Updated: Oct 21, 2020
Did you know mental health related issues are the No. 1 health concern driving Australians to visit their GP? It’s a sad fact that almost 50% of Australians will experience a mental illness at some point in their lifetime, yet only half of these people will access treatment.
Last week, October 10th, marked World Mental Health Day. A day to raise awareness & open conversations relating to all things mental health. In honour of this day, our client, Medical Director, opened a panel discussion to look at the current state of mental health care in Australia. Is the system set up to support this growing issue? What role does technology play? How can we look after the mental health of our all-important health care workers?
2020 has tested our collective resilience with catastrophic bushfires, devastating floods, & now a global pandemic. The effects of these events have touched almost every aspect of our lives, from our economic stability, to our health & our family dynamics. As a result, our mental health has taken a huge hit.
Dr Louise Stone, GP & clinical associate professor at ANU Medical School, identified while natural disasters tend to bring people together, pandemics drive people apart as “people have difficulty connecting”.
Medicare data from April to June 2020 shows a 30% increase in the number of patients who’ve visited GPs for a mental health consult compared to the same period in 2019. This increase has been reflected in online mental health support services such as Beyond Blue.
Help-seeking levels still worryingly low
Why don’t people seek help? Despite increased awareness and uptake, studies show that 54% of people don’t seek treatment for mental health conditions. Dr Stone noted of the many barriers to seeking mental health treatment, one of the most prevalent was our poor capacity for inward reflection or “mentalising”. Dr Stone refers to this as a “capacity to look at the way we think and feel”, with many people (men making the majority) lacking an emotional vocabulary.
Mental illness often breeds feelings of guilt & shame, according to Dr Stone. “It requires a lot of courage & I really recognise how hard it is to get into a waiting room and be prepared to share something with me as a GP & treat me as though I’m trustworthy,” she said.
GPs a crucial “anchor” in 2020
Dr Blashki observed that GPs have played an important “anchoring” role during this challenging time. People may think it’s a clever psychological technique, but in many cases GPs just help to provide continuity & a sense of calm, “like there’s some order in the world,” he said.
To provide this constant support can take a toll. The Panel found GPs have not been prioritising their own mental health. Jason Threthowan, CEO of Headspace labelled it a “delayed response” where health care works have been so focused on everyone else, they haven’t sought support themselves.
What about GPs? It statistically isn’t fair
There is a stigma among healthcare professionals making it harder & harder to seek help. Four in ten GPs reported they have delayed seeking treatment in the past two years. A National Mental Health Survey found 3.4% of doctors experience very high levels of psychological distress (higher than the general community), and 10% have experienced suicidal thoughts.
“We know that a lot of doctors carry around this idea that our colleagues would judge us if we said we had a mental health problem, would think we were less competent, & would report us to the medical board. All those things create a wall of shame that is very difficult to break,” said Dr Stone.
As a doctor who has battled both depression and anxiety, Dr Geoff Toogood has experienced stigma and discrimination at many levels. “I faced significant stigma, both from outside & a lot from inside. I remember going to the waiting room in my general practice, petrified that someone would recognise me,” he admitted.
Burnout already affecting junior doctors
A recent study by the Black Dog Institute & UNSW Sydney found more than 25% of junior doctors are working unsafe hours, losing sleep & doubling their risk of developing mental health problems & suicidal ideation.
To address this growing concern, The Black Dog institute & NSW Health created an app purpose-built for junior doctors to access information & support for mental health.
“There are no superheroes on this planet,” Dr Sanatkar pointed out. “At the end of the day, we’re people & we’re providing services to other people.”
The panel agreed junior doctors faced unreasonable expectations to be resilient. with the app an important stepping stone to help change that perception.
Integration key for e-mental health success
When it comes to the delivery of mental health treatment, the panel agreed e-mental health has obvious benefits but must be carefully coordinated with face-to-face methods of treatment.
E-mental health has a great deal of potential but raises concerns around accessibility. Dr Stone warned to remove a therapeutic relationship is treading on dangerous ground.
“Just because it’s there, doesn’t make it accessible,” she reasoned. Some unseen “gates to e-mental health” include good English literacy, access to a device, & Wi-Fi accessibility.
The disconnect between general practice and&e-mental health support adds to this point, according to Dr Blashki. However, the solution could be to increase focus on integration.
We’re witnessing the “absolute explosion of different apps & websites” ranging from diagnosis to management to helping find prognosis to monitoring. “We’re only just scratching the surface of what’s going to be possible, but it’s very exciting in terms of accessibility, scale, & 24-hour availability of mental health treatment,” Dr Blashki concluded.
These findings demonstrate how far we’ve come in supporting those suffering from poor mental health, whilst also highlighting that we still have a way to go.
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