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Adopt a duck in mental health week

It’s Mental Health Week, aptly coinciding with a self-diagnosed bout of post-viral depression. Those of you who suffer the ‘Black Dog’ will know that a flu or virus can tip you into a depressive cycle. She Who Also Gets It commonly says: “Don’t be depressed – it’s boring.” Fine for her to say if she’s OK.

(Read to the end then come back and watch this 43 second video by Bob)

As my Ma would have said (and maybe yours too), ‘misery loves company’. Statistically-speaking, about 40% of my readers will have suffered from some kind of mental health episode in their lifetime. The other 60% will probably let this FOMM go by (“Why doesn’t he write something nice and fluffy, grumble, grumble, or at least say what he thinks instead of quoting other people?”)

The latest data from the Australian Bureau of Statistics (ABS) tells us that more than 40% of Australians aged 16-85 years have experienced a mental disorder at some time in their life. One in five (21.4% or 4.2 million people), had a 12-month mental disorder. Anxiety was the most common group of 12-month mental disorders (16.8% or 3.3 million people). Young people were most at risk with 39.6% aged 16-24 years reporting a 12-month mental disorder.

Note: 12-month disorders are categorised as including anxiety, mood, impulse-control and substance use disorders.

The latest national study into mental health and well-being was released in July. Among its findings are that 3.4 million Australians aged 16-85 years (17.5%) saw a health professional for their mental health in 2020-2021. Of these, 57.4% had a 12-month mental disorder, 17.7% had experienced a mental disorder at some time in their life and 24.0% had no lifetime mental disorder. (To quote the quintessential Aussie singer-songwriter Kasey Chambers- ‘If you ain’t worried now, you’re not paying attention..’Ed)

That latter cohort (the 24%) are probably those referred to in this World Health Organisation (WHO) report. The WHO said that in the first year of the COVID-19 pandemic, global prevalence of anxiety and depression increased by 25%.

“The information we have now about the impact of COVID-19 on the world’s mental health is just the tip of the iceberg,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This is a wake-up call to all countries to pay more attention to mental health and do a better job of supporting their population’s mental health.”

The WHO’s Mental Health Atlas showed that in 2020, governments worldwide spent on average just over 2% of their health budgets on mental health. Many low-income countries reported having fewer than 1 mental health worker per 100,000 people.

Australia stands out from the crowd in terms of investment. Government spending on mental health-related services in 2019–20 was estimated to be around 7.6% of total government health expenditure.

The Australian Institute of Health and Welfare says $11 billion was spent on mental health-related services in 2019-2020. Of the $11.0 billion, State and Territory governments spent 60.0% ($6.6 billion). The Australian Government’s $3.8 billion contribution covered Medicare-subsidised mental health services and prescriptions.

Australian Government spending on prescriptions equates to about $22 per person. Anti-psychotics (48.1%) and antidepressants (32.5%) accounted for the majority of mental health-related subsidised prescriptions.

That may well be, but I pay something close to full price for mine, mainly because my doctor told me not to accept the generic version. On the other hand, I paid $6.90 for the antiviral meds prescribed when I tested positive to Covid-19. The full price on the packet was $1,130, Now you see why Australia is so lucky to have Medicare.

Ah Covid, that was almost a month ago. I still have a cough and after walking the dog on the river circuit, I have to take some Ventolin and lie down. Multiple research reports have emerged which discuss the serious implications of ‘long Covid’ and lingering symptoms such as lung problems, fatigue and ‘brain fog’. Clearly there is much work yet to be done to establish the long-term risks of having had Covid-19.

And yet the collective Australian government response to Covid seems to be aligned to President Joe Biden’s recent claim that the pandemic is ‘over’. We shall find out after today, which is when Australian State and Territory governments agreed we should no longer be required to quarantine after testing positive. My view of it is simplistic. As of today, 10.3 million Australians have had Covid and 15,399 died with Covid – more than people killed on the roads in 2020.

Perhaps it was coincidence that the US health administration also eased its quarantine recommendations. The Center (US spelling) for Disease Control and Prevention said in August it was no longer recommending that adults and children quarantine at home after having been exposed to Covid-19. The CDC instead recommends those exposed wear a mask for 10 days and take a test on day five. The CDC is, however, saying that Covid is ‘here to stay’, recommending that people who have tested positive to the virus isolate for five days.

