If you’ve taken a glance at RACGP’s Health of the Nation 2018 report you may have been as alarmed as us to discover that mental health is Australia’s number one health concern in 2018. A whopping 62% of patients talk to their GP about psychological issues. This makes mental health more prevalent than any other health issue, followed by respiratory issues (45%) and musculoskeletal issues (43%). An even bigger concern is that this percentage is trending upwards — increasing from 61% in 2017.
With this considered, we thought we’d take the opportunity to take a deeper dive into the state of mental health in Australia in 2018.
Mental Health is GP’s Biggest Concern
Perhaps not surprisingly, according to RACGP’s 2018 report, GPs most often cite mental health (50%) as their greatest concern for the future. Obesity was the only condition that followed closely behind (45%). Far less frequently, GPs selected diabetes (18%), an aging population (14%), drug addiction (12%) and chronic pain/palliative care (8%). These were the top 6 selected answers of 85 response categories.
Where’s the data?
One of the most difficult pieces to the mental health puzzle is the lack of current data on the issue. We can thank the RACGP for conducting their Health of the Nation report, which surveyed 1,537 RACGP Fellows, because the last time the government did a National Survey of Mental Health and Wellbeing was back in 2007 — over a decade ago.
This is a big shock considering a decade ago 45% of Australians were likely to experience a mental health condition in their lifetime. We can only assume these numbers have markedly increased as mental health concerns have crept from bad to extreme.
But which exact mental health issues are causing the most concern? According to the same decade-old data, the three most common mental health issues in Australia are: anxiety disorders, depressive disorders and substance abuse.
We did a little digging to see how these issues are faring in 2018.
The most recent study we could source on anxiety was a 2017 study of 150,000 participants from 26 countries.
“Alarmingly, out of all of these nations, Australia had the highest rate (8%) of anxiety disorders in the world, beating out New Zealand, the United States, Spain, Northern Ireland and other countries known for having large percentages of people suffering from anxiety.”
Compare this to the global average of 3.7% and it’s easy to see why mental health is a growing concern across Australia.
As with anxiety, depression is an enormous problem in Australia. According to The World Health Organisation’s 2017 Report, “Australians are among the most depressed people in the world with 5.9% of the population experiencing a depressive disorder.”
This is the highest rate of depression among countries in the Western Pacific Region, and falls just short of Ukraine (6.3%) who topped the worldwide list as the nation housing the most depressed people.
Tragically, the high rates of depression in the Australian population lead 85,980 people a year to attempt suicide. Approximately, 2,920 of them succeed. As a result, suicide is the most common cause of death in Australians between the ages of 15-44, making it more likely to kill someone than a car accident or skin cancer.
The most recent data we could find on substance abuse in Australia is from an Australian Institute of Health and Welfare report published in 2016. According to this report, 1 in 20 Australians had suffered from a substance abuse disorder in the past 12 months. Of those, tobacco and alcohol were the two substances abused the most.
Although people from all walks of life can experience substance disorders, they are twice as likely to affect men than women. Additionally, substance abuse is more common among people between the ages of 16-24. As people age, the prevalence of substance abuse declines.
Substance use disorders are more than twice as likely to occur among those who were never married and those who are separated, widowed or divorced (7.5% and 7.0% respectively) compared to those who are married (3.5%).
Disappointingly, the most recent data on psychotic disorders also goes back almost a decade. According to the 2010 report People Living With Psychotic Illness, an estimated 3.1 adults in 1,000 had a psychotic illness and were in contact with public specialised mental health services. Males aged 25-34 years had the highest rates of psychotic illness (5.2 cases per 1,000).
Of all those who had a psychotic disorder, more had a diagnosis of Schizophrenia (47%) than any other type of psychotic illness, and about two-thirds (64.8%) had their first episode of psychotic illness before the age of 25.
According to the most recent The Mental Health of Children and Adolescents report, which was conducted in 2015, “Almost 1 in 7 (13.9%) Australian children and adolescents were assessed as having a mental disorder in the previous 12 months.”
ADHD was the most common mental disorder (7.4%), followed by anxiety disorders (6.9%), major depressive disorders (2.8%) and conduct disorders (2.1%).
Almost one third (30%) of children and adolescents with a mental disorder, or 4.2% of all children and adolescents, had two or more disorders at some time in the previous 12 months.
Of those with a mental disorder, one in seven (14.7%) were assessed as having a severe mental disorder. This is equivalent to 1 in 50 of all Australian children and adolescents. Adolescents suffering from a mental disorder were almost three times more likely to experience a severe mental disorder (23.1%) compared to 4-11 year olds (8.2%).
56% of children and adolescents with mental disorders had used services for emotional and behavioural problems in the previous 12 months. This means almost 1 in 2 children and adolescents suffering from a mental disorder had no professional support.
Males and females compared
Some further digging on the above areas shows that Australian males are significantly more likely to develop a psychotic disorder than females. One 2010 report showed males had 3.7 cases of psychotic disorder in 1,000 compared to females having 2.4 cases in 1,000.
Australian men are also twice as likely to develop a substance abuse problem than Australian women, and three times more likely to commit suicide. On a global scale, men are also more than three times more likely to be diagnosed with antisocial personality disorder than women.
Depression, however, is more common among Australian females (5.1%) than males (3.6%). On a global scale, unipolar depression, predicted by The World Health Organisation to be the second leading cause of global disability burden by 2020, is twice as common in women. Women also tend to experience higher rates of anxiety and somatic symptom disorders.
If there was one takeaway from all of these findings it is that we need more current data on mental health. The fact is we know mental health is the number one concern in the Australian healthcare system. In fact, it is the number one global concern according to The World Health Organisation. So, why aren’t we conducting a national survey of mental health more frequently?
I have a suspicion things have gotten a lot worse over the past decade — especially considering that on a global scale the number of people living with depression increased more than 18% between 2005 and 2015 — but until we have actual data to look at we really are just guessing.
The good news is that, while the government is behind the times on collecting national data, they have far from neglected the issue. Funding for mental health research has increased substantially in recent years and initiatives like Mental Health Care Plans and more funding for organisations like Beyond Blue, Lifeline and SANE make access to mental healthcare support much more viable for everyday Australians.
The key here is to keep the conversation running, and the data up-to-date, so we can continue to try new things and measure their impact. Without such insights we have very little chance of closing the gap on mental health concerns.