection or vaccination.

On September 29, Australia’s National cabinet unanimously agreed to scrap the mandatory Covid isolation requirement, with exemptions for those working in high-risk settings such as health or aged care.

Prime Minister Anthony Albanese said (in the same breath) that disaster payments for workers diagnosed with Covid would end, with the same exemptions for high-risk workplaces.

As The Guardian reported, all State Premiers and Chief Ministers agreed to the change, claiming it was “not sustainable” for governments to keep paying workers to stay home.

Predictably, the Australian Business Council and the Chamber of Commerce and Industry welcomed the decision.

I was taken by surprise, not expecting a Labor Government to make what is clearly an economic decision, rather than support measures that lower the risk of the virus spreading in the community.

Chief medical officer Professor Paul Kelly cautioned that quarantine measures may be re-introduced if pandemic conditions such as transmission rates dramatically changed. (Something reminds me about stable doors and horses bolting..Ed)

“We wanted to make sure that we have measures which are proportionate and that are targeted at the most vulnerable,” Mr Albanese said after the meeting. “We want to continue to promote vaccinations as being absolutely critical, including people getting booster shots.

“We want a policy that promotes resilience and capacity-building and reduces a reliance on government intervention.”

(Ed: Capacity building is ‘the improvement in an individual’s or organization’s facility to produce, perform or deploy’.

Mr Albanese was asked whether casual workers would now be forced to work while sick. His response was that the government could not keep paying for such financial supports, comparing the strategy to influenza.

“The flu has existed, and health issues have existed, for a long period of time, and the government hasn’t always stepped in to pay people’s wages while people have health concerns,” the Prime Minister said at a press conference.

While the advice here and in the US is (still) to wear a mask for 10 days after contracting or being exposed to Covid, the mask mandate for public transport was removed in all Australian jurisdictions last month. Apart from medical centres, hospitals and aged care centres, mask-wearing has become optional.

I wore mine while filming the short duck video (above). Avian flu – you can’t be too careful.

Covid triggering depression and anxiety

covid-depression-black-dog — Image: The author and black dog, moving day 2019 (before Covid-19)

It’s the lead news story you’d probably never see on prime time TV, a focus on depression and anxiety and how Covid-19 and the control response has seen more of us succumb to the Black Dog.

Newsreader: “Researchers have published new data that show the incidence of depression and anxiety among travellers stranded in Queensland has soared in recent months.

“70% of those who reported acute anxiety or depression over the past six months were people from New South Wales and Victoria who find themselves exiled in Queensland.”

(Cross-over to interview)

Interviewer: Julianna and husband Dario* have been stranded in Queensland since a road trip north in June turned into five months in exile. Our correspondent caught up with them at Sapphire, after the couple had spent a fruitless week fossicking for opals.

Julianna: “It was fun until it wasn’t fun. I mean, how many times can you go to the Qantas Museum? I miss my grandkids and I miss Victoria, the markets and all the good foods you can’t buy in outback Queensland.

Dario: “Yeh, Julianna’s right And, you know, a 20-foot caravan might seem big until you have to live in it for months on end. It always smells like fried eggs.”

Interviewer: So you have both slipped into a state of anxiety and depression as a result of not being able to go home?

Julianna: “Yeh, well it’s not logical – I mean the sun’s shining and the birds are singing and every day we feel safe because there’s hardly any cases in Queensland. But I’ve been feeling increasingly sad and apathetic.”

Dario: “And I’ve been drinking more than I usually do…

Julianna: “You reckon?”

Satire it may be, but it’s no laughing matter, this dark mood which can inexplicably darken the sunniest Queensland day. The symptoms are not hard to read: feeling tired all the time, not going out much, feeling miserable, feeling that nothing good ever happens, relying on alcohol…

Sunday is World Mental Health Day, although why we only get one day a year is something to ponder.

Multiple studies have been carried out that link the increased incidence of anxiety and depression to the global pandemic and the response by authorities to control the virus.

Professor Richard Bryant from UNSW’s School of Psychology says people find it harder to cope as time goes by.

“We are having a longer and later lockdown experience than the rest of the world, due to the lack of people who are vaccinated and the Delta strain of COVID.

“What we tend to see is that people get anxious at the start, then when the effects of social isolation wear on, it becomes a depressive reaction: people’s coping resources get eroded over time.”

Prof Bryant said the Delta strain and the effect of younger people dying has elevated anxieties among that cohort because they thought COVID was mainly a risk for older persons.(Apparently not taking into account the possibility of their catching Covid and passing it on to older people, such as their parents. Ed)

He says we can learn about the trajectories of mental health in Australia by looking at countries that are somewhat ahead of us.

“For example, one study in the UK sampled people at varying points during the pandemic. This study found that two months into lockdown, which is approximately where much of Australia is positioned now, the rate of people’s anxiety had decreased marginally relative to earlier periods during the pandemic.

However, at that stage more than half of the people participating in the study were still reporting anxiety.”

Three months after lockdowns started in the UK and restrictions were beginning to ease, half of the respondents still reported being worried about the pandemic.

As always, those most vulnerable to mental health problems were young adults, the unemployed, single parents, and people with long-term health conditions.

A recent webinar hosted by Monash Business School explored the impact that deteriorating mental health is having on the Australian economy (estimated at between $40 million and $70 million a year). Covid-19 has driven a rise in the prevalence of depression and anxiety disorders, and is linked to an overall decline in women’s mental health.