Greta Massetti, chief of the CDC’s Field Epidemiology and Prevention Branch, said the changes reflected data indicating 95% of the population has some protection, either from infection or vaccination.

On September 29, Australia’s National cabinet unanimously agreed to scrap the mandatory Covid isolation requirement, with exemptions for those working in high-risk settings such as health or aged care.

Prime Minister Anthony Albanese said (in the same breath) that disaster payments for workers diagnosed with Covid would end, with the same exemptions for high-risk workplaces.

As The Guardian reported, all State Premiers and Chief Ministers agreed to the change, claiming it was “not sustainable” for governments to keep paying workers to stay home.

Predictably, the Australian Business Council and the Chamber of Commerce and Industry welcomed the decision.

I was taken by surprise, not expecting a Labor Government to make what is clearly an economic decision, rather than support measures that lower the risk of the virus spreading in the community.

Chief medical officer Professor Paul Kelly cautioned that quarantine measures may be re-introduced if pandemic conditions such as transmission rates dramatically changed. (Something reminds me about stable doors and horses bolting..Ed)

“We wanted to make sure that we have measures which are proportionate and that are targeted at the most vulnerable,” Mr Albanese said after the meeting. “We want to continue to promote vaccinations as being absolutely critical, including people getting booster shots.

“We want a policy that promotes resilience and capacity-building and reduces a reliance on government intervention.”

(Ed: Capacity building is ‘the improvement in an individual’s or organization’s facility to produce, perform or deploy’.

Mr Albanese was asked whether casual workers would now be forced to work while sick. His response was that the government could not keep paying for such financial supports, comparing the strategy to influenza.

“The flu has existed, and health issues have existed, for a long period of time, and the government hasn’t always stepped in to pay people’s wages while people have health concerns,” the Prime Minister said at a press conference.

While the advice here and in the US is (still) to wear a mask for 10 days after contracting or being exposed to Covid, the mask mandate for public transport was removed in all Australian jurisdictions last month. Apart from medical centres, hospitals and aged care centres, mask-wearing has become optional.

I wore mine while filming the short duck video (above). Avian flu – you can’t be too careful.

B Positive – not just a blood group

blood-donor-positive — Image: Ahmad Ardity, Pixabay.com

That cute but corny aphorism came to mind as my friend Mr Shiraz misinterpreted my recent trip to Brisbane as a blood donor emergency. He wanted to know why we were braving extreme weather and I texted (flippantly) “Appointment with Dracula.”

What I meant was we had tickets to Dracula, a production by Queensland Ballet. Dracula aside (one of that company’s best IMHO), you may have noticed there is a bit of a blood donor drive happening in Australia.

The Australian Red Cross (Lifeblood) and individual State health departments are assisting in the drive to replenish blood stocks, as demand reaches a 10-year high. As a recent Facebook post by Queensland Health noted, the shortage is of the greatest importance when it comes to rare blood groups. The post encouraged people with A negative blood to “roll up their sleeves and give generously”.

Such exhortations make my skin crawl, bringing back memories of a daily blood test over a lengthy stay in hospital. My blood group is not that rare, and, despite my life being saved by a blood transfusion in 1969, I have never donated my blood to anyone. Dad, on the other hand, had such rare blood he was on a list to donate in an emergency.

It didn’t happen often, but he would at times get a call (typically at 2.30am): “Mr Wilson, we’re sending a taxi…”

Lifeblood, the donor agency of Red Cross, is on a mission to replenish its blood supplies. It appears that through the pandemic, blood donor numbers had dropped off.

As lockdowns lift in Victoria, New South Wales and ACT, elective surgeries will start again and meanwhile we are just weeks away from holidaymakers taking to the roads, with the inevitable spate of accidents.

The impact of Covid-19 has been felt among blood agencies around the world. A study published by the US Library of Medicine noted the rise of concerns, confusion, and misleading rumours with regards to blood donation during the pandemic period.

“Additionally, due to the government’s interventions such as home sheltering, mass lockdown, and curtailment strategies towards public gatherings amid the COVID-19 outbreak, the arrangement of the voluntary blood donation drives has been debarred. Likewise, there has been a general reluctance of the public to come to the blood centres to donate blood.”

Lifeblood Executive Director of Donor Services Cath Stone said half of all blood donation appointments in Australia were not being attended, while hospital demand was at its highest point in a decade.

“Our donors have shown us incredible support over the last two years; however, as life moves to COVID-normal, it’s important that people continue to donate to help ensure hospitals can continue to treat patients.”

