Prevalence of Mental Illness in Australia

Discuss about the Job Related Stress and Employment of People.

With the prevalence of mental illness in Australia, the expense associated with the cost of mental illness and the societal cost of mental disorder has increased in the country.  The widespread prevalence of mental disorder is understood from the fact that 4 million people were estimated to be living with one common mental disorder in 2015. The impact and burden of the disease may differ based on severity and episodic or persistent nature of the disorder. According to the 2015 estimate, about 2-3% of Australian population has severe mental disorder judged by severity and duration of symptoms (Australian Institute of Welfare, 2018). Considering the prevalence and burden of the condition, the need for adequate mental health services is essential to promote quick recovery of patient. The main purpose of the essay is to evaluate the mental health care system of Australia and assess whether recovery from serious mental health problem is possible for people using the mental service available or there is a need for reform in the mental health care system infrastructure. Review of recent developments in existing mental health programs management and services will also help to estimate provision of recovery oriented care for mentally ill people in Australia.

In case of western countries like Australia, health care system and services are shaped legislations and budgets set by the government. Responsibilities related to mental health policy and provision of mental health services is also taken up the Australian government. The positive aspect is that importance of good mental health has been a focus of the Australian government since the last three decades. The government has worked towards the development of mental health care services through the implementation of mental health programs and services that serves the need of Australian population affected by mental disorder (Australian Institute of Welfare, 2018). One of the commitment of the Australian government is the National Mental Health Strategy where the main motive is to improve the lives of people affected with mental disorder. The Strategy was endorsed in April 1992 and the main aim is to promote mental health of the Australian population, prevent mental disorder, reduce the impact of mental disorder and maintain rights of people with mental illness. In accordance with the aim, the National mental health policy, the National Mental Health Plan and the National Mental Health Statement of rights and responsibilities were developed (Department of Health, 2014). The overview of this plan and policy shows that Australian government developed an appropriate framework to develop advanced system of care and integrate service across health and social domain to provide care. However, the success of these plans and policies in assisting people to recover from mental illness needs to be reviewed.

Australian Government’s Commitment towards Mental Health

The sufficiency of a mental health care system to treat mental disorder can be understood from the review of available resource to treat the disorder. Guided by the National Mental Health Strategy, a collaborative government action in mental health from the year 2009-2014 was planned. This plan overlapped with the Council of Australian Governments (COAG) National Action Plan for the period between 2006 and 2011.   The effectiveness of the National mental health plan was that it guided the government regarding funding priorities for mental health. Under this arrangement, the Australian government has made services accessible and affordable to people by funding specialized mental health services through the Medicare Benefit Schedule and the Pharmaceutical Benefits Scheme (PBS). Apart from specialized mental health care services, social issues such as employment, housing and environmental stressors also increase the risk of mental illness (Mahindru, Sharma & Chaturvedi, 2016). Workplace environment determines self-esteem needs of people. According to the Maslow’s Heirarchy of needs theory, esteem needs is a form of psychological needs that needs to be fulfilled to promote well-being of a population (Niemela & Kim, 2014). Hence, to increase other form of support for people, the government also funds range of other programmes such as income support services, disability services and housing assistance. On the whole, it can be said that the National Mental Health Strategy and the National Suicide Prevention Strategy have provided the vehicle for reform of mental health services in Australia.

To promote recovery of people affected by severe mental  health conditions such as psychotic disorders, substance use disorders and severe obsessive compulsive disorder, addressing difficulty in accessing effective primary and preventive service is essential to promote recovery of people ().   Varieties of mental health services are available in Australia such as hospital based services, community mental health services and consultation with specialist and general practitioners. However, the uptake and equal utilization of these services among Australian population is one area of concern. Australia has taken innovative approach to deliver mental health services and promote a shift from hospital based care to community based care. It is strongly going in line with the deinstitutionalisation trend. This is evident from the fact that health care expenditure on psychiatric hospitals has dropped from 46% to 12% and the expenditure for community mental health services has increased from 24% to 39% in the past 20 years.  However, unless high quality community care services are available patients with mental illness are at risk of worsening symptoms and increase in length of hospital stay. For this reason, focusing on maintaining a balance between care provision and quality of service is necessary.  

