Mark Latham’s opinion piece in last weekend’s Australian Financial Review titled On the one crucial difference between worry and anxiety nearly caused the internet to explode. What started as a film review of Birdman quickly turned into a more general discussion about Mr Latham’s views on mental illness. Whilst I strongly disagree with a number of his views, I welcome them at that same time. Why? Because I welcome debate and discussion about mental illness. Mr Latham’s article reflects, in my opinion, many of the stigmas still attached to the term “mental illness” and those people suffering from one. It demonstrates that whilst Australia has come a long way in terms of how we view and treat mental illness, we still have a long way to go.
“Go to Bunnings, build a bridge, get over it.” “Harden up.” “Pull yourself together.” “Personality weakness or character flaws cause mental health problems.” These statements all share one thing in common – they reflect a poor understanding of mental illness and make it hard for people experiencing psychological difficulties to ask for help. Anxiety is not your personality. Anxiety is not worrying. Anxiety refers to a range of psychological disorders and the diagnosis can only be applied to specific symptoms. It is not “a fad” or indeed “trendy” to be suffering from a mental illness, as stated by Mr Latham. It is appallingly hard, scary and disabling.
According to the Black Dog Institute, a highly respected not-for-profit organisation specialising in rapid translation of quality research into improved clinical practice, mental illness is very common. One in five Australians aged 16-85 experience a mental illness in any year. The most common mental illnesses are depressive, anxiety and substance use disorders. Almost half (45 per cent) of Australians will experience a mental illness in their lifetime (ABS 2007 data). Importantly, 65 per cent of people with mental illness do not access any treatment (Australian Institute of Health and Welfare, 2007). And tragically, at least six Australians die from suicide and a further 30 people will attempt to take their own life. Every day. Mr Latham quotes prevalence statistics for depression – “only 2% of Australians suffer from clinical depression”. The World Health Organisation estimates that depression will be the number one health concern in both the developed and developing nations by 2030. Depression has a high lifetime prevalence – one in seven Australians will experience depression in their lifetime. Depression has the third highest burden of all diseases in Australia. In Australia, the 12-month prevalence of anxiety disorders is estimated at around 14 per cent, not 2 per cent. Frequently, people can experience both symptoms of depression and anxiety, known as a comorbid diagnosis. Still think that mental illness only happens to a small percentage of Australians in any one year?
Cost to business and the economy
Mental illness is costing the Australian economy and business a lot of money. The annual cost of mental illness in Australia has been estimated at $AUS20 billion, which includes the cost of lost productivity and labour force participation (ABS). Employees suffering from a mental illness cost business in sick leave, WorkCover claims, “presenteeism”, lowered productivity and turnover. Recent research by SANE Australia highlighted that the majority of people feel unsupported when mentally unwell, and less than half of managers (43 per cent) have an understanding of mental illness.
Duty of care/legal obligations
Companies are legally required to protect employee safety, both mental and physical, and to do what is reasonable to ensure safe workplaces. Managers are obligated to have difficult conversations with employees if they believe that their performance is suffering due to experiencing a mental illness. This is not just a legal obligation but also an ethical one.
A 2014 study commissioned by Beyond Blue performed by Price Waterhouse Coopers estimates the return on investment on expenditure in improving employee wellbeing and mental health at $2.30 for every $1 invested. This is a big bottom-line impact.
Having the difficult conversation
According to Mr Latham, “anxiety used to be seen as a regular part of life – worrying about your children’s welfare, worrying about driving in the wet, worrying when you’re your footy team is behind in half-time – but now it is a front-line health condition, the medicalisation of normality”. I am grateful our lens as a society has shifted from viewing mental illness as something to be silently accepted, suffered individually, stigmatised, under-diagnosed and poorly treated. Anxiety is not worry. Depression is not feeling sad. Mental illness is prevalent and costing us all dearly. Companies that have a comprehensive strategy for improving the psychological wellbeing of their workforce and managing mental illness in their workplace have a competitive advantage. The bottom-line impact is tangible and sizeable. Over and above the financial benefits, managing mental health issues in the workplace is the right thing to do, as a decent employer and responsible corporate citizen. And looking at the prevalence data, let’s face it, it could happen to anyone of us. In fact, odds are, one in two of us. There but for the grace of God go I.
This article first appeared In Daily, 13 March 2015.