Lifeblood’s reserves of O Negative blood are being challenged, with the number of O Negative donors falling during the pandemic, despite increased hospital demand. O Negative is a universal blood type and can be given to anyone in an emergency.

“Only 9% of Australians have O Negative blood, but it makes up 16% of orders from hospitals because it saves lives in emergencies.”

While Australians are being persuaded to donate, here’s the status of blood supplies around the world.

It is comforting to learn that 97.5% of the global population is covered by organised collecting. Almost 120 million units of blood are donated every year, but as the World Health Organisation data shows, donation rates differ wildly. Some high-income countries see seven times more donations than in low-income countries.

If you have ever been involved in a motor vehicle accident, a brawl or a workplace mishap, you will know that sometimes victims lose too much blood. Transfusions are needed for health conditions including anaemia, complications during pregnancy and childbirth, severe trauma (accidents) and surgical procedures and transplants. Transfusions are also used regularly for patients with conditions such as sickle cell disease.

The WHO and Lifeblood are vigilant about screening donations for HIV and Hepatitis A B and C, to name a few diseases.

A survey in 2018 found that 72 % of countries had a national blood policy. Overall, 64% of reporting countries, or 110 out of 171, have specific legislation covering the safety and quality of blood transfusion. National blood policies are most prevalent in high and moderate-income countries.

There are great variations between countries in terms of age distribution of transfused patients. For example, in high-income countries, the over-60 transfused patient group accounts for up to 75% of all transfusions. In low-income countries, up to 54% of transfusions are for children under the age of 5 years.

In high income countries, transfusion is most often used for supportive care in cardiovascular surgery, transplant surgery, massive trauma, and cancer therapy. In low and middle income countries, it is used more often to manage pregnancy-related complications and severe childhood anaemia.

The WHO has been campaigning to persuade countries which allow blood donors to be paid to switch to a voluntary system. In countries including the US, Austria, Germany and some Canadian provinces, individuals can earn about $50 a time for donating blood. The collecting and warehousing of plasma has become a multi-million dollar business. The main commercial advantage is that plasma can be frozen and kept for up to a year.

Blood is usually separated into three major components: Red blood, plasma and platelets. Red blood has a life span of 42 days and is used for emergency transfusions. Plasma is the colourless liquid separated from blood. It is most often used to treat burn victims and those with bleeding disorders. The main function of platelets is to stick to the blood linings and prevent bleeding. Platelets have a shelf life of five days and are most often used for organ transplants and surgeries.

Musician Mal Webb has been a blood donor for “at least two decades”.

“I recently switched to donating platelets, which means I can do it more often.”

Sometimes even when you want to donate blood, the tight regulations around blood quality can rule you out, as a friend who used to give blood found out.

“Unfortunately, they changed the rules some years ago so if you had been in England for any length of time you might have Mad Cow disease and so couldn’t donate.

“I was disappointed as I felt good giving blood, knowing I was helping other people.”*

There are examples of physicians experimenting with blood transfusion on animals as far back as 1668. The current system can be traced back to the early 19th century, In 1918, British obstetrician Dr. James Blundell performed the first successful transfusion of human blood to treat postpartum haemorrhage.

Lifeblood and State health departments face an uphill battle trying to convince Aussies to give blood. Although one in three Australians will need a blood donation in their lifetime, only one in 30 give blood every year. It seems it was always thus, though. An article in the Sydney Morning Herald in September 1949 spoke of a ‘blood donor crisis’. The article quoted a NSW Red Cross spokesman.

“Our most urgent need is to make members of the public realise that their blood is worth bottling,” the spokesman said, hijacking a WWI term more often used as the ultimate compliment on a job well done.

If you haven’t donated blood for a while or had never even considered it, here’s a handy link: https://www.lifeblood.com.au/blood

Tell them FOMM sent you.

*People who lived in the UK for more than six months between 1980 and 1996 are ineligible to give blood due to Mad Cow disease.

Mental Health Challenges Aplenty in 2020

mental-health-depression — Nibbler feeling blue after a visit to the vet

Over the past six years, I have written at least 20 blogs about mental health and my particular affliction, anxiety/depression. The Black Dog Institute says one in seven Australians will experience depression in their lifetime. It carries the third-highest burden of disease (in terms of cost to the community), in the country.

