Hello, I'm Michelle Tapper with the Latest from Science.
Around one in five Australians suffer from a mental health disorder.
And as the COVID-19 pandemic continues,
experts say mental health problems are only going to get worse.
Joining us today to discuss these issues is Academy Fellow Professor Patrick
McGorry.
He's a psychiatrist and executive director of Orygen and Professor of Youth
Mental health at the University of Melbourne. Hi Patrick. Thanks for joining us.
Thanks Michelle.
Pat, mental health is often difficult for people to talk about,
but at this point in the pandemic,
it seems that nearly all of us are being affected or we know someone who's being
affected by anxiety or depression.
What does the latest research show?
I guess the latest research shows
a series of surveys mainly so far.
That's that's sort of research that can be done in a short timeframe and shows
surging levels of distress and mental ill health across the whole
population. Now, as with any disaster or crisis,
there are variable levels of exposure of people to the crisis,
but in this case almost everyone's been exposed in some way,
even though it's a bit variable still.
So everyone is really more conscious and more personally and
viscerally probably aware that that mental health is quite fragile actually.
And they probably knew that intellectually before and obviously 5 million
Australians every year are affected by mental health.
So it was a widespread feeling before,
but it's really gone to another level now.
And I think that's worrying people quite a lot.
Now there are varying degrees of mental health problems.
What would your advice be to people who are suffering from general anxiety or
depression?
I suppose the first thing to say is that just because we're not feeling good and
we've lost a sense of wellbeing and maybe we're more anxious and with
lowered mood compared to our normal selves,
it doesn't mean we all need to be rushing out to,
to see mental health professionals.
The majority of people are going to be okay through this,
through this disaster and crisis. However,
a substantial minority will not be and it's going to be a significant surge on
top of what's normally the case.
So the trick is really to work out when you actually need to reach out
for help.
And probably some tips there would be helpful
such as if the feelings of lowered mood are deep and
worrying and associated with suicidal thoughts or deep pessimism
or if they're causing intense distress and emotional pain that is difficult to
cope with, or if they persist,
especially if they persist over a period of many days or even weeks,
that's the time to really say actually I've crossed the line here and I need to
tell someone about this and
actually reach out and seek help professional help.
Now you're based in Melbourne, which is still in stage four lockdown,
and obviously people there are doing it tough and there does seem to be no
end in sight. What is your advice for Victorians at this point?
Well, I think, with the severe lockdown,
the stage four lockdown that we're experiencing in Victoria, obviously it's,
it's more liberal in other states at the moment.
That's a problem because the normal ways of coping with,
with stress like this and a disaster or crisis is
to actually rely on your normal coping mechanisms. That might involve exercise,
it might involve social contact,
getting social support from other people and also having a sense of
of when the problem is going to end.
I think the open-ended nature of this is really affecting people,
the uncertainty.
And of course then there's the practical consequences of no meaningful social
role for many people.
If they're unemployed or their education has been disrupted,
all the sort of things that we normally rely on to get us through the day and to
get us through life are being restricted or not available.
So it's a bit of a double whammy actually.
We've got this massive crisis and then the normal sources of coping
with such crisis are removed at the same time.
So that's the problem for us here in lockdown.
There are some signs of light at the end of the tunnel though.
The numbers are decreasing again and we believe that the lockdown will be eased
fairly soon,
but I think it's been a pretty tough time and what I'm worried
about more than anything else is the economic collapse that's beckoning.
If that cannot be avoided or softened,
then I think that's where we're going to see a real surge of mental ill health
and risk of rising suicide rates.
In your opinion,
do we have enough mental health services to cater to this increased need and
what needs to be done to help people?
Well, this is where there's a massive contrast between
the response in a physical health sense to the infectious disease pandemic.
The physical health system,
the general acute hospital system and the health system generally is incredibly
well resourced by comparison compared to the
mental health system.
Even pre-pandemic we knew that the mental health system was in crisis.
We have a Royal Commission here in Victoria because of that.
The Premier has described the system as broken in this state.
We've had a Productivity Commissioner Inquiry at the Federal level,
looking at the serious underinvestment in mental health care across Australia.
So our system was absolutely overwhelmed even
prior to the pandemic.
And now we have a surge we predict around 20 to 30 per cent of new
cases, new need for care, coming down the pipe in terms of mental health care.