Professor Jayashri Kulkami, Head of the Department of Psychiatry at Monash Central Clinical School, uncovered some striking findings from an online survey conducted by her research team looking at ‘Women, COVID-19 and Isolation’.

Professor Jayashri points out that the concept of quarantine is not new, and that isolation is intended to keep people safe. Paradoxically, for some women and children, being isolated at home is doing the opposite.

“The negative consequences include the risk of losing jobs, greater economic vulnerabilities, and psychological health issues resulting from isolation, loneliness and uncertainty.”

Statistics collated by Beyond Blue, one of the many support services people can turn to, show that:

l One in seven Australians will experience a depressive illness in their lifetime;
l One in 16 Australians is currently experiencing depression.
l One quarter of Australians will experience an anxiety condition in their lifetime.
l One in seven Australians is currently experiencing an anxiety condition.
l One in six Australians is currently experiencing depression or anxiety or both.

Fortunately, support-seeking appears to be growing at a rapid rate, with around half of all people with a condition now getting treatment.

Against those long-term stats, an Australian Bureau of Statistics survey published in July found that one in five Australians are reporting high or very high levels of psychological distress linked to the COVID-19 pandemic.

Lockdowns bring unexpected positives

The New Daily’s John Elder set out to find the hidden silver lining beneath this gloomy diagnosis. He examined a survey of 3,000 people by psychologists from the University of Strathclyde in Glasgow.

The May 2020 survey found that more than half reported positive changes in their lives since COVID-19 took hold. In particular, 87% of people were more appreciative of things usually taken for granted. Respondents reported having more time to do enjoyable things, spend more time in nature, pay more attention to personal health and pursue physical activities. (Our garden has never looked so good. Ed)

These changes in behaviour were still in train for half the participants who had reported positive effects.

A December 2020 study from the University of Sydney found that 70% of its 1,000 participants experienced at least one positive effect of the pandemic.

“The top three positive effects were having the opportunity to spend more time with family; having greater flexibility in working arrangements; and appreciating having a less busy life.”

The University of Bath and the University of Lisbon surveyed mothers with one or two children (in the UK and Portugal). Many of them were working at home on reduced wages, while 93% of their children were learning from home via remote learning.

“Nearly 90% of the women found that the hardships caused by the pandemic had provided valuable opportunities. More time with the family, rediscovering small pleasures – but also time to think about their one and only life, and its meaning.”

As Elder found, and you don’t know until you go looking, the Covid pandemic has been responsible for “post-traumatic growth”. This is a formal label for what happens when people undergo a transformation after suffering adversity.

“Many people say they have found meaning in their lives – or at least have begin to ponder more deeply about these big questions that are answered more by feeling, than thinking.”

Things to ponder on Sunday, when we reflect on the 300 million people who struggle with or just simply live with depression.

As we often say around here, when the sun is shining and the birds are singing, “Well, at least we don’t live in Afghanistan.”

*not their real names

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Mental Health Challenges Aplenty in 2020

mental-health-depression — Nibbler feeling blue after a visit to the vet

Over the past six years, I have written at least 20 blogs about mental health and my particular affliction, anxiety/depression. The Black Dog Institute says one in seven Australians will experience depression in their lifetime. It carries the third-highest burden of disease (in terms of cost to the community), in the country.

So if it has never affected you, be aware. The Black Dog can sneak up on you, as we can see:

One in five (20%) Australians aged 16-85 experience a mental illness in any year;
The most common mental illnesses are depression, anxiety and substance use disorder(or all three at once);
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 disorders.
54% of people with a mental illness do not seek treatment.

And those were the statistics before the pandemic came along in March and set anxiety and depression loose.

To its credit, the Australian Government stepped up in August to offer people an extension on the subsidised specialists’ scheme.

Under Medicare, a GP can refer you to a psychologist or other mental health specialist under a plan which will pay $124 per session for a maximum of 10 sessions a year. This means if your counsellor charges $165 (the going rate for a clinical psychologist), you will be $41 out of pocket, or $410 over the course of treatment.

The Federal Government extended the scheme by an additional 10 sessions for people whose plan had run out, and whose lives were directly affected by COVID-19 lock-downs.

The extended scheme, which cost $7.3 million, will run out in March 2021.

The front line treatment of a mental illness like anxiety and depression is medication, counselling and cognitive behaviour therapy. The latter means trying to change your reactions to things that trigger your moods. Increasingly, GPs and specialists will try other methods before they resort to medication. It depends if your mood disorder is bio-chemical or triggered by trauma or personal circumstances.

I recently read the biography of now-retired rugby league great Darius Boyd, who spent the latter half of his career in therapy and then became a mental heath ambassador. For much of this season, social media trolls posted nasty things about Darius, whose form fell off (as it can do with players past their peak), as also happened to his team, the once-mighty Brisbane Broncos. Darius now spends a lot of his time as a mental health ambassador, important work when you consider that 72% of men do not seek help for mental health problems.

Men are also at greatest risk of suicide but least likely to seek help. The Black Dog institute says that in 2011, men accounted for 76% of deaths from suicide. Other groups at proportionately higher risk include indigenous Australians, the LGBTI community and people in rural and remote areas.

You may know that this is Mental Health Week, which includes community activities to bring these still-stigmatised illnesses into the daylight. There’s the One Foot Forward initiative, where people volunteer to walk a certain number of kilometres through October and raise money through sponsorship for the cause.

An Australian survey of 5070 people found that 78% said their mental health had worsened during COVID-019. One in four were worried they would be infected and one in two worried that families or friends would be infected. Psychological distress levels were higher, with raised levels of depression (62%), anxiety (50%), and stress (64%).

