What+Australia+Thinks+About+Mental+Illness

By Elizabeth Henderson Student Number: 8315302 Tutor: Judith Meikejohn

**CULTURAL ARTEFACT** [|Removing the Stigma from Mental Illness]

This video describes the importance of removing the stigma of mental illness in society, highlighting the fact that these conditions are similar to any other illness and that the sufferer has no control over their condition. It also comments on the importance of educating oneself before making assumptions about a person and their condition. Some common myths about mental illness are addressed, and five ways to avoid stigmatization listed. The video itself is a series of pictures, many artworks by Vincent Van Gough, accompanied by text and the songs “Fix You” by Coldplay and “Our Lives” by The Calling.

**PUBLIC HEALTH ISSUE** The prevalence in mental illness in Australia is concerning, with a recent study showing that 20% of the Australian population have shown symptoms of such an illness, and 45% of these reporting a lifetime disorder (Australian Institute of Health and Welfare, 2011). In 2003, mental illness was also identified as the leading cause of healthy years of life lost due to disability (Australian Bureau of Statistics, 2009). The way in which Australia deals with mental health today is therefore an important topic for social discussion. A mental illness is classified as a ‘health problem that significantly affects how a person feels, thinks, behaves, and interacts with other people’ (Department of Health and Ageing, 2007). It includes such disorders as depression, anxiety, schizophrenia, bipolar mood disorder, personality disorders and eating disorders. The Australian Government have dedicated many resources to the care of Australians suffering from these diseases, but, as highlighted in this video, the research shows that stigma and myths that surround mental illness are the real issues that needs attention to improving the lives of sufferers (SANE, 2006; Department of Health and Ageing, 2007).

**LITERATURE REVIEW** In 2007, 20% of Australians had experienced symptoms of a mental disorder in the last 12 months, while 45% percent had experienced such an illness at some point in their lives (Australian Bureau of statistics, 2009). The Department of Heath Western Australia predict that, in the year 2016, the burden of disease for psychosocial illness will become higher that the rates of cardiovascular disease (Rudd, 2007). The cost of mental illness in Australia due to lost productivity and labor force participation is estimated to come to $20 billion (Australian Bureau of Statistics, 2009). It is easy to see that mental health is an important issue in Australia, and it’s management has been a topic of concern for a number of years, with rates remaining relatively constant for over a decade (Australian Institute of Health and Welfare, 2000; Australian Institute of Health and Welfare, 2008).

The Australian Government has invested a substantial amount of resources into research, services and support to those suffering from mental illness. The responsibility of certain areas of mental health care are assigned to certain committees with the aim to more effectively provide suitable care. Research is conducted by the Mental Health Information Strategy Sub-Committee (MHISS) in the form of National Minimum Data Sets (NMDS), collected annually by each state and territory. This information is then used by the MHISS to advise on initiatives to attend to the aims of the National Mental Health Strategy (Australian Institute of Health and Welfare, 2011). This strategy began in 1993 with the intention of expanding treatment and support services, as well as moving towards community-based care (Department of Health and Ageing, 2011).

Most of the progress in mental health in the last decade has been a result of this strategy. Total government spending on mental health increased by 137% between 1993 and 2008, not including a range of health and welfare services provided by the government such as income support, housing services, domicilary care and employment and training opportunities (Department of Health and Ageing, 2011). In reducing the size of stand-alone hospitals by 63%, and subsequently doubling the number of psychiatric beds in general hospitals, mental health patients are being less isolated in their care (Department of Health and Ageing, 2011). Spending on community-based mental health services has also increased by 272% between 1993 and 2008 (Department of Health and Ageing, 2011).

Although the Australian Government has efficiently increased resources and support services for those suffering from mental illness, rates are still high, with a 1999-00 government report stating a 18% prevalence compared with 20% in 2007-08 (Australian Institute of Health and Welfare, 2000; Australian Institute of Health and Welfare, 2008). In 2007, approximately 872,000 people suffering from a mental illness felt they had an ‘unmet need for assistance’, the most common being for counseling, next information and social intervention (Australian Bureau of Statistics, 2009). In the same year, about two thirds of these people reported not using any of the services available, indicating a lack of accessibility or perhaps a lack of awareness (Australian Bureau of Statistics, 2009). And although there has been a move away from psychiatric hospitals to more community-based care in order to reduce the isolation and stigma attached to mental illness, these issue are still very much apparent in today’s society (SANE, 2006; Mental Health Foundation of Australia, 2009).