So if it has never affected you, be aware. The Black Dog can sneak up on you, as we can see:

One in five (20%) Australians aged 16-85 experience a mental illness in any year;
The most common mental illnesses are depression, anxiety and substance use disorder(or all three at once);
Of the 20% of Australians with a mental illness in any one year, 11.5% have one disorder and 8.5% have two or more disorders.
54% of people with a mental illness do not seek treatment.

And those were the statistics before the pandemic came along in March and set anxiety and depression loose.

To its credit, the Australian Government stepped up in August to offer people an extension on the subsidised specialists’ scheme.

Under Medicare, a GP can refer you to a psychologist or other mental health specialist under a plan which will pay $124 per session for a maximum of 10 sessions a year. This means if your counsellor charges $165 (the going rate for a clinical psychologist), you will be $41 out of pocket, or $410 over the course of treatment.

The Federal Government extended the scheme by an additional 10 sessions for people whose plan had run out, and whose lives were directly affected by COVID-19 lock-downs.

The extended scheme, which cost $7.3 million, will run out in March 2021.

The front line treatment of a mental illness like anxiety and depression is medication, counselling and cognitive behaviour therapy. The latter means trying to change your reactions to things that trigger your moods. Increasingly, GPs and specialists will try other methods before they resort to medication. It depends if your mood disorder is bio-chemical or triggered by trauma or personal circumstances.

I recently read the biography of now-retired rugby league great Darius Boyd, who spent the latter half of his career in therapy and then became a mental heath ambassador. For much of this season, social media trolls posted nasty things about Darius, whose form fell off (as it can do with players past their peak), as also happened to his team, the once-mighty Brisbane Broncos. Darius now spends a lot of his time as a mental health ambassador, important work when you consider that 72% of men do not seek help for mental health problems.

Men are also at greatest risk of suicide but least likely to seek help. The Black Dog institute says that in 2011, men accounted for 76% of deaths from suicide. Other groups at proportionately higher risk include indigenous Australians, the LGBTI community and people in rural and remote areas.

You may know that this is Mental Health Week, which includes community activities to bring these still-stigmatised illnesses into the daylight. There’s the One Foot Forward initiative, where people volunteer to walk a certain number of kilometres through October and raise money through sponsorship for the cause.

An Australian survey of 5070 people found that 78% said their mental health had worsened during COVID-019. One in four were worried they would be infected and one in two worried that families or friends would be infected. Psychological distress levels were higher, with raised levels of depression (62%), anxiety (50%), and stress (64%).

A World Health Organisation report in May warned that significant investment in mental health support was needed owing to COVID-19. Those at particular risk of COVID-related psychological distress include children, women minding children and/or working from home, older people, those with existing mental health disorders and front-line health-care workers.

Depression, or what Winston Churchill famously dubbed the Black Dog, comes and goes, whether you take medication or not. The severity might be dampened down, but you still don’t want to get out of bed or finish reading the second or third book you started.

I find walking, bird-watching and playing guitar the best diversions and, surprisingly given my tendency to introversion, I rarely knock back opportunities to socialise, even when I’m feeling off the boil. It’s not quite ‘snap out of it’ – unhelpful advice too often doled out by people who don’t understand mental health – but it is something.

If you could capture the molecule that for no reason decides to tell your brain “ wake up, you are no longer depressed”, I’d bottle it and give it away free to fellow sufferers.

Periods of respite come along; I felt momentarily cheered when a young friend told me she was with child for the second time. I was cheered further when seeing my fledgling rose garden start to bloom. Cheerfulness came with two snail mail letters, one from a friend in her mid-80s, who wrote a long letter for my birthday, which she never forgets. She befriended our family in Scotland (I was five) before we emigrated. Mary posted the letter in New Zealand on September 22 and it turned up on the 14^th October – just one example of how COVID-19 has broken down communications with family and friends.

I know people who have new grandchildren they are yet to meet, and people who would have liked to be at particular funerals and could not go. Then there were the people who could not visit a loved one who was dying of the virus because of restrictions on hospital visits.

So yes, snap out of it indeed.

But then I accidentally tuned in to ‘Dr’ Trump, self-diagnosing himself as ‘immune’, followed by the Gladys and Daryl fiasco, which tipped me back into the pit. I’m also aware that the passing of my peers – loved ones, friends, acquaintances and fellow musicians – remind me that I’m nearer the end than the beginning.

