The Australian mental health crisis:
A cautionary tale for developing nations
Prof Philip Morris
MB BS BSc med PhD FRANZCP FAChAM ABPN
Bond University, Gold Coast, Australia
Australian and New Zealand Mental Health Association
Gold Coast Medical Association
I thank the Pasifika Medical Association organizers for inviting me to speak
I hope my talk will be helpful
Australia has a mental health crisis
Despite national plans and commissions of enquiry major problems remain
Suicide numbers continue to increase beyond population growth:
2004 – 2098 suicides; 2017 – 3128 suicides – a 49% increase
During this time the population of Australia has increased:
2004 – 20.1 million, 2017 – 24.7 million – a 23% increase
Behind Estonia and the USA, Australian has the third highest rate of increase in suicide deaths from overdose between 2001 to 2015
Although stigma and discrimination has reduced for individuals suffering from depressive illness, individuals with schizophrenia remain less understood and an ‘outcast’ group
Mental illness remains a barrier to employment
Despite multiple national mental health plans and a decade of changes to public mental health services, concerned individuals and patient support groups are saying that the care of mentally ill individuals is a disgrace
Recent reports condemn widespread emergency department access block due to lack of inpatient beds for psychiatric patients and condemn prolonged treatment of psychiatric patients in emergency departments
This results in inappropriate care and violations of human rights for these patients
In response to another proposal for a royal commission into mental health in Victoria, two senior academics complained that there have been too many enquiries but not enough action on their recommendations
So, is there anything developing countries can learn from Australia?
We can learn from the mistakes made in Australia
Stop closing mental hospitals – reform them instead
Stop rationing inpatient treatment – provide needed inpatient and community residential rehabilitation care (step up and step down)
Rewrite new mental health acts that serve to deny patients access to treatment – across the world new ‘least restrictive treatment’ mental health acts are associated with increased suicide rates
Stop ‘mainstreaming’ of mental health services – this denies the unique needs of individuals suffering from mental illness – opt for a
‘parallel and integrated (with general health services)’ model
Treat mortality statistics and suicide rates (national suicide toll) as an index of the access, equity, and quality of mental health services – use audits of mortality and suicide to enhance accountability
To prevent mental illness (especially the ‘high prevalence’ conditions like depression, anxiety disorders and substance abuse) –
Focus on improving the quality of the relationship between the developing child and his or her main carers from conception to age five
Strong, secure, and trusting emotional attachments or bonds lead to better coping skills, greater resilience, and a higher threshold for developing mental illness
This applies to developing or developed countries, to those with black, brown, yellow or white skin, and to all ethnicities and cultures
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Dear Dr Philip Morris, you are so right in what you have to say about mental illness. Yours sincerely, S Dunlop.