Current literature focuses on the need for understanding and building relationships between the patient, mental health professional, carers, and community groups (Rudd, 2007). A recent survey supports this, showing that many people with a mental illness believe ‘less stigma was the number one thing that would make their lives better (Hocking, 2003). One of the major issues presented in the past decade is the need for nursing education in mental health and how to deal with patients suffering from a mental illness (Calloway, 2007; Happel, 2010; Happell & Platania-Phung, 2005; McCann, Moxham, Farrell, Usher & Crookes, 2010). Nurses generally have the highest level of contact with patients, and so are responsible for most of their care (Happell & Platania-Phung, 2005). However, current nursing curricula is focused on generic skills, with the content of undergraduate courses lacking in skills and knowledge relating to mental health as stated by the Department of Human Services in 2001 (Happell & Platania-Phung, 2005). By integrating a focus on mental illness into the current nursing degrees, nurses will have a better understanding of those suffering from a mental disorder, and will better be able to build ‘relationship capital’ with these patients – ‘informal networking, information and exchange and capacity building’ (Rudd, 2007). This is considered to be the major change to the health care system needed to best provide the needs of mental health patients (Rudd, 2007).

The main issue identified in society pertaining to mental illness, however, is the incredible stigma attached. As identified in a brochure about mental illness by the Australian Government, ‘one of the biggest obstacles for people recovering from mental illness is confronting the negative attitudes of other people’ (Department of Health and Ageing, 2007). This discrimination comes from everywhere. In a recent survey, three out of four mentally ill persons said they had experienced stigma (SANE, 2006). This prejudice against their condition was reported from the community, their family and friends, and even health practitioners and nurses (SANE, 2006)! Discrimination against the mentally ill has also been reported when buying and claiming insurance, seeking housing, and even in seeking physical health care (Mental Health Council of Australia, 2011; SANE, 2008; SANE, 2008). In fact, discriminatory behavior by doctors can even lead to premature death for the mentally ill, with a tendency to discount the complaints of these patients as delusional (Hocking, 2003). Supporting this concern, a recent survey shows that, despite 90% of mentally ill patients reporting a chronic physical condition, almost half of these people also stated that their doctor had not discussed improving their health through exercise or diet (SANE, 2008). Considering the high rates of diabetes and heart disease amongst people with a mental disorder, this needs to be addressed urgently (SANE, 2008).

The level of stigma in the Australian community is obviously very significant. However, programs, campaigns and initiatives to combat this discrimination have been a major focus of many non-government organizations (NGOs) over the last number of years. In 2008, the government recorded about 400 NGOs involved in mental health (Department of Health and Ageing, 2011). The two most prominent of these are //beyondblue// and SANE Australia. Both of these organizations provide not only support and resources for the mentally ill, but also advertising campaigns, short films, and programs such as Movember, Anxiety and Depression Awareness Month and peer-support programs designed to raise awareness, improve knowledge and thus eliminate the historical prejudice and myths associated with mental conditions (Beyond Blue, 2008; SANE, 2011). In accordance with awareness programs initiated by NGOs such as these, discrimination is in fact reducing, with a recent survey indicating that 56% of those suffering from a mental disorder agree that attitudes towards their condition were improving (SANE, 2006). However, considering the evidence of discrimination against these people in the Australian community, there is still a long way for us to go.

**CULTURAL AND SOCIAL ANALYSIS** In attempting to understand the high prevalence of mental disorders in today’s society and how they come about, Durkheim’s theory of suicide can be applied – a theory that considers an individual’s level of societal integration as well as their ability to cope with rapid social change (Wills, 2002). During such times, an individual can experience ‘normlessness, helplessness, meaninglessness or estrangement from society and its changing norms’ (Wills, 2002). Changing circumstances also produce stress as individuals are forced to adapt accordingly (Wills, 2002). Durkheim also points out that ‘stress-buffering’ institutions such as the family, church and religion are weakened during these times, and as such separation from these ties occurs (Wills, 2002). All of these factors – stress, bereavement, relationship breakdown, social isolation, and unemployment – that Durkheim recognizes as resulting from such social change are also identified as factors contributing to the onset of a mental illness (Department of Health and Ageing, 2007).

Today’s society is identified as being in the ‘postmodern’ era – a time characterized by lack of organizations, increased individualization, weakened cohesion, isolation, and, specifically, rapid social change (Wills, 2002). Durkheim’s theory is therefore applicable to Australia’s current situation. A number of theories are also associated with this era that can come into explaining the acceptance of mental illness within the Australian community.

