Matter of Public Importance - Mental Health

MENTAL HEALTH.

Wednesday 30 October, 2019.

Mr NEWBURY (Brighton) (15:42):

Our mental health is as important as our physical health, yet our focus is often on our physical health.

So too has been the historic focus of government, the development of policy and the investment of public funding. This may be partly because, as the recent Productivity Commission paper The Social and Economic Benefits of Improving Mental Health noted, many of the costs of mental ill health are intangible. The commission set out the very tangible costs of mental ill health, including psychological distress, social isolation, lower social participation, stigma and discrimination.

It is worth spending a moment outlining the breadth of mental ill health both in our country and beyond our borders. The Australian Bureau of Statistics National Survey of Mental Health and Wellbeing estimates that 45 per cent of Australians will experience a mental health condition and, further, that in the 2017–18 financial year there were 4.8 million people—which roughly represents 20 per cent of all Australians—with a mental or behavioural condition.

The most common mental illnesses are anxiety and depressive-related issues. Around 1 million Australian adults have depression. That represents one in seven experiencing depression in their lifetime. Over 2 million Australians have anxiety, which represents one in four experiencing anxiety in their lifetime. These statistics are not cold numbers but show that we will all know a family member, friend or colleague who suffers mental ill health. In fact we will know many.

The picture in Australia is not unique to the one within our borders. The World Health Organization has identified depression as one of the leading worldwide health problems. They estimate that 300 million people suffer from depression worldwide—300 million people. A paper published by the team at the Queensland Centre for Mental Health Research at the University of Queensland called Burden of Depressive Illnesses by Country, Sex, Age, and Year found that the Middle Eastern and Northern African regions suffer the highest rates of depression. The report, which also called for more research to be done quantifying the broader costs of mental ill health, concluded that:

… depressive disorders are a global health priority …

which—

reinforces the importance of implementing cost-effectiveness interventions to reduce its ubiquitous burden.

Although it is limited, there is some research that has quantified the material costs. The National Mental Health Commission has estimated that the economic cost of mental ill health in Australia is more than $60 billion each year. The Productivity Commission has highlighted that the costs, and I quote:

… of lower participation and productivity are about double the level of healthcare expenditure on people with a mental illness.

The current work of the Productivity Commission on mental health will no doubt be groundbreaking, and I note the draft report is due to be published tomorrow. In terms of government spending on mental health services, the commission estimates that in 2016–17 the federal government contributed at least $12 billion to mental health-related services and payments while the state and territory governments contributed at least $4 billion. Internationally the commission states that expenditure by our combined governments on mental health services is moderate.

Rather than only focus on the broader issue, I would like to take the opportunity to raise an aspect of depression that affects many young families in our community every day, that being postnatal depression.

Up to four of every five women are estimated to develop the baby blues shortly after childbirth. The baby blues usually occur between two and 10 days after childbirth and bring a strong emotional feeling. These feelings tend to dissipate within two weeks.

Beyond Blue estimates that for one in six women these feelings continue and develop into postnatal depression. Usually this form of depression comes within weeks of birth, but it can manifest itself within a year of a child being born. Mothers have described the at times crippling feelings of anxiety and inadequacy but most of all the overwhelming feeling of guilt and shame. Many mothers have described to me the shame they feel for experiencing depression. These conversations are difficult and confronting, but as a community these conversations are important have.

These conversations are important for both new mothers and new fathers. A number of fathers from my community have approached me to speak about this issue. All of those fathers asked to speak to me separately and privately. Each came from a different walk of life and all had a different story. All had a partner who had been touched by depression after the birth of a child, and many had been touched themselves. In fact one in 10 men will experience postnatal depression themselves. Although there is some degree of public discussion about postnatal depression, there is no doubt that postnatal depression in men is less prominently addressed, and one wonders whether the cold statistics under-report the incidence in fathers.

These conversations with the men who approached me were extremely difficult because most of them saw their role in the family unit as being the supporter of their partner. But as we spoke it was clear the toll upon them was profound and had a profound impact upon them all. Some were overcome by emotion. All loved their partners, even the one whose relationship has since broken down. All of the men said clearly that they had completely misunderstood postnatal depression. All had not seen the signs in themselves and none knew that treatment paths were available to them too. In fact those fathers all similarly to described their guilt in failing their partners and failing their families.

It did take time in some cases, but all of the affected families did seek help, though most of the men did not seek help from a health professional. Those men who approached me felt that they could have been better equipped. All of those men had attended pre-birth courses and suggested that those courses could be enhanced.

In their report Healthy Dads? The Challenge of Being a New Father, Beyond Blue found 45 per cent of fathers are not aware that men can experience postnatal depression, and 43 per cent of first-time fathers see anxiety and depression after having a baby as a sign of weakness—that is half. These findings clearly illustrate that there is one policy area where we can and should do better.

Internationally, mental health is now key policy issue. The World Health Organization’s Mental Health Atlas sets out up-to-date information on mental health services available worldwide. It is a significant, ongoing document that encourages countries to, and I quote:

… provide comprehensive, integrated and responsive mental health and social care services in community-based settings …

In its issues paper the Productivity Commission draws out community-based responses to mental ill health and draws a link between that issue and homelessness. The paper states:

Mental ill health is closely linked with housing problems and homelessness … In 2017–18, about one third of people who had accessed specialist homelessness services were experiencing mental ill-health.

To that end, last year the government opened five emergency accommodation shelters in Brighton East as part of its Towards Home program. The accommodation is based at South Road. At the time the policy was announced my community raised two significant concerns: firstly, that the shelters were temporary structures and not permanent buildings and, secondly, that the shelters were many kilometres away from adequate services. In short, the program lacked the integrated service focus encouraged by the World Health Organization. Tenants have been living at South Road for much of the year, a number of whom have significant mental health issues. One of the tenants at the site recently met with me to speak about a fellow tenant with serious mental health issues, for whom they believe the government has not provided access to proper services at the site.

Without nearby services to assist, there have been serious issues there at South Road. For example, at 1.00 am on 9 October an assault occurred involving two residents. Police attended the incident after reports of screaming. At least one of those involved in the incident required medical attention. After the incident one of the residents hung blood-covered clothing on the external wall of their property. This has understandably led to distress for neighbours and especially to distress for neighbouring children, who saw the clothing. This was all within sight of streams of young children who use South Road as a thoroughfare to nearby schools each day.

Adjacent neighbours have also reported antisocial behaviour both at the site and in the surrounding area. In fact neighbours have reported damage to their properties, including damage to guttering, damage to roof sheets, broken mailbox locks, plants being ripped out and residents or their associates jumping over neighbours’ fences into their private property. Our mental health is as important as our physical health, and governments have rightly shifted their focus to the development of policy and investment in this space. But there is more to be done, in terms of both destigmatising issues like postnatal depression and making sure that our policy responses, including the way that we integrate solutions in a community setting, are adequate and take into account the broader community.