Prev
Next

The Government’s thrown the black dog a bone

Patrick McGorry

by Patrick McGorry

25 May 05:40am

Must Reads

The Punch is moving house - this is a caption

The Punch is moving house

385

Will Pope Francis have the vision to tackle this? - this is a caption

Will Pope Francis have the vision to tackle this?

122

Advocating risk management is not “victim blaming” - this is a caption

Advocating risk management is not “victim blaming”

251

Filed under: Depression, Health Spending, Mental Health, Suicide

28 comments

The recent Federal budget has underlined the fact that mental ill-health is the major health issue facing Australians in the early part of the 21st century. 

Illustration: Sturt Krygsman

Responding to the reality that Australians now regard mental health among the top three national concerns, just behind the economy and climate change, all sides of politics now support substantial growth in investment in mental health care. 

The Gillard Government allocated $2.2 billion as a decent down payment in a tight budget on mental health reform, crucially beginning to build strength in early intervention models for young people, who bear the main burden of onset for the major mental disorders of adult life.

Yet even this investment will merely lift the proportion of the total health budget from 7 per cent to closer to 8 per cent. 

Most European nations and New Zealand spend 12-14 per cent. The burden of disease across the lifespan linked to mental illness is indeed 14 per cent, number three behind cancer (19 per cent) and cardiovascular disease (16 per cent). 

Yet in contrast to serious physical illness, mental ill-health strikes in young people on the threshold of productive life where it contributes not 14 per cent but over 50 per cent of the burden of disease. 

As the World Bank has said, if a 22 year old dies from suicide or becomes disabled by depression or psychosis, it is not only a human tragedy but an economic disaster which, when repeated in hundreds of thousands of young Australians, seriously weakens our whole society. 

Even up to 44 years of age, 36 per cent of the burden of disease is caused by mental ill-health, and suicide is the leading cause of death in this age group.

The reality is that depression, which occurs from puberty through to the mid-20s, remains front and centre in the current surge of mental ill-health.

While uncommon in younger children where disorders such as autism, ADHD and anxiety affect about 9 per cent of children, depression steadily emerges during adolescence, building into a disorder in its own right, or featuring as a gateway and partner to other common disorders such as psychosis, personality disorder and substance use disorders. 

Most people who experience mental ill-health during this stage of life (26 per cent in any given year) receive little or no help.

This is partly because it has been assumed that because mental ill–health and distress is common in young people that it is “normal” and acceptable. 

Poor awareness of the pattern of mental ill-health across the lifespan plus a fear of “labelling” has meant young people and families have been abandoned to struggle for long periods with disabling and tenacious distress and social and educational impairment. 

A recent New Zealand study has shown between 18 and 24 years that 50 per cent of young people will manifest diagnosable mental disorders, over half the time repeated episodes, which, far from being trivial or “normal”, will significantly affect their social, vocational and economic well-being at age 30. 

Most people who do eventually receive treatment for depression in later life will have suffered with it for many years, having first experienced their first episode in emerging adulthood.  Depression and mental ill-health blights lives. 

This is why the government’s investment in building the missing element in our system of health care, a youth mental health model, is so welcome. 

If you need help, or just to talk to someone, visit Sane, BeyondBlue, or Lifeline.

This piece was contributed as part of The Australian’s Shaping Our Future series , which this week is tackling the challenges and opportunities facing healthcare in the future.

Most commented

28 comments

Show oldest | newest first

    • Carz says:

      06:37am | 25/05/11

      The government may have thrown the black dog a bone but at the same time it has taken away its food bowl. Yes, depression funding for youth early intervention has received a boost but in reality mental health services have been slashed. The program which saw affordable access to psychologists is no longer what it was. In the past a person needing psychological help could get 12 appointments part funded by Medicare (or wholly funded if the psychologist bulk billed), plus another six with compelling circumstances, making psychological help a lot more affordable for thousands. That program has now been cut to just six appointments with another for in compelling circumstances. Hardly a bonus for mental health in this country, particularly when you consider the for many, without this program, it would mean being stuck on waiting lists for counsellors (not psychologists). Waiting lists that can be months long.

      Reply

    • Against the Man says:

      06:51am | 25/05/11

      Ahh….I’ve posted many comments on this happening even before the budget was passed. But it is interesting how they have cut GP Medicare fees to do a health plan, which means less referrals to psychologist, mental health team…......and so that $2.2 billion never really gets spent.

      So the Australian public has once again been screwed over by the sleek and sly Gilltard/Roxon team of con artists.