Michel Foucault is widely accepted as the father of postmodern theories (Mohr, 1995). Foucault believed in the cultural and social origins in the nature of meaning, values, identities, knowledge and power (Mohr, 1995). To put it simply, what is in our minds shapes who we are, and therefore how we behave, which in turn shapes our culture. Our culture then determines what is in our minds. Thus, our beliefs (about those suffering from a mental illness, for example) are determined by our culture. Postmodernism suggests that, focusing on an equality of rights, the individual is an ‘intersection of social identities’ (Mohr, 1995). Considering every single person is a different combination of these identities, this theory therefore suggests that all people are equal. However, the social identities are socially constructed according to ‘types’, and thus a certain ‘type’ of person will be inevitably be viewed by society differently (Mohr, 1995). So, while the introduction of postmodern thinking into today’s society is changing the perspective of mentally ill peoples as equals, the social construction of these ‘types’ of people is difficult to change.

An understanding of how these stereotypes occur is important for developing strategies in order to change them. While culture determines the social construction of mentally ill ‘types’, and is also a result of what is in our minds, therefore changing the knowledge of society and developing an understanding for mental disorder sufferers on an international scale, we might be able to combat the historical stigma against this group.

Also important to the support of the mentally ill is a knowledge of who is affected, and narrowing resources to target these groups. Another sociologist, Ulrich Beck, builds on Durkheim’s theory to suggest that rapid social change also produces increased ‘risk’ – ‘circumstances which threaten our trust in society leading to widespread personal insecurity’ (Wills, 2002). In postmodern society, the decrease in traditional institutions, being forced to continually ‘remake’ ourselves, and individualization causing people to be left to make their own decisions, increases this ‘risk’ (Wills, 2002). Beck speculates that this increased personal risk strengthens class divisions. Those with a higher socioeconomic status have the resources to protect themselves against risk, while those of lower socioeconomic status cannot, resulting in poor mental health (Wills, 2002). This theory is consistent with current literature, with people in lower socioeconomic situations reporting more symptoms of mental illness (Lahelma, Laaksonen, Martikainen, Rahkonen & Sarlio-Lahteenkorva, 2006).

Current research also points to a higher level of mental illness in younger people, especially mood disorders and substance use disorders (Australian Bureau of Statistics, 2009). Again, this could be related to Durkheim’s theory, as this age group experiences more of a social change as they move out of home, start a family, enter further education or finding suitable employment (Stein & Dumaret, 2011). A paper on the mental health of young people ageing out of care and entering adulthood supports this theory, with findings suggesting that there is an ‘increased risk of mental and physical problems at the time of ageing out of care’ (Stein & Dumaret, 2011). In addition, the family as a protective institution is weakened further as young people move out of home, increasing their level of Beck’s ‘risk’ (Wills, 2002).

Considering this information, the social construction of the mentally ill requires an increased awareness and advocacy on an international level to change our cultural stigma. As proved through Durkheim, Beck, and postmodern theory, the society we live in produces an increased risk for mental illness, particularly for those of low socioeconomic status and in young adults. Public health experts therefore need to focus their attention on these groups in the prevention and treatment of mental illness in Australia.

**ANALYSIS OF THE ARTEFACT AND MY LEARNING REFLECTIONS** The YouTube video //Reducing the Stigma of Mental Illness// articulates perfectly the effect that stigma in our society has on those suffering from a mental disorder. The clip makes some excellent points that really cause its audience to consider their personal contribution to stigmatization. It mentions the fact that it is human nature to fear what we don’t understand, and thus we put labels on people that are different to us because of that fear. And although much of Australian society would say that we are accepting of mental illness, wearing arm bands and ribbons on certain days and raising money for services, the video points out that we pick and choose certain disorders to accept. A long list of other mental illnesses flashes across the screen, and we can see that we do in fact have a negative attitude towards many of them. The lyrics of the song //Fix You// by Coldplay in the background also identify the pain associated with a mental illness:

//And the tears come streaming down your face// //When you lose something you can’t replace// //When you love someone but it goes to waste// //Could it be worse?//

With ‘//something lost’// referring to their health, and the reference of having no one they love to support them. The next song then reflects the hope of overcoming their disease, or perhaps the stigma associated with it:

//Cause these are the days worth living// //These are the years we're given// //And these are the moments// //These are the times// //Let's make the best out of our lives// //Even if hope was shattered// //I know it wouldn't matter// //Because these are the moments// //These are the times// //Let's make the best out of our lives//

What really struck me was the artwork of Vincent Van Gough in the background. He is one of my favorite artists - and he suffered from a mental disorder. He was shunned, placed in mental institutions, had two unsuccessful romances and was even abandoned by his family and friends, living a tortured, lonely life before finally committing suicide in 1890. Yet he still produced such beautiful artworks with a sensitivity to colour and eye for detail that could only be produced by someone with a real genius and utter passion for his work. Today, we say how horrible it was for people to treat someone with depression in this way, yet we do the same to people with different mental illnesses.

