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What affects Australians’ mental health and wellbeing?
Franco Greco • Nov 25, 2019
According to the Productivity Commission, 23% of Australians are estimated to be at risk of experiencing a mental health illness. What factors increase your risk of experiencing symptoms of mental illness?
The Productivity Commission (PC) estimates about 17% experienced an episode of mental illness in the past 12 months. This covers a spectrum of illness severity across mild, moderate or severe conditions. Mild conditions are those that can be either self managed or managed within primary care, while moderate conditions require specialist support. Only about 3% of Australians experience a severe mental illness in a given year, necessitating hospitalisation or treatment from specialist community mental health teams. Roughly one third of these people have a persistent disorder or complex needs.
Based on prevalence rates, the PC also estimates that about 23% are deemed to be at risk of experiencing an episode of mental illness because, in the past 12 months, they had emerging symptoms, a mental illness prior to the last year, or were exposed to another risk factor.
Mental health and wellbeing are influenced by a wide range of factors, which may act to protect a person’s wellbeing or increase their risk of experiencing symptoms of mental illness (refer to figure below). The interactions between specific factors and individual mental health are complex, and change over time.
Individual attributes, such as a history of physical and mental illness or stressful life events, may increase the risk of a person experiencing mental illness. Positive engagement with family, friends and the wider community and the ability to manage economic circumstances and gain access to economic and social opportunities through education are often seen as factors that protect a person’s mental health and wellbeing.
The presence and relative importance of these factors change over the life course (refer to figure below). In particular when they influence early life experiences, these factors can have life long effects on mental health. Extensive research has established the link between adverse childhood experiences and mental health in adulthood (Bellis et al. 2019).
On the other hand, people with more positive experience of childhood and adolescence are typically better placed to deal with the choices and challenges of adulthood. The ability to balance between work and time with family and friends, deal with unemployment, participate in the wider community rather than being excluded or isolated have an impact on an individual’s mental health.
PC lists three key risks that can affect some people more than others
Although most people will be exposed to some of the risk factors associated with mental illness at some stage of their life, some people are likely to have longer exposure to multiple risk factors and an increased risk of developing a mental illness.
Submissions to PC inquiry, as well as an extensive body of research, have pointed to three risk factors — isolation, exposure to trauma and socioeconomic disadvantage — as major contributors to increased risk of mental illness among vulnerable population groups.
These factors not only increase the risk of a person developing a mental illness, but they also reduce the likelihood for them to engage with support services.
Isolation is created not only by geography
Isolation has many causes. It is often geographic, and affects those who live in rural and remote areas. People may be at higher risk of mental illness due to low rates of access to services, higher risks from weather events or natural disasters as well as occupational risks associated with farming and mining.
Isolation is not exclusively defined by geography and also poses a risk for those living in regional and urban areas. Older people and those without access to transport can easily become isolated in their own homes. For some in culturally and linguistically diverse (CALD) communities, language barriers can contribute to isolation. The (Lesbian, Gay, Bisexual, Transgender, Intersex and Queer (LGBTIQ) community is also more likely than the general population to face stigma, discrimination, social exclusion, homophobia, transphobia, stereotyping, ostracising and harassment.
Discrimination can create a sense of isolation. The impact of being different, being excluded and the more subtle forms of discrimination such as being ‘left out’ or avoided can impact on mental health and lead to delay or avoidance in seeking treatment. Almost half of Aboriginal and Torres Strait Islander people who have experienced discrimination have reported feelings of psychological distress (ABS 2011). Discrimination can act as a risk factor for the development of depression and anxiety.
Exposure to trauma can have implications across generations
Some people are more likely than others to be exposed to a high level of trauma, and therefore are at higher risk of mental illness. For some, this may be an occupational hazard — emergency service workers (police, ambulance, fire fighters) and military personnel are at particular risk of being exposed to trauma resulting in post traumatic stress disorder (PTSD).
For others, it is due to their exposure to traumatic events of war and violence. For example, refugees to Australia are at higher risk of mental illness, due to their experiences of living in refugee or displaced person camps or exposure to armed conflict.
Aboriginal and Torres Strait Islander people have a higher risk of being exposed to trauma, including intergenerational trauma.
Socioeconomic disadvantage has strong links to mental health and wellbeing.
Entrenched economic disadvantage remains a reality for a large number of people — about 700 000 people in Australia have been in income poverty for at least the past four years. Unemployed people, those with disability and Aboriginal and Torres Strait Islander people are at higher risk of income poverty and deprivation (PC 2018).
People experiencing financial stressors, such as low income or poverty, and/or compromised financial security, such as being unemployed or having excessive debt, are at increased risk of developing a mental illness.
Data shows that people living in the most relatively disadvantaged areas of Australia reported significantly higher levels of psychological distress and mental illness than those living in the least disadvantaged areas.
This article has been drawn from the Productivity Commission, Draft Review of Mental Health
(Vol 1, pp 118-123). The link has been provided below.
If you are experiencing mental health issues or wish to discuss an issue that is causing you distress, it may be helpful to speak to a trained mental health professional.
If this is an Emergency you should stop immediately and contact or go to the appropriate service such as Lifeline (13 11 14) or 000 for Police or Ambulance, your local Hospital, your GP, or a regional Mental Health Service.
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