      Well done guys, after all why should take care of Australians when you have your own personal agendas and friends at the nursing union to take care of.

      Read more in the Medical Observer this month. I think all medicos should go on strike and stop taking the bullying and abuse from this sham government.

      Reply

    • TChong says:

      08:07am | 25/05/11

      AtM what is your problem with Nurses and Nurse Practioners?
      Is it becuse the majority are female?
      Women should know their place?
      Doctors should strike to get their way ? ( agree, everyone should have that right to fight for what they believe in )
      But nurses should not have industrial representation? Why?

    • Soames says:

      11:23am | 25/05/11

      Suggest you keep watching and listening to the news, i.e, paraphrasing, reports on the effect of pot smoking young adults, the increased THC toxicity of the Australian crop, bikie gang distribution, and phychosis induced schizophrenia, as a result of mixing the ‘fix’ with prescribed drugs, tobacco, and amphetamines. There’s a good proportion of your argument, and the need to stop your useless and non-productive criticism of government bodies, and time to make a constructive effort, rather than vindictive bile.

    • Against the Man says:

      12:47pm | 25/05/11

      TChong aka Mr Zero Credibility, no one associates nurses exclusively with females, ever heard of male nurses Mr Know-It-All. Guess we know who the real sexist is smile And if anybody should know where their place is, it should be you, TChong aka the Roxon lapdog! I guess you are happy with the Roxon-Nursing union ‘collaboration’ but some of us don’t approve of corrpution that milks the taxpayers!

      Wake up and get real. Nurses have a role, an important role. But their role is not to be doctors or bill Medicare like doctors when providing a different service. Thanks to their pseudo doctor role, there is less money to train and employ real doctors!

    • Jim says:

      01:17pm | 25/05/11

      Chongy - why latch on to one line from AtM’s post and ignore the rest (not a swipe at you per se, but it seems to be all too common here). What are your thoughts on the false increase in mental health funding and the dodgy way Gillard/Roxon have gone about it?

    • TChong says:

      03:27pm | 25/05/11

      Dear , dear AtM ,
      Thats where the confusion lies?
      The “nurse practioiner “isnt going to usurp doctors, but to fill in the gap when no doctor is avaible.
      What they will be able to bill medicare for will be a small % of what doctors can.-ie why would this , or any govt create a larger problem for itself by enlarging the medicare bill.?
      Suggest you read AHPRA web site, or varios other websites that discuss the scope and role of NPs.
      With a bit of knowledge , you might see your fear and loathing is actually, and fortunately unwarranted.
      BTW- AtM, you are obviosly a proud supporter of Doctors industrial solidarity - (Yur 1st post), but why not so for nurses.?
      I find it hard to work out why you see these two groups should have different rights, industrially.

    • Against the Man says:

      04:17pm | 25/05/11

      TChong, don’t change the issue. It isn’t about nurses’ taking over the doctor’s territory! It is about the qualifications and responsibilities! Why does the doctor have to chase up the pathology results ordered by a nurse or be responsible for the medication interactions? If the NP has the ‘scope’ to order the test or prescribe and diagnose than they should follow through, not take the Medicare rebate and get the GP to follow up and clear things up.

      You obviously don’t understand the issue, but please continue to make a fool of yourself and help promote my cause! smile

      Where are your buddies John A Neve or Seano? I figures as someone with zero credibility after losing countless debates with me you would have faded away with whatever dignity you have left…...............

      Jim, TChong is the zero credibility man who likes to change the story so as not to deal with the direct issue or question, a true ALP drone if there ever was one! smile

    • TChong says:

      04:52pm | 25/05/11

      AtM - didnt know Rupert employed you as a moderator at this site.
      No matter what the story you give yur usual rant, and not too many object..
      But , Mr Nocredability, why dont you tell again of how you exposed “secret"deals between nurses and the govt, and how Roxon heeds your posts-( you actually made that claim)  wink

    • Against the Man says:

      06:29pm | 25/05/11

      TChong, you haven’t addressed the issue! Why cut Medicare rebates to GPs and why give Medicare rebates to nurses who refer to GPs in the majority of the cases? Please whatever you do, don’t answer the question because I have you pinned down just like last time!

      Remember old fellow when I challenged you to list all of Gillard’s significant achievements? You NEVER responded on both occasions! Care to make it strike three? That is why you are Mr No Credibility.

      Challenged thrown down, name the achievements and please they have to be significant with the deal signed and sealed thus the health care deal with the States is out, Malaysian Asylum policy is out, Cash for Clunkers is out…...........