Another point identified by the video is that these illnesses are just like any other illness – caner, diabetes, heart disease – and yet they are considered by society to be different. Not only do they have the hardship of living with these conditions, but they must also cope with the stigma and isolation that accompanies it.

This assignment has taught me just how much of an issue mental illness is in Australia – I had no idea just how high the prevalence of these conditions was! It has taught me to really examine myself and my beliefs, and to consider life from the position of those that are discriminated against in society. It really amazes me how these people can go on living normal, productive lives dealing not only with the debilitating symptoms of their condition, but also the discrimination of the rest of society, and even by their family and friends. These people don’t deserve the labeling and discrimination that we place on them because of a simple illness - they deserve our respect and admiration for all they go through. We owe them at least that.

**REFERENCES** - Australian Bureau of Statistics. (2009). //Australian social trends, March 2009: Mental health//. Retrieved from: [] - Australian Government, Department of Health and Ageing. (2007). //What is mental illness?// [Brochure]. Canberra, NSW: Author. - Australian Government, Department of Health of Ageing. (2011). //National mental health report, 2010.// Retrieved from the Australian Government Department of Health and Ageing Website [] - Australian Institute of Health and Welfare. (2000). //Mental health services in Australia 1999-00//. Retrieved from the Austrlaian Institute of Health and Welfare Website [] - Australian Institute of Health and Welfare. (2008). //Mental health services in Australia 2007-08//. Retrieved from the Austrlaian Institute of Health and Welfare Website [] - Australian Institute of Health and Welfare. (2011). Mental health FAQ. Retrieved from [] - Beyondblue. (2008). Programs and Strategies [Brochure]. Hawthorn: Vic. - Calloway, S. (2007). Mental health promotion: Is nursing dropping the ball? //Journal of Professional Nursing, 23(2), 105-109.// [|doi:10.1016/j.profnurs.2006.07.005] - Happell, B. (2010). Moving in circles: A brief history of reports and inquiries relating to mental health content in undergraduate nursing curricula. //Nurse Education Today, 30(7), 643-648.// [|doi:10.1016/j.nedt.2009.12.018] - Happell, B. & Platania-Phung, C. (2005). Mental health issues within the general health care system: The challenge for nursing education in Australia. //Nurse Education Today, 25(6),// 465-471 doi:10.1016/j.nedt.2005.04.005 - Hocking, B. (2003). Reducing mental illness stigma and discrimination – everybody’s business. //The Medical Journal of Australia, 178(9), 47-48.// Retrieved from [] - Lahelma, E., Laaksonen, M., Martikainen, P., Rahkonen, O. & Sarlio-Lahteenkorva, S. (2006). - McCann, T. V., Moxham, L., Farrell, G., Usher, K., Crookes, P. (2010). Mental health content of Australian pre-registration nursing curricula: Summary report and critical commentary. //Nurse Education Today, 30(5), 393-397.// [|doi:10.1016/j.nedt.2009.08.002] - Mental Health Foundation of Australia. (2009). Our history. Retrieved from [] - Mental Health Council of Australia. (2011). Government support for Mental Health Commission shows commitment to reform. Retrieved from [] - Mohr, R. D. (1995). The perils of Postmodernism. //The Harvard Gay & Lesbian Review, 9-13.// Retrieved from [] - Rudd, C. J. (2007). Topic: Current issues in mental health service provision in Australia. //Journal of the Royal College of Nursing Australia, 14(3), 3-4.// [|doi:10.1016/S1322-7696(08)60556-9] - SANE Australia. (2006). Stigma and mental illness. Retrieved from [] - SANE Australia. (2008). Opportunity lost: lack of physical health care is hurting people with mental illness. Retrieved from [] - SANE Australia. (2008). People living with mental illness face housing crisis. Retrieved from [] - SANE Australia. (2011). Projects. Retrieved from [] - Stein & Dumaret. (2011). The mental health of young people aging out of care and entering adulthood: Exploring the evidence from England and France. //Children and Youth Services Review, 33(8).// doi:10.1016/j.childyouth.2011.08.029 - Wills et al. (2002). Ready to Die: African-American Adolescent Male Suicide. //Social Science & Medicine, 55, 6,// 907-920. Retrieved from __[]__

Note: the Beyondblue brochure can be downloaded online as a PDF from []