A Contributing Life is the first national Report Card on mental health and suicide prevention in Australia.
Having spent a considerable amount of time over the last few days reading and studying the report, I wished to highlight and offer my own opinion and experiences on some of the issues it has raised regarding mental health treatment and support in Australia.
1. …people with severe mental illness live 10-32 years less than the general population.
Take a moment to think about that.
People with a mental illness are dying much younger than the general population – and this isn’t just because of the increased chance of suicide. People with illnesses such as bipolar or schizophrenia have much higher rates of heart-related problems, diabetes and obesity than the general population. They also have a much lower chance of receiving treatment for physical illnesses.
I have lost count over the years how many times I’ve visited a GP to discuss physical health problems only to have them disregarded because of my mental health. Weeks later, with the problems still occurring, I return to the GP to be told the same thing.
Months later, ditto.
In one case, doctors are only now beginning to take a physical health problem seriously as it has begun to seriously affect my ability to function on a day-to-day basis. I first went to the doctor about this eleven years ago and have seen doctor’s about it, on average, several times a year since; always to be told ‘it’s just your anxiety’ or ‘it’s just your stress levels’ without any investigation, testing or analysis.
2. …poor dental health is also a significant burden.
“Patients with severe mental illness are three and a half times more likely to have lost all their teeth than the general population, and around six times more likely to have decayed, filled or missing teeth.”
My teeth are appalling and a major contributing factor to my body image issues. I rarely smile in public (or private) and do whatever I can to hide my teeth from the world. Throughout my homelessness – courtesy of physical assault – I lost one and a half teeth and asked several service providers (both homeless and mental health organisations) what my options were in regards to this issue. I was told to focus on stabilising my mental health and overcoming homelessness as there would be time to deal with these dental issues at a later date.
Three years later I have serious tooth infections, dental decay and at times excruciating pain. Living with mental health and homelessness I have had other things to worry about, but I firmly believe the organisations I visited should have assisted in helping me access dental treatment as there is now a good chance I will be losing my teeth.
3. …900,000 people each year are missing out on getting the [mental health] services available to them.
To be honest this figure is (much) lower than I was expecting it to be and I seriously question it’s validity.
However, 900,000 people missing out on services is completely unacceptable regardless of the reason.
At various times in my life every reason on the graph (right) has affected my ability to access help – with the most outstanding being I asked but didn’t get the help.
In October 2007, I was taken to the hospital by the police following a psychotic episode and suicide attempt. I was discharged after twenty minutes with three anti-depressants and told that “I was fine”. Within weeks I became homeless.
In January 2008, I was informed after begging a mental health team to hospitalize me that it could not happen as “I was not a danger to other people”. Within twenty-four hours my self-harm escalated to a suicide attempt, with the suicide letter being posted on my blog.
In August 2008, a psychiatrist I was seeing laughed at me when I tried to discuss the escalation of memories and nightmares following my assault and rape the previous year. Weeks later the problem became so severe my GP altered my medication; the anti-depressants and mood stabilizers were tripled and an anti-psychotic introduced with immediate (urgent) effect due to escalation of hallucinations, psychosis and suicidal ideation.
Throughout my homelessness (2009-2012) I repeatedly tried to access mental health services when I was stable enough to navigate the system (which in all honesty wasn’t all that frequently). Invariably I was told that: “I wasn’t ‘mentally ill’ enough to need help”; “I was ‘play-acting’ to manipulate help to get out of homeless” and that “there were people far more unwell than I so I had to wait my turn”.
In December 2012, a psychiatrist treated me so badly (formal complaints were made by several people) that I vowed never to return to mental health services….ever! To this day I continue to state that I would rather die than return to any mental health organisation in Australia.
4. …men account for over three-quarters of all deaths by suicide.
In Australia, there are more than 2000 deaths by suicide every year and a staggering 65,300 reported suicide attempts.
