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What is mental health?
Mental health is 'the capacity of individuals and groups to interact with one another and the environment, in ways that promote subjective well-being, optimal development and the use of cognitive, affective and relational abilities'. A diverse range of social, environmental, biological and psychological factors can impact on an individual's mental health. In turn, people can develop symptoms and behaviours that are distressing to themselves or others, and interfere with their social functioning and capacity to negotiate daily life. These symptoms and behaviours may require treatment or rehabilitation, including hospitalisation.
The initial focus of the NHPA initiative in mental health is upon depression.
Why is mental health a National Health Priority Area?
Mental health is one of the leading causes of non-fatal burden of disease and injury in Australia. It is associated with increased exposure to health risk factors, poorer physical health, and higher rates of death from many causes including suicide. Mental health problems are responsible for a large proportion of disability cases, incur high direct and indirect costs, result in high numbers of hospitalisations, and impose a heavy burden of human suffering, including stigmatisation of people with mental disorders and their families.
More than three million Australians are estimated to experience a mental disorder, with more than 50% of those affected long term. Mental health disorders are believed to be more prevalent among residents of rural and remote area than those in metropolitan areas, and also for people of Aboriginal or Torres Strait Islander descent. Suicide rates, especially among young males, are much higher for these groups than the general population.
The 2007 second National Survey of Mental Health and Wellbeing estimated that 1 in 5 Australians aged between 16 and 85 years experienced one or more of the common mental disorders in the 12 months before the survey. These were mood disorders (such as depression), anxiety disorders and substance use disorders. An additional one-quarter of those surveyed, while not experiencing one of these disorders in the 12 months beforehand, had done so at some time in the past. Thus, 45% of respondents had experienced a mental disorder in their lifetime. This equates to 7,286,600 Australians aged 16 to 85. (Australia's health 2010 pages: 166-168, June 2010)
A mental or behavioural disorder was recorded as the underlying cause of death for 667 deaths in 2007-0.5% of all deaths in that year. These deaths exclude suicide and dementia. Most of the deaths with a mental or behavioural disorder as the underlying cause of death were due to the use of psychoactive substances such as alcohol and heroin. (Australia's health 2010 pages: 171-172, June 2010)
The 2007 Survey of Mental Health and Wellbeing estimated that 12% of the population aged 16-85 years had used a health service for a mental health problem in the previous 12 months. This equates to 1.9 million people, of which 63% were female. Females with a mental disorder in the previous 12 months used services at a greater rate than males-41% compared with 28%. (Australia's health 2010 pages: 172-173, June 2010)
More than one-quarter (26%) of the youngest age group (16-24 years) had experienced a mental disorder in the preceding 12 months. Overall prevalence rates decreased as age increased. Anxiety disorders were the most common in all age groups. Substance use disorders were the least common, except in the 16-24 years age group where they were ranked second. (Australia's health 2010 pages: 166-168, June 2010)
There were more mental health-related encounters for female patients than there were for male patients (61.5% and 38.5%, respectively). However, allowing for the higher rate of GP attendances for females, the difference between the sexes was not as marked-an estimated 12.4% of all female encounters with GPs were mental health-related compared with 10.6% for males. (Mental health services in Australia 2007-08 pages: 14-17, August 2010)
Why focus on depression?
Depression is a mood disorder characterised by feelings of sadness, loss of interest or pleasure in nearly all activities, feelings of hopelessness and suicidal thoughts or self-blame. It is understood to be a condition that generally comes and goes, that is more likely at certain stages of the life cycle, and is driven either by genetic and biological factors or is a result of response to major life events. Depression is commonly linked with a range of health risk behaviours, including tobacco use, illicit drug use, alcohol misuse and dependence, eating disorder and obesity.
In recognition of its high prevalence, associated social, human and economic costs, and public health impact in Australia, the National Health Priority Action Council (NHPAC), in consultation with the National Mental Health Working Group (NMHWG), identified depression as requiring a particular focus under this National Health Priority Area.
Depression was the most frequently managed mental health-related problem in 2008-09, accounting for 34.3% of all mental health-related problems managed and 2.8% of all health problems managed. (Mental health services in Australia 2007-08 pages 15-17, August 2010)
Depression occurs frequently in combination with other mental disorders such as anxiety disorders. It also occurs in combination with other National Health Priority Area diseases and conditions. Depression is also commonly associated with suicide in all age groups. After a previous suicide attempt, depression is the next highest risk factor for youth suicide.