A World Health Organisation report in May warned that significant investment in mental health support was needed owing to COVID-19. Those at particular risk of COVID-related psychological distress include children, women minding children and/or working from home, older people, those with existing mental health disorders and front-line health-care workers.

Depression, or what Winston Churchill famously dubbed the Black Dog, comes and goes, whether you take medication or not. The severity might be dampened down, but you still don’t want to get out of bed or finish reading the second or third book you started.

I find walking, bird-watching and playing guitar the best diversions and, surprisingly given my tendency to introversion, I rarely knock back opportunities to socialise, even when I’m feeling off the boil. It’s not quite ‘snap out of it’ – unhelpful advice too often doled out by people who don’t understand mental health – but it is something.

If you could capture the molecule that for no reason decides to tell your brain “ wake up, you are no longer depressed”, I’d bottle it and give it away free to fellow sufferers.

Periods of respite come along; I felt momentarily cheered when a young friend told me she was with child for the second time. I was cheered further when seeing my fledgling rose garden start to bloom. Cheerfulness came with two snail mail letters, one from a friend in her mid-80s, who wrote a long letter for my birthday, which she never forgets. She befriended our family in Scotland (I was five) before we emigrated. Mary posted the letter in New Zealand on September 22 and it turned up on the 14^th October – just one example of how COVID-19 has broken down communications with family and friends.

I know people who have new grandchildren they are yet to meet, and people who would have liked to be at particular funerals and could not go. Then there were the people who could not visit a loved one who was dying of the virus because of restrictions on hospital visits.

So yes, snap out of it indeed.

But then I accidentally tuned in to ‘Dr’ Trump, self-diagnosing himself as ‘immune’, followed by the Gladys and Daryl fiasco, which tipped me back into the pit. I’m also aware that the passing of my peers – loved ones, friends, acquaintances and fellow musicians – remind me that I’m nearer the end than the beginning.

So I was sad to hear that Irish songwriter Kieran Halpin had died aged 65, and offer this brief tribute. Kieran, who graced our lounge room on several occasions, was a dedicated FOMM reader. He sometimes emailed to say how much he enjoyed particular outback travel pieces. A long while ago, Kieran and family spent a year touring Australia in a motor home, guitar in back. He loved the wide open spaces and the starry nights of the outback and drew inspiration there. An inventive and prolific writer, he had the happy knack of writing songs that other singers wanted to cover. Kieran’s songs like Nothing to Show for it All, Angel of Paradise and All the Answers were covered by artists including Delores Keane, Vin Garbutt, Niamh Parsons, The Battlefield Band and Dutch singer Ilse De Lange. As is often the case, the songs were better known that the man who wrote them.

When I call you in the morning tell you everything’s alright

I can’t see into the future I don’t see the danger in the night

Cos when I hear the siren wailing

I see the flashing of the light

I know that there is trouble there is a battle yet to fight

I may not have all the answers no

I wouldn’t have it any other way

http://kieranhalpin.com/

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The joys of gardening

joys-gardening-company — (Photo: SWPAG (aka Laurel Wilson, suitably attired for gardening – the T-Shirt quote says ‘Economic Rationalism Isn’t’)

This week, determined to write something without uttering the C word, I decided on a blow-by-blow description of our efforts to establish a garden. Great minds do think alike, apparently, as The Conversation published a timely piece on Monday. “It’s a great time to try – a vegetable patch.” The Conversation’s thrust is that we (the people) have more reason now than at any other time in recent history, to grow our own food. If you take heed of the dire warnings from the International Monetary Fund, by the time the global recession really kicks in, it will be harvest time!

My thumbs have definitely greened over years of associating with She Who Plants and Grows (SWPAG). In the early days, keen to be seen as doing my bit, I weeded down the narrow but sunny side of the house. Alas, the two weedy-looking plants I ripped from the ground were tamarillos, planted by SWPAG. There was a degree of cold shoulder for a while. Mollified, I tried a parody – “I’m sorry I killed your tamarillos, every night I’ve been hugging my pillow”.

You had to be there.

We always planned to build small vegie gardens in the relatively small back yard of our new abode on the Southern Downs. We went down to the Big Green Shed and spent the equivalent of a months’ worth of fruit and vegie supplies on above-ground garden beds, compost, manure, cane mulch and assorted seedlings.

Then we set about building the first of the timber, no-dig garden beds. After a considerable amount of finessing and swearing, we concluded that the metre-square pre-cut garden beds were not at all precise.

By trial and error we put the first one together, using a battery-powered screwdriver and a hand-held Phillips head screwdriver to finish the job.

The swearing started with repeated attempts to get the box level.

“Next time let’s get the ground level first,” I suggested.

There’s a recipe to follow when making a no-dig garden bed. First you build a layer of small twigs and branches for drainage, then a layer of cardboard. Next a layer of cane mulch, then a bag of manure, another layer of cane mulch, a layer of our very own compost, husbanded (and I use the word correctly), from our own vegetable and fruit scraps, lawn clippings and anything compostable that wasn’t a weed. Then more layers – cane mulch, manure, compost and then more cane mulch. Finally, SWPAG said: “That’s enough.”

We stopped for a cup of tea and a biscuit, which turned into an hour-long bout of stooging about the house complaining about various aches and pains and watching last week’s Gardening Australia.

Later, we watered the new garden and let it sit. Magpies appeared from nowhere and started foraging around the edges where we’d stirred up all kinds of magpie food.

