Mental illness is more ubiquitous than cancer. How can we help the ‘missing middle’?

Federal elections can act as a launchpad or watershed for major health reform. However, despite mental ill-health being the most potent of all disease categories in its contribution to disability, impact on the economy and as a major cause of premature death, it is typically the bridesmaid at election time. Promises of funding always feature “m” words not “b” words; that is, millions not billions. Yet every Australian is directly or indirectly affected by mental illness. It is even more ubiquitous than cancer and typically strikes early in life, not late. Polls always place mental health higher on the list of priorities for voters, especially undecided ones, than politicians acknowledge. The major parties still have time to address this blindspot.

The late Hans Rosling in his liberating book Factfulness shows us that, despite the impression most of us have, the facts show that most elements of our lives and of nearly all societies are slowly, silently, improving. Although many aspects of life remain bad and unacceptable, at the same time they are better than they were, even compared to 20 to 30 years ago.

As someone who has worked in mental health care for nearly 40 years, I would say this is true, even for mental health care. However, in contrast to the dramatic improvements we have seen in funding and outcomes in other areas of healthcare, notably cancer and heart disease, the improvements in mental healthcare are superficial and patchy, and have not had much, if any, positive effect on outcomes, such as suicide incidence and recovery rates. For more complex and severe forms of mental illness, the situation has become worse in terms of access, quality and the humanity of treatment. That is a big statement when one considers we have replaced the old Dickensian institutions and placed the care of the severely mentally ill in the hands of acute general hospitals. But there is a great deal of truth in it if one looks at the facts and the lived experience of people with mental illness and their families.

– The Guardian

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