So I was sad to hear that Irish songwriter Kieran Halpin had died aged 65, and offer this brief tribute. Kieran, who graced our lounge room on several occasions, was a dedicated FOMM reader. He sometimes emailed to say how much he enjoyed particular outback travel pieces. A long while ago, Kieran and family spent a year touring Australia in a motor home, guitar in back. He loved the wide open spaces and the starry nights of the outback and drew inspiration there. An inventive and prolific writer, he had the happy knack of writing songs that other singers wanted to cover. Kieran’s songs like Nothing to Show for it All, Angel of Paradise and All the Answers were covered by artists including Delores Keane, Vin Garbutt, Niamh Parsons, The Battlefield Band and Dutch singer Ilse De Lange. As is often the case, the songs were better known that the man who wrote them.

When I call you in the morning tell you everything’s alright

I can’t see into the future I don’t see the danger in the night

Cos when I hear the siren wailing

I see the flashing of the light

I know that there is trouble there is a battle yet to fight

I may not have all the answers no

I wouldn’t have it any other way

http://kieranhalpin.com/

FOMM Back Pages:

Asthma and Australian Dust Storms

dust-storm-asthma — Australian dust storm September 23, 2009. Image from NASA (CC)

As a kid growing up in the North Island of New Zealand, I don’t recall ever seeing dust storms of the type seen in the Australian outback. In recent weeks, we’ve seen clouds of ochre dust blowing in from South Australia. The worst dust storms converge on the eastern seaboard, shrouding cities in an eerie, fog-like miasma.

You may recall the really bad one (September 2009) when motorists in Sydney and Brisbane drove with their lights on in the middle of the day.

Fortunately, the red dust (which gets into everything), lasts only a few days, although the customary early spring westerlies tend to blow them east in sequence.

While he was writing about the Dust of Uruzgan (Afghanistan) at the time, songwriter Fred Smith could have been describing dust storm conditions in the outback.

“It’s as fine as talcum powder on the ground and in the air
And it gets in to your eyes and it gets in to your hair…
…It gets in the machinery and foils every plan…”

Yes, and it gets in rainwater tanks when the next rains wash the dust off iron roofs. Residents of Auckland, some 1,500 kms away, have previously reported how dust storm drift from Australia turned their roofs a curious pink colour.

While New Zealand can fairly claim that it does not have dust storms in-country, it certainly sees the worst of them drifting across the Tasman. Reports of red ochre dust settling on the New Zealand Alps date back more than a century. You may have seen reports like these in recent years:

A series of dust storms in 2019, intermingling with smoke from bushfires, reached New Zealand\s Southern Alps, some 2,000 kms away. The ABC published photos, taken by adventurer Liz Carlsson, of the Mount Aspiring glacier sporting a red/pink discolouration.

University of Queensland geographer Hamish McGowan told the ABC it was not uncommon for this to occur during periods of severe drought in eastern Australia.

“In the right conditions, dust particles can be blown across the Tasman Sea by north-westerly winds, coming down on the Southern Alps in rain or snow and leaving behind an orange discolouration,” Professor McGowan said.

The same phenomenon can be seen in the Australian Alps. Black or grey discolouration is more likely to be ash falling from bushfire smoke clouds. The population in general is more aware, now that we have the technology to show images taken on mobile devices, or from satellites or drones.

Dust storms quickly remind me that I should take my asthma preventer medication as directed. Like so many asthmatics, I’m guilty of forgetting/ignoring the inhalant medication if I’m feeling free of symptoms. Australia’s 2.7 million asthmatics ought to know that asthma attacks can be random. They are also triggered by air quality factors including industrial air pollution, a high pollen count, smoke, dust and indoor environmental hazards (house dust, pet dander).

I do remember that 2009 dust storm, as we were in Brisbane for Queensland Ballet’s season launch at QPAC. People with any kind of respiratory condition should be on red alert when a dust storm comes calling. Luckily, I had my asthma inhaler with me (and needed it).

The numbers of people presenting at hospital emergency departments with respiratory symptoms were well above average on that day. Analysis of the air pollution found the 2009 dust storm to be far worse than any bushfire or dust storm event of the previous 15 years.

The Environmental Health Journal said extremely high levels of particulate matter were recorded on September 23, 2009.

Daily average levels of coarse matter (<10 microns (μm) peaked over 11,000 μg/m³ and fine (<2.5 μm) particles over 1,600 μg/m³.

The World Heath Organisation guideline is that any level of fine particulate matter over 35 μg/m is considered unhealthy.