So we have a really significant health crisis here in
mental health. The system was already under tremendous pressure before,
and now we we're expected to respond to this new surge.
So I think governments really need to get their heads around that.
So it seems we're in a pretty dire situation. Now Pat,
suicide is something that's not often discussed,
but the fact that it is the leading cause of death in people age 15 to
44 in Australia is shocking.
And there are around 3000 deaths a year.
Do you think we're going to see a rise in these figures and what can be done to
prevent it?
The Prime Minister has actually understood the seriousness of this public health
threat by appointing a Suicide Prevention Advisor,
Christine Morgan, even prior to the pandemic. So,
I think he and the government are concerned about this and they have taken some
positive steps in this regard. The media are doing very well with suicide.
They're reporting it more prominently. It was on the front page of Sydney
newspapers over the weekend, that cluster of suicides in Sydney.
So I think that is an issue that's really coming out of the shadows and breaking
through the taboo that's been around for so long.
So far there's good news, there has not been,
as far as we can tell a rise in suicide numbers above the already way too
high level.
So that says that we've still got time to act to prevent the rise that that's
actually predicted.
Scientific modelling from University of Sydney and University of Melbourne have
predicted a rise in suicide in the context of the pandemic,
but it's probably got a lead time and we do have time to act to reduce that
risk of rising suicide rates.
The biggest driver of those rising suicide rates is a combination of two things.
One is the economic recession that's that's underway now.
That's probably the most potent one,
and the lack of mental health services that I mentioned a moment ago,
that the failure of governance to build a system that's at scale
and fit for purpose is the other big threat there.
If those issues are addressed.
And I think Federal and State governments are starting to do that,
and I'm really applaud the early actions they've taken there,
but they've got to take this very seriously and build a system that's fit for
purpose and at scale.
And they've also got to soften the economic effects of the pandemic
on the general public.
It sounds like the worst is yet to come.
The suicide predictions show that the rise in suicide risk will
gradually build up over the coming months and will last for years. So,
yes, the worst is yet to come if we don't do anything about it. But,
the really good news is we've got time to do that. And,
governments are waking up to this fact, the Prime Minister,
the Premier here in this state, it's at the front of their minds now.
Whereas I think in the past, it was pretty much down the pecking order.
And what is the economic cost of mental health problems?
We currently spend about 7 per cent of the health budget on a problem that's
worth at least 14 per cent and probably even more than that,
of the health burden. So we're in Australia,
we're spending probably less than half of what we really need to spend.
I'll just give you a comparison.
We spend $22 billion a year on 400,000 people with physical disability
through the NDIS.
We spend 10 billion a year on five million Australians with mental ill health.
So the mismatch is extraordinary.
The Productivity Commission really nailed this because they showed that we spend
$10 billion on direct healthcare, which is a significant under-spend.
And the cost of that under-spend actually resulted in losses of 130 billion a
year to the Australian economy and worldwide.
The World Economic Forum has shown that 35 per cent of loss of GDP caused
by noncommunicable disease is explained by mental illness and something
like 18 per cent is explained by cancer.
So mental illness is twice as important as cancer in terms of its impact on the
economy.
And finally, Pat, what should people do if they,
or someone they know is struggling with mental health problems?
If you yourself, or someone very close to you is struggling with mental health,
the most important thing you can do is actually acknowledge it and get over that
natural reluctance we have to seek help.
And the way to do that is to go through pathways of trust or pools of trust,
as we say. Talk to someone that you trust.
And if you're fortunate enough to have such such people in your life,
most people do,
but reach out to someone that you can trust and then try to ask them to help
you. Or if you're in the,
if you were that person help help your relative or friend to a
competent mental health professional via primary care is probably the best
way in at this stage. But, shop around,
try to find the best person that you can and someone that you actually can
relate to and engage with. And who also has the skills to help you.
That's not an easy task because of the underfunding and the pressure on the
system, but it's very important to persist with that,
so that it could save your life. It could,
and it certainly is the right thing to do.
Thanks for all that great advice, Patrick, we really appreciate your insight.
Professor Patrick McGorry, thanks for your time.
Thanks Michelle.
And don't forget for regular video updates from the Australian Academy of
Science, make sure to follow us on social media. I'm Michelle Tapper,
see you soon.