That was Friday. Night fell and we watched the latest edition of Gardening Australia. This truly national show has something for everyone, no matter where you live, even this peculiar temperate/arid zone where 100mm of rain in a day leads news bulletins.

On Saturday we decided to spice up the day with a trip to the dump. The fellow at the boom gate (1.5 metres away), said “Not another load of garden waste!”. (It’s the new excursion in these ‘iso’ times. Ed)

We got up early on Monday morning and set our minds to building the other two garden beds. Now that we knew what we were doing (Ed; LOL), in no time at all we had three above-ground garden beds. The magpies were ecstatic and the dog christened all of them.

Our fledgling herb garden, established a few months ago, was contained elsewhere in a dozen pots of various sizes. Curiously (I thought), SWPAG tasked me to move the 12 pots, strategically positioning them inside the second above-ground garden bed.

“So we didn’t really need the second bed?” I ventured, without a trace of criticism or sarcasm.

“Yes we did – it looks tidy that way”.

The thing about gardening, it has to be regarded as a hobby, because financially (the wooden boxes alone cost $147), it makes no sense at all. But it’s great for your mental and physical health, gives a sense of accomplishment and creates convivial times spent outdoors. Best of all, you have something to show for your labours.

I mentioned Gardening Australia – despite the obvious expertise of the presenters, it baffles me how few of them wear gloves or dust masks when handling compost, gypsum, dynamic lifter and a host of other elements added to the soil.

The harmful bacteria and fungi in potting mix have been known to cause lung ailments such as Legionnaires’ disease or Histoplasmosis (the latter a fungus that lives in parts of the US, Central and South America, Africa, Asia, and Australia).

The risk is accentuated if you store bags of potting mix in a moist and warm environment where fungi can multiply. This article in The Conversation qualifies the warning by adding that the risk of contracting lung disease from using potting mix is slim. Nevertheless, I wear a dust mask when using potting mix, cane mulch or any soil additive that gives off dust. SWPAG takes it one step further and wears a respirator.

Sometimes, breathing noisily, she complains in a muffled voice (like Dark Helmet in the 1987 Mel Brooks spoof, Spaceballs):

“I can’t breathe in this thing.”

Wearing gloves is a sensible protective measure. If you are a guitarist (or a person who likes to cultivate long nails) it will protect them from damage. If you have any tiny cuts or abrasions, gloves will guard against picking up infection, or worse, tetanus. There is a vaccination one should have to guard against the latter, a serious bacterial infection that causes muscle spasms.

Even Good Housekeeping magazine got in on the gardening hazards topic, warning gardeners against everything from Lyme disease (we don’t have this in Australia, or so it is said), heat stroke and poisonous plants to a stern warning about harmful chemicals used in lawn and garden care products.

Robyn Francis of Permaculture College Australia, on the other hand, says people should get their hands dirty and soak up the serotonin in the soil. She cites research that “dirt-deficiency in childhood is implicated in contributing to quite a spectrum of illnesses including allergies, asthma and mental disorders.”

No need to be more paranoid than we already are, folks. Be like Bob – wear a hat, mask and gloves and stay 1.5 metres away from potentially hazardous substances.

Which reminds me of the time a friend was staying with us in Maleny and helped SWPAG plant an edible fruit tree down the back of our half-acre block. Just as they neared the bottom of the hole they’d prepared, a large hairy spider jumped out, rearing up and showing fearsome fangs. To this day they ae not sure if it was a deadly Funnel Web or the less harmful but no less scary Trapdoor Spider.

Risks aside, you could do worse, in this strange time we Australians have abbreviated to ‘Iso’, than to establish a small vegetable and/or herb garden. If, like so many city folk these days, your back yard is small, fear not. Josh from Gardening Australia has (almost) the last word.

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Movember and a short history of facial hair

Movember-moustaches — Grandad Wilson with a circa 1920 moustache

Fourteen years ago a couple of Aussies came up with ‘Movember’ – a campaign to raise awareness of men’s health issues including prostate cancer and depression. There are many ways to take part in Movember (which lasts for the month of November). The most visible way is to join other men who are growing a Mo for 30 days and ask people to pledge support.

No better time to introduce Grandad Wilson (;left), posing in his stonemason’s workshop in rural Scotland, circa 1920s. Now that’s what I call a moustache!

I have another, more sombre photo of Grandad in his WWI Corporal’s uniform in front of a small platoon of soldiers. Some of them are sporting a ‘Mo’, and, if I may observe, many of them are yet to make twenty years of age. I wonder how many of them made it to 20.

It was interesting to discover that from the Crimean war onwards, men in the military were forbidden to shave their upper lip. Attitude to hairy faces in the armed forces and police have changed many times since.

Moustaches were all the fashion in the early part of the 20^th century, thanks in part to silent era movie stars like Charlie Chaplin and Oliver Hardy. Both comedians’ sported Toothbrush moustaches – five centimetres of hair above the lip, trimmed vertically, thus mimicking the bristles of a toothbrush. This type of Mo virtually disappeared after 1945 because of the negative association with the toothbrush moustache cultivated by the defeated Chancellor of Germany, Adolf Hitler.

Chaplin wore his Mo with pride in the 1940 satirical film, The Great Dictator. He alternately plays a Jewish barber who loses his memory and finds himself subject to tyranny, and the tyrant himself, Adenoid Hynkel. Nearly 80 years on, Chaplin’s first full-length talking film is still rated at 93% by movie review site Rotten Tomatoes.

