Nursing Essay Mental Health Strategies in Australia
The most prevalent mental illnesses in Australia are Depression, Anxiety & Substance Disorders (AIHW, 2018) and can vary in both severity and duration. Mental Illness and Mental Disorders are terms used to cover the multiple mental health and behavioural disorders which currently exist. (AIHW, 2018) People living with mental illness or disorders have poorer physical health and higher mortality rates compared with those who have good mental health. It is important to note that poor mental health can lead to chronic physical health conditions the same way that chronic physical health conditions can lead to poor mental health.
The 2007 National Survey of of adults estimated that almost half of the population aged 16-85 will experience some form of mental illness in their lifetime. Anxiety disorders were the most prevalent within this survey with 1 in 7 experiencing anxiety, 6.2% experiencing Depression and 5.1% experiencing Substance Disorders such as alcohol dependency. (NSMHWB Report, (ABS 2008)
Mental Illnesses also include conditions with a lower prevalence, such as eating disorders and personality disorder. (DoHA 2010) Schizophrenia, Schizoaffective Disorder, Bipolar Disorder and Delusional Disorder are some of the Psychotic Illnesses that can occur in individuals. (Morgan et al. 2011)
Mental Disorders vary in severity and duration, they can be episodic or persistent. It is estimated that 2-3% of Australians have a severe mental disorder, judged by diagnosis, symptoms and their duration and the degree of disability caused (DoHA 2013).
Mental and Substance use disorders have been estimated to be responsible for 12% of the total burden of disease in 2015, and are fourth as a broad disease group, placing after Cancer, Cardiovascular diseases and Musculoskeletal Diseases (AIHW 2019)
Mental and Substance Use Disorders were concluded to be the second largest contributor to non-fatal burden of disease in Australia (AIHW 2019)
Mortality rates of Australians who accessed Mental Health related treatments in 2011 accounted for 49.4% of all deaths (75,858 deaths) and the standardised death rate for those aged 15-74 years who accessed mental-health related treatments in 2011 was 2.4 times higher than the standardised death rate for Australian’s of the same age group.
Suicide accounts for a small amount of all deaths in Australia, however at least 6 Australians die from Suicide due to mental illness and a further 30 will attempt to take their own life daily.
The risk factors vary for Mental illness and can be just one factor or a combination of many, some of these contributing factors are noted below:
Low self esteem
Poor social skills
Negative family environment
Poor academic achievement
The Ottawa Charter designed by The World Health Organisation in 1986 consists of five strategies for Health Promotion at a global level:
- Building Health Public Policy:
– Mental Health related programs and services funded by the Australian Government such as the Medicare Benefits Schedule (MBS), the Pharmaceutical Benefits Scheme (PBS) and the Repatriation Pharmaceutical Benefits Scheme (RPBS)
Medicare Benefits Schedule – mbsonline.gov.au – a list of all medical services that include a rebate or coverage by Medicare.
Pharmaceutical Benefits Scheme – Provides subsidised prescription drugs to Australians.
Repatriation Pharmaceutical Benefits Scheme – Provides prescription
medicine/drugs to veterans at a concessional rate or free.
– Income support & disability services for those suffering from Mental Illness funded by the Australian Government.
– Specialist care for mental illness delivered in public hospitals, community mental health care services and residential mental health care services.
– The Australian Human Rights Commission – Disability Discrimination Act 1992 (Cth)
– The Australia-wide Privacy Act 1998 (Cth) – Employers cannot disclose to anyone that you have a mental illness without your consent, this information can only be used for a purpose, e.g. adjusting your role or working environment to suit your mental health condition.
– WH&S Legislation
- Create Supportive Environments:
– Crisis Support: Multiple non- government organisations such as Mental Health Australia, Sane Australia, Beyond Blue, Lifeline Australia & Headspace.
– Work Policies and Procedures and Anti-Harassment Policies.
– Charities such as Black Dog Institute
– Access to Education – education for all Australians, Public and Private education.
– Mental Health interventions at work
- Strengthen Community Action:
– Campaigns such as #It Aint Weak to Speak – Breaking the stigma of Mental Health by Livin – Livin work to break the stigma of mental health and create a community to connect, support and encourage each other to talk about their feelings and challenges.
– Suicide Prevention Charities such as R U Ok Day – “A conversation could change a life” It is a national day held every September.
– Youth & Community programs
– Life skills programs
– Elderly social support – community activities
– Targeted programs i.e. migrants, indigenous people.
- Develop Personal Skills:
– Mental Health workshops & awareness
– Mental Health promotional activities in school
– Early Childhood Interventions – providing stable environments & opportunities for early learning
- Reorientating Health Services:
– The World Health Assembly approved an Action Plan in 2013 for a “Comprehensive Mental Health Action Plan for 2013-2020” The goals of this action plan are to promote mental wellbeing, prevention of mental disorders, provide & enhance care and recovery, promote human rights, reduce mortality, morbidity and disability for people with mental illnesses and disorders. The Action Plan also includes 4 key objectives:
– Strengthen effective leadership & governance
– Provide comprehensive, integrated and responsive mental and social care services
in community- based settings.
– Implement strategies for promotion and prevention in mental health
– strengthen evidence and research for mental health, as well as strengthening
These above 5 strategies of the Ottowa Charter have been developed to target inequalities and inequities, by actioning the social determinants of health. By overcoming this, the World Health Organisation can reach their goal of Social Justice.