      TChong more people are waking up to the reality of the ALP, the poll numbers have never been lower for Gilltard and friends! smile

    • Robert Smissen of country SA says:

      11:57pm | 25/05/11

      TChong, If you were physically ill you see your GP, who, if he/she can’t cure refers you to a specialist & you go UP the medical chain until your are cured or you die, with mental health you see your GP, then you go DOWN the chain to nurse practioners if you are lucky or to a poorly trained social worker, then you are shunted around & rarely see a doctor again

    • acotrel says:

      06:56am | 25/05/11

      I wonder why there are so few clinical psychologist counsellors available to the mentally ill?  The use of drugs by psychiatrists will never successfully treat an underlying psychological problem.  Treating the symptoms might bring comfort to patients, but it’s never a ‘cure’?

      Reply

    • MarK says:

      07:58am | 25/05/11

      “The use of drugs by psychiatrists will never successfully treat an underlying psychological problem”

      How true.

      In support I am going off my medication today.

      I appreciate the advice.

    • Jordan Rastrick says:

      03:57pm | 25/05/11

      “The use of drugs by psychiatrists will never successfully treat an underlying psychological problem”

      The scientific data disagrees with you.

      “Treating the symptoms might bring comfort to patients, but it’s never a ‘cure’?”

      Neither is psychologial counselling. Both drugs and therapy are only tools that help manage mental illness; there are no cures.

    • acotrel says:

      03:18am | 26/05/11

      @Jordan
      ‘Neither is psychologial counselling. Both drugs and therapy are only tools that help manage mental illness; there are no cures.’

      That’s a very definite negative statement.  Are you also a proponent of euthanasia?

    • Jordan Rastrick says:

      01:53pm | 26/05/11

      Only when most seriously depressed.

      I’m not saying cures are impossible in theory, nor that some people don’t recover more or less completely and permanently from mental ill health.

      And you certainly don’t need to be cured for your life to be worth living.

      But it is a simple fact there are no known medical cures for any serious mental illness, only treatments. In fact, as things stand, most disorders are incurable by definition; as the eitology is very poorly understood, the diagnostic criteria is usually “If you ever experienced symptoms X, you have Y.” If the symptoms go away, you’re in remission, but no one can ever be sure if the underlying causal factors have been eliminated, because there’s such a paucity of scientific understanding as to what they are.

    • AnthonyG says:

      08:56am | 25/05/11

      Is it any wonder when a third of our citizens are asking to pay higher power bills. The world has gone completely insane.

      Reply

    • sludger says:

      09:20am | 25/05/11

      As I have written previously, I had late onset mental health problems (in my late 30’s) which resulted in a long hospitilisation.  I was lucky though, then we still had healing places like Rozelle with tranquil surrounds, grass, water and just space.  Plus I had access to my psychiatrist several times a week, good psychologists, excellent trained nurses and a range of therapists.  In all, a combination of treatments, counselling and medication slowly helped me rebuild.  I am now productive, and in a good professional job.  However, the system now is a sorry mess.  This announcement of 2.2b is all smoke and mirrors.  The fact is, mental health is given lip service.  It is acknowledged, hands are wrung, programs announced and funding allocated.  However, with the tightening of access to these programs, people are less likely to receive help.  And the centres such as Rozelle are gone, replaced now by shiny steel and concrete in hospitals - and even then you would be lucky to get in.  Now we push them on the street and wring our hands even more when many turn to drugs, alcohol or end up homeless or in jail.  I love this country, but in this area we are very backwards and our politicians should be ashamed.  It is not the people of Australia, who I have always found to be compassionate, it is our grovelling, snivelling politicians from both sides of the fence.

      Reply

    • Matt says:

      10:42am | 25/05/11

      But is the science settled, Patrick? That’s what I want to know.

      Reply

    • Shane says:

      02:01pm | 25/05/11

      @Matt, Absolutely settled, as long as you don’t actually press the issue when they use the vague and complete guess-work term “chemical imbalance in the brain.”

      Meanwhile, as the definition of “mentally ill” expands at a furious rate to take in everything from binge drinking to paranoid schizophrenia, more and more Australians are told they suffer from depression. Apparently grief, bereavement and sadness no longer exist. Nope, those are totally unnatural human responses that must be medicated accordingly.

      But then again, with $2.2 billion being written on cheques, it’s no surprise the mental health industry has sprung up over the last generation or so, completely out of proportion with the actual need.