Sufficiency of Mental Health Care System in Australia

One of the issues that have affected the quality and outcome of patients include regional disparities in access to care. The incidence of mental health issues and inequities in service access is particularly high for rural communities management. For this reason, mental health inequities are particularly high for indigenous people in Australia compared to non-Indigenous population. Disparities in access were the reason for poor distribution of mental illness among the group. According to survey report in 2010, 26% of Aboriginal and Torres Strait Islander people aged above 15 years reported problems in accessing mental health services. The reported problems in accessing services was particularly higher for Aboriginal and Torres Strait Islander adults with high level if psychological distress, self-assessed health status and those with disability. The problem was found to be higher for people living in remote areas compared to those living in other areas (Australian Bureau of Statistics, 2011). This implies that despite availability of funds and advancement of mental health services, unmet population needs of all sections of population has not been addressed. Hence, to promote optimal health and recovery from mental illness among indigenous population, it is essential that health planners obtain population level information related to how indigenous people are using the services and the extent to which these services are accessible (McIntyre et al., 2017).

The positive aspect of the mental health care system of Australia is that they have focused on identifying the above mentioned challenges and addressing them too. The ‘Better Access’ initiative is ones such program that looks to improve access to mental health services. The increase in the number of individuals accessing services suggests increase in the volume of Better Access MBS items. The initiative has addressed accessibility and affordability issues. However, still more work is needed to achieve equality across geographical areas and population group. For example, inequalities were reported across people with low income and those living in low socioeconomic regions. In case of working with indigenous people, the problem was that problem linkage between the community and other resources were not possible (Department of Health , 2010). This was the scenario presented in the year 2010. However, the current strategies seem to be more effective in dealing with the inaccessibility issues. For example, the Commonwealth Government has expanded Medicare items under the ‘Better access to Mental Health’ initiative and it included telehealth items for rural and remote patients. The items were introduced in November 2017 to support people living in rural areas to access mental health service via video conference and skype. It was also ensured that the technology was capable of delivering high quality service in accordance with security and privacy laws (Vines, 2018). To promote long term use of such services, it is also essential that professional bodies collaborate with GPS to ensure that the service is available to those most in need of care.

Regional Disparities in Access to Mental Health Care

Apart from the attention of government on addressing quality and accessibility issues in mental health care, the past five years has also seen major emphasis on recovery oriented practices in mental health plans. The evidence for this is the Fourth National Mental Health plan, where the number 1 priority area was to promote adoption of recovery-oriented culture in mental health services. Recovery orientation has been desired by many people with lived experience of mental illness. In accordance with the Fourth National Mental Health Plan and the Roadmap for National Mental Health Reform 2012-2022, recovery approach to care has been embedded in all policy and reforms related to mental health (Brown, 2013).  The advantage of recovery oriented approach is that it considers the social determinant of health factor for health and well-being. This means recovery has been visualized by connections with individual, family and community and also by visualizing recovery within the context of age, gender and developmental stages (Kidd, McKenzie, & Virdee, 2014).

The mental health priority of recovery oriented practice can be regarded as the most innovative and effective strategy to support Australian population to recover from serious mental illness. It is guided by six principles of uniqueness of the individual, real choices, attitude and rights, dignity and respect, and partnership and communication.

These principles guides mental health care professionals and services regarding the approached needed to provide care to diverse population group. The principle of uniqueness related to acceptance of the fact that recovery is unique for each individual and empowering patient is the main goal of care. It also promotes respecting individual choice of patient and  promote and protect basic rights of each patient. It also acts to address dissatisfaction with care issues by respecting values, beliefs and culture of each individual.

Lastly, achieving individual goals and aspiration of patient was also provided by proper partnership with clients and tracking progress in key outcomes such as family relationship, housing, employment and education (health.gov.au, 2017). The uniqueness of the recovery oriented principle is that the recovery oriented care approach supports mental health care professionals to develop the behavior, attitude, skills and knowledge needed to engage in collaborative practice and achieve optimal mental health outcome for the Australian population (Le Boutillier et al. 2015). In the long run, recovery oriented care would help to promote good practice and good leadership across mental health service in Australia and it would help in the development of a mental health care system for the 21^st century.