What got me thinking about Movember and moustaches in general was the November 2 appearance of rugby league coach Brad Fitler on TV, sporting the wispy beginnings of a moustache. Taking a gentle ribbing from panel commentators on Nine’s broadcast of the triple-header league international, Fitler said, ’it’s for a good cause’.

To become a Mo Bro, you must first sign up as a clean shaven dude as of November 1 then start growing and grooming a Mo.

The movement got its start in 2003 when mates Travis Garone and Luke Slattery met up for a quiet beer in Melbourne. The moustache was unfashionable at the time, but they found 30 blokes willing to take up the challenge. From humble beginnings, Movember has branched out into 20 different countries and raised $600 million for charities like the Prostate Cancer Foundation.

As Fitler says, it’s a good cause, raising awareness of men’s’ health issues, symptoms of which a lot of men ignore, often at their peril.

Cancer Council statistics estimate that 1 in 7 men will be diagnosed with prostate cancer. The good news about this form of cancer, which comprises 25% of all male cancers, is that it is slow-growing, so unsurprisingly there is a 95% chance of reaching the five year mark. Unlike some forms of cancer, prostate cancer can be quickly picked up by a blood test which all men over 45 should have every year.

Movember also aims to lift awareness about depression in men and the risk of suicide, still the leading cause of death in Australians aged 15 to 44. Men are three times more likely to commit suicide than women. It has been estimated that around 60,000 Australians attempt suicide every year. So it serves a useful purpose simply by putting these issues under your nose, as it were.

Movember’s rules quite rightly stipulate no fake moustaches, beards or goatees. They also state the Mo must be kept groomed and that participants must ‘act like gentlemen’.

Mo’s come in all shapes and sizes. In my experience of cultivating a Chevron in the 1990s (left), they take longer than a month to become vigorous, so don’t expect too much from Movember participants (especially those who start late). Film stars have helped to give the moustache some cachet through the eras where they were prominent on the silver screen. Clark Gable enhanced his suave country gentlemen looks in Gone with the Wind. His was a Pencil moustache, also favoured by actors including Errol Flynn and David Niven, writer George Orwell and musician Little Richard. The Pencil Mo is defined by a carefully shaved gap between the two sides.

Chaplin and Hardy, as we mentioned, wore the now-taboo Toothbrush Mo. Tom Selleck sported a handsome Chevron in Magnum PI, starting a 1990s comeback of the coarse-haired, thick moustache.

Wrestler Hulk Hogan is often mentioned for his magnificent Fu Man Chu that droops down either side of his mouth. Actor Sam Elliott has worn a Fu Man Chu for so long it is now snowy white, still enhancing his twinkling smile. And what a contrast between the suave, smooth-shaven 007 and Sean Connery’s moustachioed character in The Untouchables. Musician Frank Zappa gets a mention in this list by artofmanliness.com, but on Movember’s definition it’s a fail, as he also had a ‘soul patch’ under his bottom lip.

I recommend scrolling through this list of celebrities known for their moustaches. The impressive Handlebar moustache worn by German philosopher Frederick Nietzsche (left) stands out from the crowd. Imagine kissing that! In my long experience of having a beard and mo of varying lengths, there are certain foods that men with facial hair like Frederick should avoid:

Spaghetti bolognaise
Soup (minestrone in particular)
Tacos
Icecream
Lamingtons
Pavlova and cream cakes in general

It is interesting to note that the list of hirsute blokes listed by artofmanliness.com does not include Groucho Marx or famous fictitious characters like Hercules Poirot and Boston Blackie. As it turns out, Groucho’s famous set of bristles was fake (at least in the early days), which is curious when you think how his combination of eyebrows, glasses, Mo and cigar so often feature at fancy dress parties. Likewise, Chaplin’s Toothbrush mo was painted on in the early days of films featuring his character, The Tramp, mainly to disguise his age (he was 24 in the first silent film in 1914).

Poirot’s waxed moustache (often described in Agatha Christie’s books as ‘magnificent’, ‘immense’ or ‘splendid’), is an integral part of the series.As Poirot says to Hastings (in Peril at End House): “If you must have a moustache, let it be a real moustache – a thing of beauty such as mine.”

Kenneth Branagh’s turn as Poirot in the 2017 remake Murder on the Orient Express, acknowledged the importance of Poirot’s facial hair to the character’s character. To that end, numerous movie sites let it slip that Branagh had some cosmetic help with that.

I mentioned Boston Blackie, featured in Jimmy Buffet’s song ‘Pencil-thin moustache’, a tribute to the first half of the 20^th century.

Boston Blackie was a fictional character created by author Jack Boyle. A jewel thief and safecracker, Blackie became a detective in adaptations for films, radio and television. And yes, like Clark Gable, Errol Flynn and others, he had a Pencil moustache. It is not recorded whether his was au natural or faked with greasepaint.

As Buffett says of male grooming in an era ‘when only jazz musicians were smokin’ marijuana’ – ‘Brylcream, a little dab’ll do ya’.

(Live at the Byron Bay Blues fest, 2017) https://youtu.be/YKn15lEBL9s

Insomnia and the four poster bed

insomnia-four-poster-bed — Image: Elizabethan ornate oak four poster bed. Wikipedia, Public Domain

It may come as no surprise, given our circumstances, to read that I/we have suffered bouts of insomnia these past few weeks. Selling up and moving from our home of the past 17 years was one major stressor that contributed to fitful sleep. Then there is the (ongoing) uncertainty about where we will end up living, which in our case requires two people to agree on the location, condition, ambience and price of another home. Thirty-seven house inspections later, we are just about there.