I have written extensively about suicide in the past, from the point of view of my own attempts, to the pain of losing loved ones and steps that can be taken to help those who may be suicidal. It is an issue that is hugely important to me and something that I still believe Australia has no real idea how to tackle.
“In 2007, 41 per cent of those aged 16 to 85 who had suicidal thoughts and made attempts in the past 12 months did not
use mental health services.”
The most simple thing that can be done is to continue encouraging those contemplating suicide to speak out about what they are feeling. The continuing silence and shaming of suicide is merely contributing to the belief that this issue should not be spoken about.
“Importantly, we also know there are protective factors against suicide – being connected with family, friends, culture, school and communities; having someone who cares about you and having someone you care about; having positive attitudes and ways to tackle problems; having financial stability, good health and access to mental health support when you need it.”
5. …no one should be discharged from hospitals, custodial care, mental health or drug and alcohol related treatment services into homelessness. Access to stable and safe places to live must increase.
The fact that this is happening (and continuing to happen) in Australia should be a cause of national shame.
Homelessness is one of the most distressing states that you can find yourself in. There is no safety, no care, no love, no support. There is just you, sitting in a park, hoping that you will survive the day. For vulnerable people to be discharged from services supposed to help those with serious health problems into this state is a disgrace.
Not including the October 2007 incident, this occurred to me three times during my time homeless, and on each occasion my mental health problems escalated as a result; on one occasion a suicide attempt followed within a week.
No-one – woman, man or child – should ever have to experience this.
6. …the proportion of people with a mental health condition who are not in the labour force is more than one and a half times compared with the general population (32 per cent compared to 21 per cent).
I want to work. I want to be a functioning member of society. I want to contribute. I want to be part of a social network. I want all of this.
As do most who suffer from mental illness.
“We know that there are many benefits for people to gain from having work, such as expanding social relationships and skills, a better sense of self, involvement with others and financial independence, but we also know there are obstacles such as lower education levels, lower socioeconomic status and poor employment levels that makes it more difficult for people living with a mental health issue.”
However the likelihood that I will ever realise this dream is becoming slimmer with each passing day. My mental health issues, the trauma from homelessness and my continued social isolation are all serious barriers that need to be overcome before I can return to a contributing life.
After my breakdown in 2007 it was eighteen months before I began looking for work. This period, in mid 2008, coincided with my name being a search term to find my blog for the first time since I had begun writing it. The same thing happened in 2009 in the months leading up to my homelessness. Both occasions being something I do not consider a coincidence, especially given I was more than qualified for the jobs I was applying for (most no greater than ‘cleaner’) but following interviews where it was alluded I was a high-placed candidate for the job, within hours my name was used as a search term to find my blog where my life with mental illness and homeless was laid bare for all to see (and discriminate).
The simple fact is, most employers will not employ someone with a serious mental illness. Even a disability employment service I have seen told me admitting your mental illness to potential (or current) employers is not recommended due to discrimination.
Whether the same can be said for educational establishments I’m unsure, but given the prevalence of discrimination, I would suggest that it is.
However, having read the report in its entirety, I am prone to agree with John Mendosa and other experts in the field who have questioned the point of yet another report into the state of mental health in Australia.
Although I agree with every issue raised, not only because of my own personal experiences with the system, but my firmly held belief that those with mental health issues deserve to live a life just as much as everyone else does, there was nothing in the report that surprised me. In fact, most of the issues made have been raised many times over the last several years and yet, once again, we continue to discuss, debate and converse about the issue rather than do anything to combat it.
Sixty-five thousand attempted suicides a year is unacceptable, discharging mentally ill and vulnerable people onto the street is unacceptable, the continued discrimination against the mentally ill is unacceptable and Australia needs to act fast to stop the situation from getting worse.
Hopefully in twelve months time – when the next report card is due – it will see Australia be awarded a gold star, rather than a visit to the Principal’s office.
~ All quotes and graphics from A Contributing Life: The 2012 National Report Card on Mental Health and Suicide Prevention ~