The number of working-age Australians receiving the Disability Support Pension for mental health issues increased by about 50 per cent over a 13-year period, even though prevalence of the conditions remained stable.
Researchers led by associate professor Samuel Harvey from the Black Dog Institute and the University of NSW have raised the “paradox” after studying the prevalence and impact of conditions such as depression and anxiety between 2001 and 2014.
The unexplained surge in DSP payments for people with mental health issues is likely to reignite the political debate over the rigour applied to welfare assessments. It may also inflame tensions between governments over the cost of support, including through the National Disability Insurance Scheme.
Reporting their findings today in the Medical Journal of Australia, the researchers dismissed the “common belief that we are in the midst of a mental health epidemic” but warned that the impact of psychiatric conditions on work, society and the economy was significant, and still not fully understood.
“Over the same time period, the proportion of the Australian population receiving DSPs for psychiatric conditions increased by 51 per cent, equivalent to one additional DSP for mental ill health for every 182 working-age Australians,” they wrote.
“While the increase may reflect better recognition of and greater willingness to diagnose mental disorders in working Australians, it also means greater emphasis on, and more research into, improving occupational outcomes for people with mental illness are needed.”
Growth in spending on the DSP has stabilised in recent years but it is still a significant part of the federal budget, forecast to cost about $17 billion in 2017-18.
Mental health experts have repeatedly called for a greater focus on early intervention and effective treatment.
The researchers noted that most people with depression or anxiety continued to work in some capacity but the conditions were taking up a greater proportion of new DSPs granted.
Commenting on the results, Harvey Whiteford from the University of Queensland said the findings on prevalence matched other studies and surveys but the reason for the DSP trend was unclear.
The researchers gave four possible reasons for the trend.
Professor Whiteford downplayed the prospect of fewer jobs leading more people on to the DSP, saying they would more likely have gone on to the unemployment queue, and dismissed the possibility of an underlying increase in incidence of mental illness being partly masked by treatments.
“The first and second possibilities, an increasing tendency to apply a psychiatric disability label and a change in disability policy settings for welfare support payments, seem most plausible, and should be further explored,” he wrote in an MJA editorial.
“Empirical evidence about how providers select the disability type is scarce, as is information on how changes in disability policy have affected the awarding of pensions to people with mental health problems.”
Professor Whiteford called for an examination of the threshold for the allocation of DSPs and the type of support offered.
He also noted that “the challenges posed by the introduction of the National Disability Insurance Scheme for people with psychiatric disability are significant”.
This piece by Sean Parnell was first seen on ‘The Australian’ June 12 2017.