(We should also remember that major cities known for air pollution routinely record <2.5 μm levels of 50 and higher).

The EHJ authors reported that the dust storm returned on September 26, with elevated PM (particulate matter) levels of an “unprecedented order of magnitude higher than those experienced during previous years.”

The fine particles are the main problem for people with respiratory complaints, as they deeply penetrate the airways.

The 2009 dust storm originated in drought-stricken western New South Wales. Last week’s storms reportedly started in outback South Australia.

Reports of giant dust storms in Australia pre-date the technology which can now spot them from above. Dust storms were common during the series of droughts that afflicted Australia in the last decade of the 19^th century. Still, scientists are predicting that climate change will make dust storms larger and more frequent.

A Science Daily report predicts that climate change will amplify dust activity in parts of the US in the latter half of the 21st century.

A statistical model developed by researchers at Princeton University and the National Oceanic and Atmospheric Administration (NOAA) predicts that climate change may lead to the increased frequency of spectacular dust storms that will have far-reaching impacts on public health and infrastructure.

Despite their dramatic visual impact, Australia’s dust storms are a blip on the the global chart. The World Meteorological Organisation says most sand and dust storms occur in the arid and semi-arid regions of Northern Africa, the Arabian Peninsula, Central Asia and China. Australia, America and South Africa make minor, but still important, contributions.

The WMO estimates that 40% of aerosols in the troposphere (the lowest layer of Earth’s atmosphere) are dust particles from wind erosion. Global estimates of dust emissions vary between one and three gigatons per year.

Spectacular though they are when they appear on the horizon, dust storms are infrequent and often blow over in a day or two. Bushfire smoke, however, as the 2019/2020 Black Summer bushfires demonstrated, have far more serious ongoing health effects.

An Asthma Australia report details the effects of the bushfire smoke between July 2019 and March 2020. The air pollution caused a public health emergency, adding to the direct bushfire impacts already felt by communities. Bushfire smoke contains high concentrations of fine particulate matter.

“At its worst, the smoke resulted in the Air Quality Index reaching more than 25 times the hazardous level (in Canberra, January 1 2020),” the report states.

The Air Quality Index reached greater than 10 times the hazardous rating on multiple occasions in certain areas of Sydney between November and January.

“It is estimated the bushfire smoke was responsible for more than 400 deaths, 2,000 respiratory hospitalisations and 1,300 presentations to the Emergency Department for asthma.”

The most recent study by the Australian Bureau of Statistics found that 2.7 million Australians (one in nine or 11.2% of the total population) had asthma in 2017-18.

“Over the last 10 years, the prevalence of asthma increased in the Australian population from 9.9% in 2007-08 to 11.2% in 2017-18″.

This is as good a time as any to remind you that September 1-7 is National Asthma Awareness Week.

Don’t leave home without your puffer.

Odd socks stamp out mental health stigma

My choice to wear a matchless pair of socks today was a deliberate tribute to Mental Health Week. Odd Socks Day is just one of the many events sponsored through October to remind us that one in five Australians suffer a mental health disorder in any 12-month period.

I’d never heard of Odd Socks Day, but spotted a flyer in a café somewhere and tucked it away for future reference. It’s a national anti-stigma mental health campaign now in its fourth year, using odd socks as a metaphor that anyone can have an off day.

Despite the fact that the majority of people visiting GPs are consulting them about mental health or psychological issues, those with physical ailments are not confronted with the same level of discrimination, stigma and social shame.

Young people are particularly vulnerable to stigma. Research in 2016 uncovered some alarming facts about stigma and what an obstacle it is to people trying to recover from a mental illness. Headspace found that 26% of young people aged 12-25 would not tell anyone if they had a mental health problem and 22% would be unlikely/very unlikely to discuss it with their family doctor.

Fifty-two percent of young people (12-25) identified with having a mental health problem would be embarrassed to discuss the problem with anyone and 49% would be afraid of what others think.

The Royal Australian College of General Practitioners recently found that 62% of people (via the traditional 10-minute consultation), were seeking support for mental health disorders.

The most common mental health ailments likely to afflict people are depression, anxiety and substance abuse. Sadly, many people struggling with depression use drugs and/or alcohol to self-medicate, often with negative results.