Better Access Initiative to Improve Access to Mental Health Services

By the discussion on the evaluation of mental health care system of Australia in promoting recovery of patient, it can be concluded that that the Australia Government focused on addressing mental health needs of Australian with the implementation of several mental health plan and policies. The National Mental Health Strategy is one such initiative that guides health care services to provide adequate support to people with mental illness and make services affordable to them with the use of MBPS (Medicare and Pharmaceutical Benefits Schedules). Despite advancement in mental health services, several issues like that of health inequities and accessibilities was seen. However, the Australian government took innovative steps to overcome these adversities and prepare a health care system that embraces recovery oriented approach to care. Appropropriate use of technology and useful collaboration process with key stakeholders can help to transform and increase coverage of mental health services for the Australian population.

Reference:

Australian Bureau of Statistics (2011). 4704.0 – The Health and Welfare of Australia’s Aboriginal and Torres Strait Islander Peoples, Oct 2010  Retrieved from: https://www.abs.gov.au/AUSSTATS/[email protected]/lookup/4704.0Chapter955Oct+2010

Australian Institute of Welfare (2018). Mental health services in Australia. Retrieved from: https://www.aihw.gov.au/reports/mental-health-services/mental-health-services-in-australia/report-contents/summary/prevalence-and-policies

Australian Institute of Welfare (2018). Mental health services in Australia. Retrieved from: https://www.aihw.gov.au/reports/mental-health-services/mental-health-services-in-australia/report-contents/summary/overview

Brown, P. (2013). A national framework for recovery-oriented mental health services: Policy and theory  Retrieved from https://www.mhima.org.au/pdfs/Recovery%20Framework%202013_Policy_theory.pdf

Department of Health (2010). Improved access to mental health services. Retrieved from: https://www.health.gov.au/internet/publications/publishing.nsf/Content/mental-ba-eval-dexec-toc~mental-ba-eval-dexec-imp

Department of Health (2014). National Mental Health Strategy. Retrieved from: https://www.health.gov.au/internet/main/publishing.nsf/content/mental-strat

health.gov.au (2017). Principles of recovery oriented mental health practice.  Retrieved from: https://www.health.gov.au/internet/main/publishing.nsf/content/CFA833CB8C1AA178CA257BF0001E7520/$File/servpri.pdf

Kidd, S. A., McKenzie, K. J., & Virdee, G. (2014). Mental health reform at a systems level: widening the lens on recovery-oriented care. The Canadian Journal of Psychiatry, 59(5), 243-249, Retrieved from: https://journals.sagepub.com/doi/pdf/10.1177/070674371405900503

Le Boutillier, C., Chevalier, A., Lawrence, V., Leamy, M., Bird, V. J., Macpherson, R., … & Slade, M. (2015). Staff understanding of recovery-orientated mental health practice: a systematic review and narrative synthesis. Implementation Science, 10(1), 87, doi: https://doi.org/10.1186/s13012-015-0275-4

Mahindru, P., Sharma, M. K., & Chaturvedi, S. K. (2016). Job Related Stress and Employment of People with Mental Illness: A Catch 22. Journal of Psychosocial Rehabilitation and Mental Health, 3(1), 31-33, Doi: https://doi.org/10.1007/s40737-016-0046-9

McIntyre, C., Harris, M. G., Baxter, A. J., Leske, S., Diminic, S., Gone, J. P., … Whiteford, H. (2017). Assessing service use for mental health by Indigenous populations in Australia, Canada, New Zealand and the United States of America: a rapid review of population surveys. Health Research Policy and Systems, 15, 67. https://doi.org/10.1186/s12961-017-0233-5

Niemela, P., & Kim, S. (2014). Maslow’s Hierarchy of Needs. Encyclopedia of Quality of Life and Well-Being Research, 3843-3846, Retrieved from: https://link.springer.com/content/pdf/10.1007/978-94-007-0753-5_1737.pdf

Vines, R. (2018). Increasing access to mental health services for those in rural, remote and very remote Australia. Retrieved from: https://www.psychologycouncil.nsw.gov.au/increasing-access-mental-health-services-those-rural-remote-and-very-remote-australia