      And as long as McGorry and his ilk can irresponsibly use statistics like claiming there are nearly a million Aussies “locked out” from mental health services, the places where that money could be better spent (like, oh, I don’t know, bowel cancer screening or something similar that saves more lives than mental health intervention) will have to make do with the scraps off the budgetary table.

    • Jordan Rastrick says:

      04:04pm | 25/05/11

      Hi Shane,

      Have you ever actually spoken to a psychiatrist about any of these issues? Because I’ve been treated by several and none remotely resemble your strawperson depiction - all have discussed the limitations and disadvantages of medications suggested to me in depth, and have been careful to explain that normal human emotions such as grief are not pathological in the absence of rigorous clinical diagnostic criteria.

      “, the places where that money could be better spent (like, oh, I don’t know, bowel cancer screening or something similar that saves more lives than mental health intervention)”

      Care to produce some evidence to back this claim up?

      Reply

    • Shane says:

      04:55pm | 25/05/11

      Well Jordan, we have roughly 1700 suicides in Australia each year (ABS).
      We have roughly 14200 cases of bowel cancer diagnosed each year, and over 4000 deaths (AIHW).

      Now let’s consider the budgetary finances: $2.2billion for mental health and suicide prevention and $140million for bowel cancer screening.

      Let’s also consider that screening for bowel cancer can lower mortality by 90%, since it finds the cancer early (CCA). Now consider that the $140million allocation is being spent continuing a program the government itself acknowledges is not good enough and not in keeping with the best science available. So let’s say the potential number of lives saved if the program was fully funded is 90% of 4000, which is 3600 lives saved.

      So, based on the fact that 3600 > 1700, I can safely say that the $2.2 billion booster for mental health and suicide prevention services was out of proportion to the harm caused.

      Now, I also acknowledge that not all that $2.2 billion goes towards lowering that 1700 figure, so let’s be conservative and say 3/4 goes to mental health and 1/4 goes to suicide prevention. That still leaves us with $550million. So, that $550million is being spent to try and reduce suicides (1700 deaths a year), which the bowel cancer screening program desperately cries out “With $550million we could prevent twice as many deaths!”

      Now, let us go even further and say that current suicide prevention programs are doing their job very well (which I truly believe) and that they probably prevent 5,000 (generous) suicides each year. Well, once again, I’m afraid bowel cancer has that number beat. You see, if the bowel cancer screening program was in place, we could actually lower the number of DIAGNOSES dramatically, since the screening can actually prevent cancer ever getting started! Amazing! So we could cut the current number of people diagnosed with bowel cancer (14200) down to the low thousands, by a figure in excess of 5000.

      Ain’t maths grand?

    • Kate says:

      05:54pm | 25/05/11

      As Carz mentions above, it is hardly a ‘bonus’ that Medicare subsidised visits to psychologists and psychiatrists will be cut to six sessions rather than the current limit of 12. It’s great if more young people with mental health problems can be identified and given support, but what about all the people with depression and anxiety disorders who don’t require hospitalisation, but who do require therapy and treatment? A Medicare subsidised option is the only way that some people in need of care (myself included) can afford to see a mental health professional.
      I would fully support the entire $2.2 billion being directed towards the provision of further Medicare subsidies and other affordable mental health care options. It’s all well and good for the Government to jump around saying ‘look at us, we’re spending money!’, but is it really going where it is most needed? If not, it’s a bit of a policy failure.

      Reply

    • bikinis on top says:

      07:42pm | 25/05/11

      Black dogs bark too much and too loudly.
      They make us feel sick.
      What a relief it is when black dogs get lost.
      Let black dogs out of your car and forget all about them.

      Reply

    • concerned says:

      11:05pm | 25/05/11

      I don’t believe that Australians regard mental health is the among the top 3 national concerns. This is just a massive PR spin and utter bulldust. We have been subjected to this propaganda for far too long and prescriptions have been skyrocketing along with the poor people addicted to prescription drugs without any improvement and only demands for more money with worsening results. Their inflated figures of the mentally ill have already been exposed. Show us the survey results that say this? It is fantastically successful marketing from multi-billion dollar drug companies who wisely market disease via prominent spokespeople rather than promoting the drugs themselves (which they can advertise in American but not here) and it is being shoved down our throats and pumped every second by highly paid spokespeople with questionable connections and conflicts of interest to wit Patrick McGorry and co. We need full disclosure of all conflicts of interest from those who spout these so called opinions so we can see who they are really working for.
      Cancer and heart disease kills more people in this country than depression and mental illness. Yet we don’t see a Cancer Minister in the Pm office do we? We don’t see a Heart Disease Minister.

