Mental Health in Australia

Mental health problems in Australia are common. This paper explores the current state of mental illness in Australia, existing and emerging treatment options, as well as the role that social work plays in a treatment team. Mental illness can vary in severity; they can be episodic or persistent over time. Approximately one in five Australians lives with a mental health condition in any one year, equating to 20% of the population (Black Dog Institute, 2020). Furthermore, it is estimated that almost half of all Australians will experience a mental illness at some point in their life (Department of Health, 2020).

The most common mental health conditions in Australia are anxiety, mood disorders (depression, bipolar) and substance use problems, especially alcohol. One-quarter of Australians will experience an anxiety disorder in their lifetime, with more women than men likely to experience anxiety and depression (Department of Health, 2020).

Mental health is a crucial driver to productivity and economic participation in Australia, as such as potentially impacts upon a person's social engagement, sense of belonging, community connectedness, and living standards.  Mental illness has a significant impact on a person's ability and morbidity. Mental illness is the single most notable contributor to time spent living with ill health and the third main contributor to total years of loss of healthy life (Australian Institute of Health and Welfare, 2016). In 2015, the Australian Burden of Disease Study found that mental illness was responsible for 12% of the total burden of disease among Australians, raking fourth behind Cancer (18%), Cardiovascular diseases (14%) and Musculoskeletal conditions (13%) (AIHW, 2019).

The onset of mental illness is typically mid-to-late adolescents, with the highest prevalence of mental illness for Australians in those aged between 18-24 (Black Dog Institute, 2020). Childhood mental health disorders are linked to a range of long-term harmful social, economic and criminal outcomes in adulthood (Young, 2016). Therefore, early intervention and treatment for mental health problems are crucial.

Mental Health Treatments

Mental illness is treatable, though, some people, may try many different treatment options with limited results. According to the National Survey of Mental Health and Wellbeing 2007, 35% of people that live with a mental illness receive treatment (Australian Bureau of Statistics, 2008). Though, a more recent study conducted by the CSIRO estimates that the population treatment rate for 2009-10 is around 46% (Whiteford, et al., 2013). There are many barriers to help-seeking, for example, stigma, cost, access to services, mental health literacy and side effects from pharmaceuticals. There are numerous options for treating common mental illnesses; the correct treatment can help a person's condition improve despite the presence of some ongoing symptoms. At times, a person may be confused by their symptoms, mainly if mental health literacy is low; thus, they may not realise that they are unwell, which can delay treatment.

The re-emergence of therapeutic uses for mind-altering, psychedelic drugs has brought the field of mental health to a new frontier in research and the treatment of mental illness. Outlined below are the current treatment options within Australia, followed by a discussion on the emergent psychedelic treatment opportunities around the globe.

Psychological therapy

There are several different types of psychotherapy, including supportive therapy, cognitive behaviour therapy (CBT) psychodynamic therapy, interpersonal therapy, narrative therapy, group, couple and family therapy. Psychological therapies provide people with talking therapies, providing a space for people to talk about their thoughts, feelings and emotions. Psychological treatments can reduce the distress associated with a person's symptoms or trauma and may be used in combination with other treatments such as medication.

Medication

The use of medications is one of the foundation treatments for mental illness. In Australia, the most commonly prescribed medicines are antidepressants, which can be used for anxiety or depression. Mood stabilisers are used for bipolar disorder, and antipsychotic medication is used for schizophrenia or psychosis. The use of psychotropic medicines is ubiquities (Meadows, 2012). Medications used to treat common mental illnesses such as depression and anxiety are also quite imperfect concerning side effects, many people experience significant problems, especially with long time treatment (Meadows, 2012). Side effects may include gastrointestinal problems, weight changes, nausea, loss of sexual desire, insomnia, dry mouth and blurred vision.

Lifestyle changes

Exercise is known to help relieve or prevent anxiety or depression, as well as alternative activities such as yoga, meditation, mindfulness practice and light therapy. Avoiding illicit drugs and alcohol is also recommended, as is a healthy diet and proper nutrition. Some studies, such as the SMILES project through Deakin Universities Food and Mood Centre, suggest that the Mediterranean diet can have a noteworthy impact on mental health.

Community support programs

There are opportunities for people, particularly those living in metropolitan areas to access community support programs, such as peer support groups, Anxiety Support Groups, Social Anxiety Support Groups, and Eating Disorder Support Groups.

Emerging Therapy

In the last decade, scientific attention to serotonergic psychedelics (Psilocybin, MDMA, Ketamine) has dramatically increased. Preliminary evidence of clinical studies administering psychedelics in conjunction with psychotherapy has shown robust efficacy in treating trauma-related disorders and some forms of common mental illnesses such as anxiety and depression (Nichols, Johnson, & Nichols, 2016). In some cases, psychedelic-assisted therapeutic interventions demonstrate momentous and rapid effectiveness in the treatment of severe mental health problems that rival existing pharmacotherapy treatments (Hutchison & Bressi, 2020).

Social Work

Social work is a discipline dedicated to the advancement of social justice and the promotion of social change. Thus, social work should continue at the forefront of treatment innovations for pervasive and chronic mental illness. Social workers are experienced and accustomed to working with clients in tandem, providing support, advocacy, guidance and psychoeducation on the use of traditional psychoactive medications treating mental illness (Hutchison & Bressi, 2020). As a profession that is committed to the healing, empowerment and health of communities, the field of social work has a unique role to play in the research, education and engagement of psychedelic-assisted therapy.

Mental illness is common; one in five Australians will live with a common mental illness in any one year. There are numerous treatment options available, though only 35% of people receive treatment. Medication is often prescribed by a treating physician, though adverse side effects are one of the driving reasons why people stop taking medication. With prevalence so high, we need a paradigm shift to explore alternative options for assisting people who live with a mental illness.

References

AIHW. (2019). Australian Burden of Disease Study: impact and causes of illness and death in Australia 2015. Australian Burden of Disease Study series no. 19. Cat. no. BOD 22. Canberra: AIHW.

Australian Bureau of Statistics. (2008, October 23). National Survey of Mental Health and Wellbeing: Summary of Results, 2007. Retrieved from Australian Bureau of Statistics: https://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4326.0Main+Features32007?OpenDocument

Australian Institute of Health and Welfare. (2016). Impact and causes of illness and death in Australia 2011. Australian Burden of Disease . Canberra.

Black Dog Institute. (2020, April). Facts and Figures. Retrieved from Black Dog Institute: https://www.blackdoginstitute.org.au/wp-content/uploads/2020/04/1-facts_figures.pdf

Department of Health. (2020, January 30). Mental Health. Retrieved from Department of Health : https://www.health.gov.au/health-topics/mental-health

Hutchison, C., & Bressi, S. (2020). Social Work and Psychedelic‑Assisted Therapies: Practice Considerations for Breakthrough Treatments. Clinical Social Work Journal .

Meadows, G. (2012). Mental Health in Australia Collaborative Community Practice. Oxford University Press .

Nichols, D. E., Johnson, M. W., & Nichols, C. D. (2016). Psychedelics as Medicines: An Emerging New Paradigm. Clinical Pharmacology and Therapeutics , 209-219.

Whiteford, H. A., Buckingham, W. J., Harris , M. G., Burgess, P. M., Pirkis, J. E., Barendregt , J. J., & Hall, W. D. (2013). Estimating treatment rates for mental disorders in Australia. Australian Health Review, 38(1), 80-85.

Young, C. (2016). Diet and Mental Health. Retrieved from Food & Mood Centre: https://foodandmoodcentre.com.au/2016/07/diet-and-mental-health/