But as you would all know (Australian home owners move on average every seven years), the transitional period is quite stressful. We have moved our luggage from one place to another four times since vacating the premises on September 11. Naturally enough, you leave things behind. For example, I’m supposed to wear black leather shoes for our choir performances this weekend. So far, all I have found is a dowdy pair of brown loafers and a pair of old man slippers (the kind with a flap held in place by Velcro). She Who Had No Clue Where My Black Shoes Were said, “Why don’t you go to the Plaza tomorrow and buy a new pair?” Now there’s a thought.

These past few weeks we have been ‘couch surfing’, courtesy of benevolent friends and relatives, who in truth provide much more than a couch (and a spot for the dog). Still, strange beds, different locations and fluctuating bed times clash with the heightened stress of the displaced person. Not to mention this weird spring weather where you kick the doona off at 11pm and wake up cold at 4am.

For years I thought it was normal to wake at 2.10am with no expectation of falling asleep again. If I did, it was inconveniently about 35 minutes before the alarm told me it was time for work. This was not always the pattern. Sometimes, I could not get to sleep at all, other times I’d fall asleep the minute my head hit the pillow then wake again in 20 to 30 minutes, hyper-vigilant and twitching.

Over the years I discovered there are many different forms of insomnia and the ones outlined above are only some of them.

Medical research agrees that the first line of treatment for insomnia should be behavioural modification. Eat your evening meal at a sensible hour, don’t read, log on to the Internet or watch TV two hours before going to bed. Don’t drink tea or coffee after 2pm. Go to bed at the same time every night, roll on to your side and switch out the light.

The second line of treatment is medication, usually of the type prescribed for anxiety or depression. An article in the Journal of Clinical Sleep Medicine informs us that 40% of adults with insomnia have a co-existing psychiatric disorder.

“Among these psychiatric disorders, depression is the most common, and insomnia is a diagnostic symptom for depressive and anxiety disorders,” writes Dr Thomas Roth, PhD.

As Dr Roth’s paper asserts, 30% of the general population suffer from chronic insomnia; women and older adults are most at risk. Primary sleep disorders including restless legs syndrome, snoring and sleep apnoea can also lead to insomnia.

The artistic side of the brain quite likes insomnia. Some of my best work, and maybe some of yours, has been created in the wee small hours.

But when you have to front up for work and use your brain and make decisions all day, three or four hours sleep just doesn’t cut it. The phrase ‘burning the candle at both ends’ comes to mind. It means excessive work with no time for rest.

The phrase comes from a time when candles were expensive and burning them at both ends implied a wasteful way to achieve an obsession. As the American poet, Edna St Vincent Millay wrote: “My candle burns at both ends. It will not last the night, but ah, my foes, and oh, my friends, it gives a lovely light.”

In the 1990s, when I was working long hours by day and staying up late writing songs, I sometimes had a dozen candles burning at once. On Saturdays I would take my son to New Farm Park and later to my favourite writers’ retreat, a coffee shop in a massive old woolstore at Teneriffe, an inner Brisbane riverside suburb. The Australian Estate Woolstore had been converted to a furniture warehouse with three huge floors full of classy furniture. It was fun to roam around and check out the stock, bounce on a few beds, try a leather recliner or two and vow that one day, we’d own one of those. Son was 9 or 10 and happy to go off and explore while I’d sit in the coffee shop overlooking the river, blowing froth off my cappuccino and trying to capture the images of the day in a battered old journal.

One time son came back to tell me I had to check out this huge bed.

“It’s got a roof and curtains, Dad.”

The four-poster bed was a beauty for sure, and it had a price tag to match.

“We’d never get it through the front door,” I lied. “Besides, Mum and I are quite happy with the bed we have.”

He went back to building a fort with a pile of sofa cushions while I went back to my journal and jotted down the first lines of a new song “I went down to the wool store, to buy myself a bed; it might help with my insomnia, it was something that I read”.

The Australian Estates Woolstore was later converted to apartments, swept up in the gentrification process that changed Teneriffe from an age-worn industrial suburb to a residential precinct favoured by young urban professionals.

There are lots of coffee shops now in Teneriffe, but none had that sleepy tranquillity, imbued with the ambience of the wool store’s expansive wooden floors and big casement windows that let in the natural light.

Now known as Saratoga Apartments, the Australian Estates Woolstore in Macquarie Street was built in 1926.

Not that Teneriffe’s apartment dwellers would want to be reminded, but I recall the spectacular McTaggart’s Woolstore fire in January 1990. The fire in Skyring Street took hold quickly as the brick and timber building, its floors soaked with lanolin from years of storing bales of wool, exploded. The building was completely destroyed within an hour and the rubble was still smoking next day. That fire took old timers back to 1984 when the Dalgety’s Woolstore at Teneriffe met a similar fate. Those with an interest might like to track down a video called Back to the Brass Helmet which details many of the huge fires the Queensland Fire Service have been called upon to extinguish.

That’s the interesting thing about history – those who like to write down what happened, when, how and where, leave fascinating trails for those of us who care to follow. I went on to finish the song, prosaically called Four Poster Bed. It’s a tongue-in-cheek story about a fellow who spirits a girl away from another chap in a bed shop. It’s fictional, but I like to think it has somehow preserved the edgy, consumerist mood of the early 1990s.

If you had credit, and a degree of lust, you could buy anything.

Last week: Elanora Park is managed by Brisbane City Council, not Redland City Council

Odd socks stamp out mental health stigma

My choice to wear a matchless pair of socks today was a deliberate tribute to Mental Health Week. Odd Socks Day is just one of the many events sponsored through October to remind us that one in five Australians suffer a mental health disorder in any 12-month period.

