- What is mental illness?
- Who is most likely to have mental illness?
- What is the burden of mental illness in Australian society?
- How do people get mental illness?
- When do people get mental illness?
- How do we treat mental illness?
- What services exist for people with mental illness?
Serious and persistent mental illness means a mental illness which is severe in degree and persistent in duration, which causes a substantially diminished level of functioning in the primary aspects of daily living and an inability to cope with the ordinary demands of life, which may lead to an inability to maintain stable adjustment and independent functioning without long-term treatment and support and which may be of lifelong duration. Serious and persistent mental illness includes schizophrenia as well as a wide spectrum of psychotic and other severely disabling psychiatric diagnostic categories, but does not include infirmities of aging or a primary diagnosis of mental retardation or of alcohol or drug dependence.
(Wisconsin statutes, Chapter 51)
Examples of types of mental illness include short-term and long-term conditions and psychotic and non-psychotic disorders, such as depression, anxiety, bi-polar, affective disorders, mood disorders, personality disorders, schizophrenia and eating disorders.
The prevalence of mental illness is high in Australia and other western countries. About one in five adults will experience symptoms of mental illness in a 12 month period—this means that 2.4 million Australians had at least one condition during the last year. The most common illnesses are anxiety, depression and alcohol dependence disorders. Psychotic illnesses such as schizophrenia and severe mood disorders are less common, but are usually very disabling.
Every person is vulnerable to mental health concerns, although some mental illnesses, such as schizophrenia, appear to be more common in some families. While men and women have similar overall prevalence rates, men are more likely to have substance use disorders and women are more likely to have experienced anxiety disorders.
The Australian Institute for Health and Welfare reported mental disorders to be the third leading cause of overall disease burden, accounting for 13 per cent of total burden and 27 per cent of total years lost to disability. Mental disorders rank third after heart disease and cancer as the largest causes of illness related burden in Australia. However, they represent the largest cause of disability, accounting for nearly 30 per cent of the burden of non-fatal disease. Depression and anxiety account for nearly half of thisburden. Depression was the leading single cause of disability.
(The burden of disease and injury in Australia, AIHW, 1999)
Mental disorders are estimated to account for substantial lost productivity in the workplace. In Australia it is estimated that absenteeism due to depression accounts for around six million working days lost each year, at a cost to employers of approximately $1.2 billion. In addition, depression is estimated to reduce workers performance by at least 40 per cent. For the Australian workforce as a whole, this equates to around 30 million working days per year with reduced productivity, at a cost to employers of approximately $2.3 billion.
(Work Outcomes Research and Costs-benefit [WORC] Project 2000, University of Queensland)
Although a predisposition to some mental illnesses can run in families, everyone is potentially vulnerable. Risk factors for mental illness include illicit drug use, smoking, alcohol misuse and dependence, socioeconomic disadvantage and life events such as trauma, stress, bereavement, unemployment etcetera.
Mental health conditions typically appear in people in their early adult years and may be a single episode or may recur throughout their lives. The 1997 National Survey of Mental Health and Wellbeing found that the prevalence of mental illness was highest among 18 to 24 year olds, reflecting high rates of substance use disorders, and was lowest for people aged over 65 years.
Many factors can trigger the onset of a mental illness, including stress, bereavement, relationship breakdown, child abuse, unemployment, social isolation, accidents and life-threatening illnesses.
Mental disorders fall into two categories and treatment depends upon which type a person presents with.
Psychotic illnesses are a group of illnesses that affect the brain and cause a change in thinking, emotion and behaviour. People with psychoses might develop delusions, or have hallucinations. The most well-known psychotic illness is schizophrenia, and includes bi-polar disorder and major depressive disorder.
Effective medication and support from health professionals mean that most people who experience a psychotic illness are able to live productive and rewarding lives.
Non-psychotic illnesses can affect some people's ability to cope with day-to-day activities such as going to work, enjoying leisure time and maintaining relationships. They include anxiety disorders, depression, eating disorders, post-traumatic stress and obsessive-compulsive disorders.
Most non-psychotic illnesses can be effectively treated, usually with a combination of medication and therapy, which help the person understand their illness, manage their symptoms and lead satisfying lives.
(Mental Illness—The facts, National Mental Health Strategy)
In Australia there is a range of services offered for consumers. There are multiple providers working in specialised mental health services, primary care services or other health services.
- Specialised mental health services are those in which the primary function is to provide treatment, rehabilitation or community support for people affected by mental illness. Such activities are delivered from a service or facility which is readily identifiable as both specialised and serving a mental health function. These include services provided by state and territory mental health services such as psychiatric units in hospitals, community residential units, child and adolescent services, as well as private psychiatrists and psychologists.
- Primary care services are those providing a socially appropriate, universally accessible level of care, supported by integrated referral systems. They do so in a way that gives priority to those in most need, maximises community and individual self-reliance and participation, and involves collaboration with other sectors. These include services such as community health centres, general practitioners and allied health professionals.
- Other mental health services include those not classified as primary care or specialised mental health care services, but provide some form of mental health care or rehabilitation. These include services provided by public and private aged care homes and private hospital units.
(Senate Inquiry into the provision of mental health services in Australia, Australian Government 2005)