      Reply

    • Jordan Rastrick says:

      02:34pm | 26/05/11

      “with the poor people addicted to prescription drugs”

      Most prescribed substances used to treat mental illness are not addictive.

      “without any improvement”

      Scientific controlled studies indicate otherwise, with the possible exception of drugs being used to treat mild cases of depression and anxiety, which may indeed be indistinguishable from placebo.

      “and only demands for more money with worsening results.”

      The recent funding is primarily aimed at early intervention, precisely because it is demonstrably more cost effective than managing conditions post-onsent with heavy use of medications. I think perhaps you’re mistaking Australia with America? And I don’t know where your “worsening results” idea comes from.

      “Yet we don’t see a Cancer Minister in the Pm office do we? We don’t see a Heart Disease Minister.”

      No, we don’t. Funnily enough paintings kill almost no people compared to any of these things, and yet we still have a Minister for the Arts.

      Mental health differs in several key respects from physical health, that are important from a policy perspective, which is why it warrants its own ministerial portfolio; that doesn’t mean the two portfolios are of equal importance or influence.  If Professor McGorry was asking for the majority of health funding, you might have a point.

      Reply

    • Kcuf says:

      12:49pm | 09/07/12

      I have been a client of wotch for the past 7 years and i am so grtafeul to them they have saved my life and provide an amazing service. My worker has been there every step of the way and has been my biggest supporter and has helped me to find myself and be off medication for 2 years and out of the hospital for 3, and i agree that the hospital system treats us like criminals when all we are looking for is understanding, thank you wotch from the bottom of my heart

      Reply

    • pandora jewelry sale says:

      10:51am | 19/10/12

      Aw, it was quite a excellent post. In notion I’ve to spot in writing similar to this moreover - taking time and actual effort to generate a actually excellent article?but what can I say?I procrastinate alot and also by no indicates appear to go completed.
      pandora jewelry sale http://www.pandoracharmsbracelets.com

      Reply
 
Sorry, comments are now closed for this article.

Facebook Recommendations

Read all about it

Punch live

Up to the minute Twitter chatter

Paul Colgan

Colgo 26 May 13 08:20AM

RT @BusInsiderAU: Tajikistan Blocks YouTube After Video Of Dancing President Goes Viral - http://t.co/QYCQ6f3m8W

Paul Colgan

Colgo 26 May 13 07:53AM

@JohnBurnsST I will save you the trip mate - back home around the 17th of December for a couple of weeks

Paul Colgan

Colgo 26 May 13 07:50AM

@JohnBurnsST Do you know if the SBP will publish that Apple story online?

Paul Colgan

Colgo 26 May 13 07:46AM

French Soldier Stabbed In Neck In Paris http://t.co/FzmOcCx8RN

See all tweets

Recent posts

The latest and greatest

The Punch is moving house

by The Punch Team

385

The Punch is moving house

Good morning Punchers. After four years of excellent fun and great conversation, this is the final post…

Will Pope Francis have the vision to tackle this?

by Hannah Harborow

122

Will Pope Francis have the vision to tackle this?

I have had some close calls, one that involved what looked to me like an AK47 pointed my way, followed…

Advocating risk management is not “victim blaming”

by Sarrah Le Marquand

251

Advocating risk management is not “victim blaming”

In a world in which there are still people who subscribe to the vile notion that certain victims of sexual…

Nosebleed Section

choice ringside rantings

From: Hasbro, go straight to gaol, do not pass go

Tim says:

They should update other things in the game too. Instead of a get out of jail free card, they should have a Dodgy Lawyer card that not only gets you out of jail straight away but also gives you a fat payout in compensation for daring to arrest you in the first place. Instead of getting a hotel when you… [read more]

From: A guide to summer festivals especially if you wouldn’t go

Kel says:

If you want a festival for older people or for families alike, get amongst the respectable punters at Bluesfest. A truly amazing festival experience to be had of ALL AGES. And all the young "festivalgoers" usually write themselves off on the first night, only to never hear from them again the rest of… [read more]

Light weight

Gentle jabs to the ribs

Superman needs saving

Superman needs saving

Can somebody please save Superman? He seems to be going through a bit of a crisis. Eighteen months ago,… Read more

28 comments

Newsletter

Read all about it

Sign up to the free News.com.au newsletter