Tuesday, 26 August 2014
Tonight I would like to discuss an issue that is most serious, and has not been discussed enough. In fact, many would say that, through neglect or indifference, it has been swept under the carpet. My interest was triggered by a constituent, Robert, who has stopped me in the street on a number of occasions over the past few years and has articulated this issue very well to me. He knows people, friends, who, because of the level of the anti-psychotic medication they are on, could sleep 16 hours a day or more. Effectively, one-third of their living years are lost. He talks about other symptoms and side effects they have. My constituent calls this a 'major humanitarian disaster' in Australia, and his views deserve to be heard and debated so that we may get a better outcome.
At the outset, I want to make it clear that I am not in any way suggesting that people should not be prescribed antipsychotic medications where necessary, and nor should they go off it in any way without appropriate medical advice. I am simply suggesting we listen to credible experts in mental health about alternative methods and support, or alternative therapies, in accordance with the best medical practice, that can lead to a reduction of the dose of such medications, and with it a better outcome overall for both the patient and for society at large.
The National Mental Health Commission released a National Report Card in 2012 on Mental Health and Suicide Prevention. One of the main recommendations encourages all governments to work collaboratively in setting a target to reduce early death and improve the physical health of people with mental illness. According to the report card, the poor physical health and early deaths of people with mental health difficulties is a serious national problem. This premature mortality of people with serious mental illness is lethal discrimination, according to some, where thousands of people are dying from suicide, heart disease and cancer, which are preventable and often treatable.
An Australian study from 2001, referred to in the 2012 Report Card, showed that people living with a mental illness had an overall death rate of two and a half times greater than the general population. In particular, the rates of heart related problems, diabetes and obesity are much higher than the rest of the community, and there is a 30 per cent higher chance of dying from cancer, when compared with the general population. With statistics like these, it is little wonder that the commission has labelled this a serious national problem.
The 2012 report card admits that antipsychotic medications that are prescribed to manage severe mental illnesses, such as schizophrenia, are directly associated to the risk of severe physical illnesses. This is a double blow for those suffering from severe mental illness, who will now add a decline in their physical health, and ultimately their quality of life to what they are facing. Our Indigenous population are the hardest hit, due to poverty, marginalisation and lack of access to good medical and psychiatric care.
I would like to relay a story told to my office of a 21-year-old man in my constituency in South Australia who was put on Seroquel, but on too high a dose. He would wake at 10 am, rush to work and apologise profusely for being late, but to no avail. He was soon fired from the position because his boss said his mental health issues were 'not their problem'. His girlfriend politely told him that she needed the security of a partner who could keep a job, and she left him. Countless others across Australia are faced with similar situations, often due to over-medication. New research has shown that much lower doses of medication from early in the course of illness can make a patient much more accessible and responsive to psychological recovery.
The population of those with a mental illness is not connecting sufficiently with the limited services available. It is estimated that only one in five people with a mental illness has a tailored mental health treatment plan with their local GP. When it comes to prescribing antipsychotic medication, it seems the burden falls disproportionately on GPs rather than on psychiatrists, who have an additional level of expertise. That concerns me. Fewer than half of all people suffering from mental illness receive any treatment. State government hospitals are unable to cope with the demand and discharge seriously ill patients back to GPs, where they languish until their next relapse.
The National Report Card in 2013 added a further eight recommendations to the existing 10 from 2012. In recommendation two, the commission highlights the need to increase the current mental health services and support from between six and eight per cent to 12 per cent of the Australian population. This increase would more closely align with the current population of Australians who suffer from mental illness.
The report card goes on to highlight the need to develop national targets and indicators for mental health reform initially recommended in the previous year's report card. Yet there has been no commitment to adopt them. Since making these initial recommendations in 2012, another 2,200 people have taken their lives each year. Of these deaths, all can be attributed to some form of mental health issue. I suggest we need to do all we can to prevent all of these deaths. According to a study conducted in 2012 by the Mental Illness Fellowship of Australia, many people using antipsychotics describe significant impairment in their everyday life as a result of medication side effects. More research is needed into the serious side effects on the health of those affected.
Mental disorders in Australia account for 13.1 per cent of the burden of disease in Australia, which equates to $20 billion lost in productivity and labour force participation. Mental illness is a leading contributor to the burden of disease, in terms of morbidity rates and disability. In a recent Medibank Private report it was revealed that $29 billion is spent on mental illness in Australia annually. These enormous costs are largely the costs of failure—pensions, prisons and poverty—and are due to a lack of quality care of patients. Quality care will actually save large amounts of money. As federal parliamentarians we need to push for reform and investment. The federal government has a huge role to play here.
Treatment for mental illness should consist of three main elements: medication and therapy, but most importantly, and quite often lacking, is expert evidence based psycho-social care and community support. There is an obvious gap of ongoing clinical support in the community and education on the various illnesses and how to cope with them.
We have all heard the statistics: almost half of Australians will experience some form of mental health issue in their lifetime, while the rest of the population will attest to having someone close to them affected. If mental health issues have such a big impact on almost all of us, and on such a personal level, why are we not making a bigger deal about it? The answer is that most people are affected but have not found their voice yet. What is needed? With 75 per cent of mental illness emerging before the age of 25, we need to look at an investment in young people with mental illness and not at welfare. Imagine what a little investment to properly manage this crisis would affect: a society that can contribute more and a happier one at that. How can we expect those with severe mental illness to play contributing role in society, when they have such proven reduced life expectancies as a result of their associated ill health in those severe cases?
Professor Patrick McGorry, former Australian of the Year and president of the Society for Mental Health Research, is a strong advocate for structured investment in mental health to decrease the premature death, preventable disability and lost productivity currently associated with this. To complement initiatives such as headspace, Professor McGorry highlights that more specialised expertise is required for a complex range of disorders in young people. With strong support and implementation, he predicts that up to $10 billion can be saved annually. This major return on investment cannot be ignored and is worth talking about In fact, I spoke to Professor McGorry earlier this evening and he endorsed concerns about the over-medication of antipsychotic medication and a lack of credible alternatives and support. In fact, he made reference to trials being carried out using aspirin and fish oil that could reduce the need for such high doses. That research is welcome.
Whilst we wait for the National Mental Health Commission to report back on the progress of the 18 recommendations made in the 2012 and 2013 report cards, I urge my colleagues to push the mental health crisis back into the spotlight. Mental Health Week, which is from 5 to 12 October this year, is another vital opportunity for Australians to talk about mental health. I am grateful to my constituent, Robert, for raising this important issue with me. I am sorry that I have not raised it earlier, but I intend to raise it again and again until we get a result. I will continue to do more work on this, because as a nation we must do better to improve the quality of life of so many Australians who deserve better.