Mental Health Week 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.

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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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