COVID has presented unique challenges for people with eating disorders. They’ll need support beyond the pandemic



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Laura Hart, University of Melbourne and Andrea Phillipou, Swinburne University of Technology

COVID-19 has changed the way we live, work and interact with one another. It has also changed the way we move, exercise, shop, prepare food, and eat.

During the pandemic, we’ve seen marked increases in reports of mental distress across the board. But Australian and international research suggests lockdown measures have presented unique challenges for people living with eating disorders.

Eating disorders are complex mental illnesses

Eating disorders include anorexia nervosa, bulimia nervosa, binge eating disorder and other diagnoses. They centre around disordered eating (for example, fasting and dieting, binge eating, or purging behaviours), and often include problems with body image.

Eating disorders are frequently associated with high levels of depression and anxiety.

For some people with these conditions, rigid routines (around exercise, food preparation or eating habits), are a way of coping with symptoms and distress.

It’s no secret the pandemic has significantly disrupted our usual routines. For example, working from home may have led people to be more sedentary, or allowed more time for exercise. Social distancing has meant we’ve spent less time seeing others and sharing meals.

A man and a woman are eating in a cafe, but the man is disinterested in his food.
People of different ages, genders and backgrounds can develop eating disorders.
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COVID-19 restrictions and social distancing measures, though imperative to reduce the spread of the virus, have resulted in a significant rise in psychological distress, especially for people experiencing social isolation, reduced or uncertain employment, financial strain, or health concerns.

We know people with existing mental health problems have been particularly vulnerable. However, people with eating disorders are vulnerable not only to these mental stressors; but also to the physical changes to everyday routines, and social conversations about eating and body weight which have popped up during lockdowns.




Read more:
How many people have eating disorders? We don’t really know, and that’s a worry


What does the research say?

Research published early in the pandemic predicted COVID-19 and the associated restrictions may increase eating disorder risk in a few important ways:

  • disruptions to daily routines and reduced access to social supports

  • increased exposure to anxiety-provoking media (messages about possible links between high body mass index and COVID, or joking on social media about weight gain during lockdown)

  • increased use of videoconferencing where people are exposed to their own image on camera

  • anxiety about contracting COVID-19 — the authors suggested this may lead people with eating disorders to engage in dieting for perceived immune system benefits.




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Australian researchers conducted what was to our knowledge the first published study on disordered eating behaviours during COVID-19. Participants with eating disorders reported a worsening of symptoms — they were restricting their food consumption, binge eating and engaging in purging behaviours more often. They also reported doing more exercise, and high levels of depression, anxiety and stress.

Studies from around the world have since shown similar results. They’ve also found people with eating disorders have reported increased fears about not being able to find foods consistent with meal plans, while disruptions to routine have led to heightened psychological distress and worsening of eating disorder symptoms.

It comes as little surprise demand for eating disorder support has increased significantly. The Butterfly Foundation — Australia’s leading support organisation for people affected by eating disorders and body image issues — has reported a 57% increase in calls to its helpline over the course of the pandemic.

Similarly, inpatient and outpatient services around Australia — particularly in Victoria where residents experienced a prolonged second lockdown — have seen demand increase, resulting in longer wait lists for eating disorder services.

A group counselling session.
People with eating disorders are likely to need extra support beyond the pandemic.
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Looking ahead

Although we still don’t know what the long-term psychological effects of COVID-19 will be, previous pandemics such as SARS have taught us these sorts of crises can result in long-term mental health impacts, and may trigger the onset of mental illness, including depression and anxiety.

We don’t know yet conclusively whether the pandemic has triggered the onset of eating disorder symptoms or increased the incidence of these conditions. It doesn’t make it any easier that our understanding of the prevalence of eating disorders in Australia was poor to begin with.

But it does seem highly likely that we will see such increases. The information we have so far suggests pandemic-related challenges can increase the risk for people with eating disorders, or those who may be vulnerable to developing them, in many and varied ways.




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In addition, some research suggests food insecurity is associated with increases in eating disorders, and binge eating in particular.

