Opinion — 01 February 2013

From Wednesday, more than a million NSW students will begin a new year at primary and high schools while another 400,000 will proceed with their studies at TAFE or university.

Now more than ever, education is a passport to personal satisfaction and worldly success, while a lack of formal qualifications excludes people from an increasingly wide range of occupations.

But we know a very substantial minority of this year’s students will struggle to complete their education because they suffer anxiety, depression or other mental conditions that affect their ability to participate at the very time when participation is most critical. The teen years, so essential for study and to prepare for an eventual safe landing in the workforce, are also a time of peak vulnerability to mental health problems.

In contrast to the most disabling physical diseases, mental illness usually makes its presence felt early.

By age 14, half of all lifetime cases are already apparent while three-quarters have their onset by age 24.

Risky drug and alcohol use may also begin at this time, and may be either a cause or a consequence of psychological problems.

Disordered eating is typically detected in adolescents, but can also affect younger children.

Mental disorders account for an exceptionally high proportion of the total burden of illness suffered by younger people – 36 per cent of it in people aged 15 to 44, according to the Australian Institute of Health and Welfare – double the impact of injuries and five times that of cancer.

The consequences can hardly be overstated.

Australian Bureau of Statistics figures show mental illness rates are as much as one-third higher in people who have not completed secondary school compared with those who have some form of post-school qualification.

The ABS data further shows that those with at least a year 12 qualification are considerably more likely to have a job at any point during adulthood, and the gap is most pronounced for those in their 20s and 30s.

Across the entire income spectrum, people who completed high school earn more money than those who left school earlier, but the difference is starkest in higher income brackets.

More than two-thirds of people in the top 20 per cent of earners completed year 12.

A federal parliamentary report last year on mental health and workforce participation described how early mental illness locks in a lifetime of disadvantage.

It found ”a lack of adequate support to complete educational qualifications can lead to lower job prospects, if not unemployment and a life on the disability support pension”.

Universities told the same inquiry they were seeing a growing number of students who require help for mental health issues – about a third of those who sought support for any type of disability.

The report, by the standing committee on education and employment, identified intimidating campuses and inflexible course structures as barriers to participation.

It said young people with mental illness frequently internalised other people’s low expectations for their education – including those of parents motivated by a wish to protect a son or daughter from stress. But schools are also a key setting for promoting positive mental health, fostering resilience, identifying students at high risk in order to prevent problems from developing, and intervening early when problems are observed.

Programs already in use across NSW aim to increase mental health literacy and teach cognitive behaviour therapy principles to enhance students’ sense of self-worth, belonging and purpose.

School counsellors provide an invaluable outlet for children’s and adolescents’ concerns, and may connect students to formal services where needed.

This year the NSW Mental Health Commission, directed by its own act of Parliament, will consult widely with individuals and representative groups to create a blueprint for reform of mental health services.

Despite previous conscientious efforts and ambitious plans, people are still not getting the help they require.

Particularly lacking are services that offer treatment and practical support to people in their community and reduce the current unacceptable high reliance on hospital-based care.

But the facts about mental illness and education – and how the interaction between them shapes the course and fabric of people’s lives – serve as a reminder that responsibility for positive change does not end with the health portfolio.

For this reason the NSW commission’s recommendations will extend to all government departments and agencies whose policies and services may affect the chance of developing a mental illness or recovering from it.

They will also have regard to the vital service role played by non-government organisations. Through the blueprint, the commission will publicly ask government agencies and non-government groups to better meet the needs of people who experience mental illness: one in five of us in any one year and many more over a lifetime.

This mandate to promote improvements across the entire spectrum of government activity sets the commission’s work apart, and presents a unique opportunity to break old circuits and secure real change for one of the most disadvantaged groups in our society.

The commission will frame its recommendations according to those things people living with mental illness and their carers say matter most.

Full participation in society, with meaningful work and a home and family, should be a reasonable aspiration for everyone.

John Feneley is the NSW Mental Health Commissioner.


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(2) Readers Comments

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