Mental health

NHPA Mental Health

Contents

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.

In 2003, mental or behavioural disorder was listed as the underlying cause in 3,241 deaths in Australia. Mental health problems are estimated to have accounted for almost 5% of all GP attendances in 2003-04. There were 301,115 hospital separations with either a mental health-related principal diagnosis or a record of specialised psychiatric care in 2002-03, comprising 4.5% of all separations.

In 1996, mental problems or disorders were responsible for over 13% of the burden of disease in Australia, in terms of disability-adjusted life years (DALYs). In monetary terms, the direct costs of mental problems or disorders was estimated at $3,018 million in 2000-01.

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.

In any given year, almost 800,000 Australian adults will experience a depressive illness - the third most common cause of illness among women and the tenth most common cause among men. In 2003-04, depression was the fourth most frequently managed problem by general practioners in Australia.

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.

About twice as many women as men experience depression. Females aged 18-24 have the highest risk of suffering from depression compared to the other age groups, whereas the prevalence peaks in males aged 35-44. Elderly people (aged 65 and over) are also at increased risk of suffering from depression, because of a range of life events including physical illness, social isolation, loneliness, chronic pain, living conditions and bereavement.

Depression causes a substantial burden of morbidity, disability and mortality. Depression accounted for just under 4% of DALYs in Australia in 1996 or 27.8% of all mental health DALYs. In direct monetary terms, it is estimated that in 2000-01, $1,042 million was spent in health system costs associated with depression. However, given the impact that depression has not only on the individual, but also on their family, friends, colleagues and society in general, the true burden is not possible to quantify.