So even if the pandemic is brought to an end with widespread vaccination, if the associated economic recession results in ongoing disruptions to food supply chains, or in impoverished households having limited or unreliable access to food, we may see further increases in eating disorders, well beyond the life of COVID-19.

It’s critical clinical services and support organisations provide extra support to these groups, not only during the pandemic, but for a significant amount of time after the crisis has resolved. This includes increased access to treatment, as well as online eating disorder supports like chatbots, and telephone hotlines.


If this article has raised concerns about body image or eating disorders, please contact the Butterfly Foundation national hotline on 1800 334 673, or visit their website.The Conversation

Laura Hart, Senior Research Fellow, University of Melbourne and Andrea Phillipou, Senior Research Fellow, Swinburne University of Technology

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Young people are exposed to more hate online during COVID. And it risks their health



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Joanne Orlando, Western Sydney University

COVID has led to children spending more time on screens using social networks, communication apps, chat rooms and online gaming.

While this has undoubtedly allowed them to keep in touch with friends, or connect with new ones, during the pandemic, they are also being exposed to increased levels of online hate.

That’s not just the bullying and harassment we often hear about. They’re also being exposed to everyday negativity — Twitter pile-ons, people demonising celebrities, or knee-jerk reactions lashing out at others — several times a day.

This risks normalising this type of online behaviour, and may also risk children’s mental health and well-being.

What are children exposed to?

Hate speech can consist of comments, images or symbols that attack or use disapproving or discriminatory language about a person or group, on the basis of who they are.

It can even be coded language to spread hate, as seen on the world’s most popular social platform for children, TikTok. For example, the number 14 refers to a 14-word-long white supremacist slogan.




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People can be exposed to hate speech directly, or witness it between others. And one study, which analysed millions of websites, popular teen chat sites and gaming sites, found children were exposed to much higher levels of online hate during the pandemic than before it.

The study, run by a company that uses artificial intelligence to detect and filter online content, found a 70% increase in hate between children and teens during online chats. It also found a 40% increase in toxicity among young gamers communicating using gaming chat.

Of particular note is the rise of hate on TikTok during the pandemic. TikTok has hundreds of millions of users, many of them children and teenagers. During the pandemic’s early stages, researchers saw a sharp spike in far-right extremist posts, including ideologies of fascism, racism, anti-Semitism, anti-immigration and xenophobia.

Children may also inadvertently get caught up in online hate during times of uncertainty, such as a pandemic. This may be when the entire family may be in distress and children have long periods of unsupervised screen time.




Read more:
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Witnessing hate normalises it

We know the more derogatory language about immigrants and minority groups people are exposed to (online and offline), the more intergroup relations deteriorate.

This leads to empathy for others being replaced by contempt. Terms like “hive mind” (being expected to conform to popular opinion online or risk being the target of hate) and “lynching” (a coordinated social media celebrity hate storm) are now used to describe this online contempt.

Being exposed to hate speech also leads young people to become less sensitive to hateful language.
The more hate speech a child observes, the less upset they are about it. They develop a laissez-faire attitude, become indifferent, seeing hateful comments as jokes, minimising the impact, or linking hateful content to freedom of speech.

Teenage girls playing soccer outside, both trying to kick the ball.
In real life, people are sent off the pitch for bad behaviour. But there is no such consequence in online gaming.
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There is also little reputational or punitive risk involved with bad behaviour online. A child playing soccer might get sent off the field in a real-life sporting game for “flaming”, or “griefing” (deliberately irritating and harassing other players). But there is no such consequence in online gaming.

Social platforms, including Facebook and TikTok, have recently expanded their hate speech guidelines. These guidelines, however, cannot eradicate hate speech as their definitions are too narrow, allowing hate to seep through.

So kids are growing up learning “bad behaviour” online is tolerated, even expected. If what children see every day on their screen is people communicating with them badly, it becomes normalised and they are willing to accept it is part of life.




Read more:
Technology and regulation must work in concert to combat hate speech online


Witnessing hate affects children’s health and well-being

Prince Harry recently warned of a “global crisis of hate” on social media that affects people’s mental health.

