Lack of investment in mental health care: A strain on lives and the economy

Australia’s mental health system is in a neglected and dire state.  Inadequate leadership and funding by successive governments is leading to the unnecessary deaths of thousands of Australians. The suicide rate is at a near 10 year high.   Not only is there a moral and social responsibility to address this issue, but there is also a strong economic argument for increasing investment in mental health care.

In Australia it is estimated that that about 20 per cent of the adult population – approximately 3.6 million people – experience mental illness.  An additional 14 per cent of children and youth – around 600 thousand – are affected.  Less than half will access care.  Suicide accounts for the greatest number of deaths in people aged 15 – 44 years.

Fortunately, public awareness and appreciation of mental health appears to be growing. This year there was public goodwill for Sydney Swans’ star forward, and most expensive player, Buddy Franklin, who withdrew from the final series due to mental health related issues.    National campaigns such as the ABC’s “mental As” have also stimulated public discussion.   Australians want a fair deal for people affected by mental illness – the same deal offered to people affected by other forms of illness, like cancer, diabetes and heart disease, to name a few.

Unfortunately, there is a stark disconnect between what the public wants, and how much action our government is taking.  Despite mental health difficulties accounting for about 13 per cent of the total health burden of disease in Australia, government spending on mental health services accounts for just over 7 per cent of the total health budget.

Governments of both sides of the political divide have failed to adequately address the gap.  There is also no clear long-term overarching strategy to ensure that the minimal funds available are being spent effectively.   Rather than increasing funding to plug gaps and chart a course to reducing the overall mental health burden, governments have turned a blind eye.  Over the last decade, the growth of investment in mental health (4.8 per cent) has lagged behind growth in overall health spending (5.3 per cent).

Mental health is the last place that governments should be looking to make “efficiencies” or reduce spending in order to address the budget deficit.  Unlike many other illnesses, that tend to occur later in life, mental illness typically strikes before the age of 25.  This is a time when a person is in on the cusp of long-term economic contribution.  Left untreated, young people are at risk of missing out on vital education and training that can result in a life of subtle underachievement, and in many cases, welfare dependence.

The economic cost of mental illness in Australia is enormous.  The Organisation for Economic Co-operation and Development estimates that in developed countries, the total cost of mental health (including intangible costs such as reduced wellbeing, emotional distress, pain and other forms of suffering) is four per cent of gross domestic product.  In Australia, this would equate to more than $60 billion.

Strong government leadership is required in order to address the burden of mental illness that is experienced by one in two people across a lifetime, as well as its evident drain on the economy.  The recent ‘Report of the National Review of Mental Health Programmes and Services’ conducted by the National Mental Health Commission has provided a useful framework for future action.

Currently, the bulk of the health budget is spent on inefficient “downstream” programs such as disability support payments.  The report argues that overtime the majority of spending should be directed towards more efficient “upstream” early intervention programs aimed at reducing the likelihood of long-term suffering.

I argue that federal and state governments also need to increase overall spending on mental health so that investment more proportionately reflects its level of impact on the community relative to other illnesses.

With the end of the mining boom and a slowing economic outlook, the Turnbull Government has spruiked the need for investing in new parts of the economy.  Flexibility and agility has become the mantra.  Mental health investment is a golden opportunity.  It has the potential to improve not only the lives of millions of Australians but also the mental wealth of the nation.  It is a blue chip share offering long-term social and economic returns.


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