By John Mendoza, University of Sydney
Mental health disorders are the greatest contributor to the burden of disability and the third largest contributor to the burden of disease after all cancers and all cardio-vascular diseases. But unlike the progress we have made over the past 30 years in both cancer and CVD, life expectancy for people with severe mental illnesses has not improved nor has their participation in employment.
At least one in five Australians will experience a mental illness every year. Nearly half (45%) of all Australians will experience at least one episode of mental illness in their lifetime. Among younger Australians, 16-25, the prevalence of mental illness in any 12-month period is 28%. Around 600,000 adults have severe disability due to mental illness and another 750,000 moderate levels of disability. These people make up the largest groups of Disability Support Pension recipients and long-term unemployed.
Respected economist, Nicholas Gruen, reported in 2013 the estimated total costs of mental illness had reached a staggering A$190 billion or 12% of GDP – more than 50% above the next highest health cost, obesity. It’s estimated that 19 million absentee days per year are attributable to mental illness across Australia.
Despite this serious drag on our productivity, we invest just 7% of all healthcare spending and just 8% of medical research funds in mental health care and research. As former Australian of the Year, Patrick McGorry has frequently said, “We are simply way off scale when it comes to investing in mental health”.
The good news
- some mental illnesses are preventable
- the severity, impact and duration of many mental illnesses can be reduced if we get help early
- the overwhelming majority of people with a mental illness will recover when provided with evidence based care and support
- the available treatments are getting better
- workplaces can implement strategies to improve mental health and wellbeing, and
- people with a mental illness can and do work productively.
Given our ageing workforce, it is in Australia’s national interest to find ways to boost productivity, ensure there are not barriers to employment for people with a mental illness and implement positive workplace strategies to both retain the existing workforce and maximise productivity.
We know that work can be therapeutic for people with a mental illness. There is strong evidence to show that a positive workplace environment and a well designed job assists in recovery in addition to reducing the cost of absenteeism.
The impact of a “bad job”
Research by the Australian National University points to the damaging effect of a “bad job”, which is defined as one with low autonomy, high repetition and poor management.
These jobs can often be more damaging to one’s mental health and well-being than having no job at all. When you add a lack of understanding, bullying or judgement, the effects multiply dramatically.
More than posters
While displaying posters and embedding messages about mental health and well-being can help support those with a mental illness or encourage all employees to take action to be mentally healthy, the most effective mental health and well-being strategies involve integrated and systemic initiatives.
- Building a clear picture of the risk – the current mental well-being of the workforce, the workplace culture, policies and procedures and environmental risks
- Engaging the leadership, staff and other key stakeholders to plan a better future – a blueprint for change
- Integrated learning and development initiatives to ensure leaders and staff build their personal and group resilience, have the skills to complete current roles and act to include others appropriately
- Reviewing existing policies and procedures to facilitate effective promotion and management of mental health and well-being, including recruitment and return to work, and
- Continuous improvement through measuring, evaluating and reporting on progress and workforce mental health and well-being status.
Mental health and productivity are linked
Regrettably too few workplaces in Australia have embraced these initiatives. Too few Australian workplaces are hiring and retaining those with a mental illness. This has to change and if it does change, it will provide a significant productivity boost to the nation just when we need it most.
I recently attended a forum in the US involving government, Defence, large and medium enterprises, researchers and service providers. Major US corporations such as tw telecom, US Postal and Union Pacific all demonstrated their efforts to reduce the impact of mental illness and in particular suicide within their workforces. What was most impressive was the sophistication of the strategies deployed – it was more than feel good – but an integrated suite of strategies to address leadership, workplace culture, employment policy and practices and mental health promotion programs.
While we are starting to see good evidence of programs in the major construction industry in Queensland and NSW resulting in fewer suicides, we do not have enough major Australian corporations or government agencies demonstrating a strategic and sustained focus on mental health and productivity. As for our governments recognising this opportunity, regrettably this is still a work in progress.
John Mendoza is a Director of ConNetica Consulting and an Adj. Professor Health and Sport Sciences, University of the Sunshine Coast and Adj Associate Professor with the Brain and Mind Research Institute at the University of Sydney.