In my former work life, the notion of taking a ‘mental health day’ was anathema to your average hard-bitten journalist, for whom the deadline reigns supreme. But in recent years the previously taboo subjects of depression and suicide are now being freely publicised and debated. The hidden cost of not properly dealing with workplace mental health problems is now an $11 billion problem for Australian commerce. There is now an argument that $1 spent on mental health services equates to a ROI (return on investment) of $2.30. So why aren’t we spending?

If there is one indicator to show how stigma and mental health ratio is shifting, it is the NRL ‘casualty ward’, which lists rugby league players and their injuries. Through the season I recall at least six players said to be having counselling for ‘psychological’ or ‘personal’ issues, the latter covering a range of non-physical traumas. Dragons half Ben Hunt spoke candidly to the media this year about seeing someone to help overcome a slump in confidence. Armchair critics (virtual bullies) did not help Ben’s situation, with a steady stream of vitriol posted on social media.

Suicide is often the end-game for people fighting ongoing battles with mental health disorders. Australia’s standardised statistics on suicide are not as high as some (11.7 per 100,000 people). Lithuania (28.6) and South Korea (26.3) head the World Health Organisation list, but Australia is nonetheless in the list of 10 countries with a suicide rate in double figures and has been for a decade.

In Australia, men are three times more likely to commit suicide (17.8 deaths per 100,000 people) than women (5.8 deaths per 100,000 people). More than 75% of all severe mental illnesses occur prior to the age of 25, and youth suicide is at its highest level in a decade.

The telling statistics revealed by the Royal Australian College of General Practitioners clearly show that the system is under untenable strain.

Author Jill Stark wrote about it in a Sydney Morning Herald opinion piece – ‘What happens when the answer to R.U.O.K is no and there’s nowhere to go?’

Stark wrote from a first person perspective, after fronting up to a GP with what she suspected was an acute recurrence of anxiety and depression. She was handed a form to fill in – a routine step in such a consultation, so the GP can make a more objective assessment of the patient’s mental health state. As Stark related, she scored 25 ‘mild to moderately depressed’ and was prescribed medication (after first being asked if she was suicidal).

The answer was no, but on the way home Stark reflected that should she indeed want to kill herself, she’d been prescribed with something well-equipped for the job.

As Stark bluntly pointed out, the time for wristbands and hashtags has passed. Doctors need the financial support Medicare can bring by allowing longer consultations for patients with complex psychological problems.

“As a matter of urgency we must stop rationing psychological services to 10 subsidised sessions per year,” she wrote.

So that was Jill Stark, wearing her odd socks in public. Bravo.

People like Jill who are having an acute mental health crisis need expert support at least once a week for as long as the crisis lasts.

The Black Dog Institute reminds us that 45% of Australians will experience a mental illness in their lifetime. One in five mothers with children younger than two will be diagnosed with depression. At 13%, depression has the third highest burden of all diseases in Australia (burden of diseases refers to financial cost, mortality, morbidity etc).

The World Health Organisation (WHO) estimates that depression will be the number one health concerned in both developed and developing nations by 2030.

That gloomy prediction was no doubt behind the WHO’s decision in 2013 to introduce an eight-year plan to change the direction of mental health in its 194 member states. The plan’s main objectives are to:

strengthen effective leadership and governance for mental health;
provide comprehensive, integrated and responsive mental health and social care services in community-based settings;
implement strategies for promotion and prevention;
strengthen information systems, evidence and research.

Global targets and indicators were agreed upon as a way to monitor implementation, progress, and impact. The targets include a 20% increase in service coverage for severe mental disorders and a 10% reduction of the suicide rate in member countries by 2020.

These are noble aims, but as the WHO observes, it requires effective leadership and governance to implement meaningful change.

Odd Socks Day is one of the rare light-hearted efforts to raise awareness of mental health. Grow, the organisation behind the campaign, runs an in-school peer program that helps young people support each other through their issues.

The overall cost of unmanaged or mismanaged mental health in the Australian workplace is approximately $11 billion a year, according to Dr Samuel Harvey. Dr Harvey, a Black Dog Institute consultant, leads the workplace mental health research program at the school of psychiatry for the University of New South Wales. He was the lead author for research published in The Lancet which found that workplaces that reduce job strain could prevent up to 14% of new cases of common mental illness from occurring.

Quite clearly, we all need to pull up our socks, odd or not, and change our attitude. If only 35% of Australians in need are actively using mental health services, we need to do more than ask R.U.O.K.

Resources: Lifeline 13 11 14, beyondblue.org.au

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