I’d never heard of Odd Socks Day, but spotted a flyer in a café somewhere and tucked it away for future reference. It’s a national anti-stigma mental health campaign now in its fourth year, using odd socks as a metaphor that anyone can have an off day.

Despite the fact that the majority of people visiting GPs are consulting them about mental health or psychological issues, those with physical ailments are not confronted with the same level of discrimination, stigma and social shame.

Young people are particularly vulnerable to stigma. Research in 2016 uncovered some alarming facts about stigma and what an obstacle it is to people trying to recover from a mental illness. Headspace found that 26% of young people aged 12-25 would not tell anyone if they had a mental health problem and 22% would be unlikely/very unlikely to discuss it with their family doctor.

Fifty-two percent of young people (12-25) identified with having a mental health problem would be embarrassed to discuss the problem with anyone and 49% would be afraid of what others think.

The Royal Australian College of General Practitioners recently found that 62% of people (via the traditional 10-minute consultation), were seeking support for mental health disorders.

The most common mental health ailments likely to afflict people are depression, anxiety and substance abuse. Sadly, many people struggling with depression use drugs and/or alcohol to self-medicate, often with negative results.

In my former work life, the notion of taking a ‘mental health day’ was anathema to your average hard-bitten journalist, for whom the deadline reigns supreme. But in recent years the previously taboo subjects of depression and suicide are now being freely publicised and debated. The hidden cost of not properly dealing with workplace mental health problems is now an $11 billion problem for Australian commerce. There is now an argument that $1 spent on mental health services equates to a ROI (return on investment) of $2.30. So why aren’t we spending?

If there is one indicator to show how stigma and mental health ratio is shifting, it is the NRL ‘casualty ward’, which lists rugby league players and their injuries. Through the season I recall at least six players said to be having counselling for ‘psychological’ or ‘personal’ issues, the latter covering a range of non-physical traumas. Dragons half Ben Hunt spoke candidly to the media this year about seeing someone to help overcome a slump in confidence. Armchair critics (virtual bullies) did not help Ben’s situation, with a steady stream of vitriol posted on social media.

Suicide is often the end-game for people fighting ongoing battles with mental health disorders. Australia’s standardised statistics on suicide are not as high as some (11.7 per 100,000 people). Lithuania (28.6) and South Korea (26.3) head the World Health Organisation list, but Australia is nonetheless in the list of 10 countries with a suicide rate in double figures and has been for a decade.

In Australia, men are three times more likely to commit suicide (17.8 deaths per 100,000 people) than women (5.8 deaths per 100,000 people). More than 75% of all severe mental illnesses occur prior to the age of 25, and youth suicide is at its highest level in a decade.

The telling statistics revealed by the Royal Australian College of General Practitioners clearly show that the system is under untenable strain.

Author Jill Stark wrote about it in a Sydney Morning Herald opinion piece – ‘What happens when the answer to R.U.O.K is no and there’s nowhere to go?’

Stark wrote from a first person perspective, after fronting up to a GP with what she suspected was an acute recurrence of anxiety and depression. She was handed a form to fill in – a routine step in such a consultation, so the GP can make a more objective assessment of the patient’s mental health state. As Stark related, she scored 25 ‘mild to moderately depressed’ and was prescribed medication (after first being asked if she was suicidal).

The answer was no, but on the way home Stark reflected that should she indeed want to kill herself, she’d been prescribed with something well-equipped for the job.

As Stark bluntly pointed out, the time for wristbands and hashtags has passed. Doctors need the financial support Medicare can bring by allowing longer consultations for patients with complex psychological problems.

“As a matter of urgency we must stop rationing psychological services to 10 subsidised sessions per year,” she wrote.

So that was Jill Stark, wearing her odd socks in public. Bravo.

People like Jill who are having an acute mental health crisis need expert support at least once a week for as long as the crisis lasts.

The Black Dog Institute reminds us that 45% of Australians will experience a mental illness in their lifetime. One in five mothers with children younger than two will be diagnosed with depression. At 13%, depression has the third highest burden of all diseases in Australia (burden of diseases refers to financial cost, mortality, morbidity etc).

The World Health Organisation (WHO) estimates that depression will be the number one health concerned in both developed and developing nations by 2030.

That gloomy prediction was no doubt behind the WHO’s decision in 2013 to introduce an eight-year plan to change the direction of mental health in its 194 member states. The plan’s main objectives are to:

strengthen effective leadership and governance for mental health;
provide comprehensive, integrated and responsive mental health and social care services in community-based settings;
implement strategies for promotion and prevention;
strengthen information systems, evidence and research.

Global targets and indicators were agreed upon as a way to monitor implementation, progress, and impact. The targets include a 20% increase in service coverage for severe mental disorders and a 10% reduction of the suicide rate in member countries by 2020.

These are noble aims, but as the WHO observes, it requires effective leadership and governance to implement meaningful change.

Odd Socks Day is one of the rare light-hearted efforts to raise awareness of mental health. Grow, the organisation behind the campaign, runs an in-school peer program that helps young people support each other through their issues.

The overall cost of unmanaged or mismanaged mental health in the Australian workplace is approximately $11 billion a year, according to Dr Samuel Harvey. Dr Harvey, a Black Dog Institute consultant, leads the workplace mental health research program at the school of psychiatry for the University of New South Wales. He was the lead author for research published in The Lancet which found that workplaces that reduce job strain could prevent up to 14% of new cases of common mental illness from occurring.

