The Australian mental health crisis:
A cautionary tale for developing nations

Prof Philip Morris
Bond University, Gold Coast, Australia
Australian and New Zealand Mental Health Association
Gold Coast Medical Association
Hello all
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

Thank You

1. TEICHER MH, SAMSON JA, ANDERSON CM, OHASHI K  (2016). The effects of childhood maltreatment on brain structure, function and connectivity. Nat Rev Neurosci. 2016 Sep 19;17(10):652-66. doi: 10.1038/nrn.2016.111.
2. VAN DER KOLK, B (2005): “Developmental Trauma Disorder: Toward a rational diagnosis for children with complex trauma histories,” Psychiatric Annals 35:5, 401-408,  May 2005.
3. SCHORE A (2008). Modern Attachment Theory: The Central Role of Affect Regulation in Development and Treatment (Clinical Social Work Journal, 2008; 36: 9-20). DOI 10.1007/s10615-007-0111-7
4. FELITTI V. J; ANDA R. F; et a. (May 1998). “Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study”. American Journal of Preventive Medicine. 14 (4): 245–258. doi:10.1016/S0749-3797(98)00017-8. PMID 9635069
5. LANIUS R., VERMETTEN E., PAIN C., Editors (2010).The Impact of Early Life Trauma on Health and Disease. The Hidden Epidemic. Cambridge University Press 2010.
McKINNON, M. C., & LANIUS, R. A (2011). Default mode alterations in posttraumatic stress disorder related to early-life trauma: a developmental perspective. Journal of psychiatry & neuroscience : JPN, 36(1), 56-9.