Quite clearly, we all need to pull up our socks, odd or not, and change our attitude. If only 35% of Australians in need are actively using mental health services, we need to do more than ask R.U.O.K.

Resources: Lifeline 13 11 14, beyondblue.org.au

FOMM back pages:

Mental Health Week – a psychiatrist walks into a bar

You wouldn’t always associate grain silos with the national funding crisis facing Australia’s mental health sector. Mental Health Australia chief executive Frank Quinlan did just that, using the silo analogy to lament the distribution of funds that so often see alcohol and drug problems and mental health problems dealt with separately.

He cited the 2016 Australian Institute of Health and Welfare report on alcohol and drug use which states that one in four people who abuse substances had also been diagnosed or treated for a mental illness.

Mental illness was the subject of a short film shown at Gympie’s Heart of Gold Festival last weekend. A psychiatrist is late for his 11am appointment with a new patient – a man who suffers from delusions that he is…a psychiatrist. It sounds like a man walks into a bar joke, but in this case, the clever premise for a 13-minute film by Josh Lawson (actor/writer) and Derin Steele (director).Lawson and Steele control the farcical plot and sharp dialogue with the panache of John Cleese and Connie Booth.

The film won the best Australian short film award at the Heart of Gold Festival, the 10^th year of this splendidly curated short film festival held in Gympie. I’m happy for the writer/director that they won best Australian short for a film by using humour to have something to say about psychiatry and mental illness.

Seeing is believing – maybe

Unlike physical disabilities (cerebral palsy, MS, spina bifida, brain or spinal cord injury, epilepsy, muscular dystrophy or the long-term effects of a serious stroke), mental illnesses are hardly ever that obvious. Once the mentally ill person’s latest acute episode has settled, they can present in society, well, as normal as you and me.

The point is well made in “The Eleven O’Clock” where the secretary (a temp), accepts what she sees as “normal”.

There is, alas, nothing funny about mental health, its proven links to alcohol and drug abuse and a lack of co-ordinated national funding that leaves so many mentally ill people in a cyclical holding pattern.

As Mental Health Australia chief executive Frank Quinlan wrote in a recent MHA newsletter, separate plans and strategies to deal with mental health perpetuate the silo model of funding.

Quinlan writes that Primary Health Networks, set up in 2015, offer an opportunity to genuinely integrate and co-ordinate programmes and services.

“But this is only going to happen if we can break down the boundaries that see separate streams of funding for drug and alcohol issues, mental health issues and various psychosocial supports.”

The 2016 AIHW report, which canvassed 23,772 people, noted that 27% of illicit drug users have a mental health issue, compared with 21% in 2013. Mental illness occurred in one in four users of ecstasy and cocaine and in 42% of methamphetamine users (29% in 2013).

The abuse of amphetamines and derivatives doesn’t let righteous boozers off the hook. One in five people who drink alcohol at risky levels have also been diagnosed or treated for a mental illness. That was a 25% increase over three years.

Patrick McGorry, professor of psychiatry at the University of Melbourne, says the overlap between mental ill health and substance abuse is enormous, yet treatment for drug abuse and mental health has been “progressively de-funded, de-medicalised and split off from mental health care.”

He told ABC News: “Mental ill health drives self-medication with drugs and alcohol and yet virtually no services are equipped to respond to this toxic blend.”

Meanwhile, many community mental health programs, be they government-funded units or NGOs, have been ring-fenced within the National Disability Insurance Service. This means that the mentally ill who do not qualify under the NDIS may be without support outside of acute hospital wards. The Federal Government set aside $80 million in the May budget with the intention of plugging the gap.

Sebastian Rosenberg, Senior Lecturer, Brain and Mind Centre at the University of Sydney, said the federal budget’s promise of $115 million in new funding over four years was one of the smallest investments in the sector in recent years. The Council of Australian Governments (CoAG) added more than $5.5 billion to mental health spending in 2006, while the 2011-12 federal budget provided $2.2 billion in new funding.

“In 2014-15, mental health received around 5.25% of the overall health budget while representing 12% of the total burden of disease,” Rosenberg wrote in The Conversation.

“(These figures) speak to the fact mental health remains chronically underfunded. Mental health’s share of overall health spending was 4.9% in 2004-05. Despite rhetoric to the contrary, funding has changed very little over the past decade.”

Rosenberg says Australia lacks a coherent national strategy to tackle mental health.

“New services have been established this year, but access to them may well depend on where you live or who is looking after you. This is chance, not good planning.”

This is where the silo analogy reappears: those with the gold key to the silo door will get a quick fix. Treasurer Scott Morrison said the $80 million allocated over four years for ‘psychosocial services’ was for Australians with a mental illness such as severe depression, eating disorders, schizophrenia and post-natal depression. The funding, which seeks matching contributions from the States, includes those who had been at risk of losing their services during the transition to the NDIS.

Some 230,000 Australians with severe mental illness have chronic, persisting illness and most have a need for some form of social support. This can range from low intensity or group-based activities to extensive and individualised support. The latest data available on this subject suggests that 22% of people with psychosocial disabilities have been unable to meet access requirements for the NDIS. (NDIS/COaG Quarterly report).

So $20 million a year won’t go very far, although as much as $160 million a year could be available if all States chip in. But each State and Territory will have to retain responsibility for what was previously known as community mental health services.

Still, you’d agree it’s a better application of taxpayer funds than the $20 million spent in 2015 on charter flights to and from detention centres on Nauru and Manus Island.

From the archives