It impacts the mental health of all involved: those giving out the hate, those receiving it, and those observing it.

If a young person has negative, insulting attitudes or opinions, this is often put down to having unresolved emotional issues. However, channelling pent-up emotions into hate speech does not resolve these emotional issues. As hate posts can go viral, it can encourage more hate posts.

And for people who are exposed to this behaviour, this takes its toll.
The increased mental preparedness it takes to deal with or respond to microaggressions and hate translates into chronically elevated level of stress — so-called low-grade toxic stress.




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In the short term, too much low-grade toxic stress lowers our mood and drains our energy, leaving us fatigued. Prolonged low-grade toxic stress can lead to adverse health outcomes, such as depression or anxiety, disruption of the development of brain architecture and other organ systems, and increases in the risk of stress-related disease and cognitive impairment, well into the adult years.

It can also cause a child to develop a low threshold for stress throughout life.

Children growing up in already vulnerable, stressed environments will be more impacted by the stress they are also exposed to long-term online.




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What to do

Unfortunately, we can’t eradicate hate online. But the more we understand why others post hate speech and the strategies they use to do this helps a child be more in control of their environment and therefore less impacted by it.

Hate speech is driven not only by negativity, but also by the simplicity in how groups are portrayed, for instance, boys are superior, girls are side-kicks. Teach children to notice over-simplicity and its use as a put-down strategy.

An aggressor (the one dishing out the hurt) can also easily hide behind a non-identifying pseudonym or username. This type of anonymity allows people to separate themselves from who they are in real life. It makes them feel free to use hostility and criticism as a viable way of dealing with their pain, or unresolved issues. Teach your child to be aware of this.


Resources on the impact of toxic stress on young people, mental health support and what to do if you experience or witness online hate are available for parents and children.

If this article has raised issues for you, or if you’re concerned about someone
you know, call Lifeline on 13 11 14.
The Conversation

Joanne Orlando, Researcher: Children and Technology, Western Sydney University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Bushfires, drought, COVID: why rural Australians’ mental health is taking a battering



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David Perkins, University of Newcastle and Hazel Dalton, University of Newcastle

Among the Bushfire Royal Commission’s 80 recommendations, released last week, was a call to prioritise mental health support during and after natural disasters.

The Australian Medical Association this week called on the federal government to implement the recommendations to lessen the health impacts of future disasters, noting the ongoing mental health fallout from the 2019-20 Black Summer bushfires.

The Royal Commission’s report comes as Australia heads into a bushfire season during a pandemic. Some farmers have this year lost their crops due to unseasonal rain and hail, as many rural communities anticipate further “big weather” events. Certain local economies, which are reliant on exports like wine and barley, are concerned about strained trade relations with China.

The combined effects of these adverse events is taking a toll on the health and well-being of rural people.

A year of cumulative stress

Australian Bureau of Statistics figures released last month showed rural suicide rates are much higher than those in the big cities.

The causes of psychological stress for rural people are many and varied, depending on who you are and where you live. Many are facing environmental and weather events at increasing frequency and intensity. Some of these events happen rapidly, such as fire and floods, whereas others are long-lasting and uncertain, like drought.

The effects of these events include direct losses such as injury and death, as well as loss of livestock and buildings. Indirect losses include declines in businesses and employment, and the disruption of social fabric when friends or family leave town.

Recovery or adaptation can take many years.




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Distress, depression and drug use: young people fear for their future after the bushfires


These stresses of course come in addition to life’s normal challenges likes illness, bereavement and relationship breakdown.

For rural people, COVID has likely compounded these cumulative stresses and contributed to higher levels of trauma, mental ill-health and in some cases, suicidal behaviour.

Band-aid policies

In most rural communities, access to mental health services is relatively poor.

There’s longstanding evidence Medicare Benefits Scheme expenditure for mental health services is skewed towards metropolitan services.

State expenditure is focused on hospital services and care for those with high and complex needs. Consequently, many rural people with mild to moderate needs are under-served.

Traditionally, governments respond to crises reactively and by treating these events as short-term and disconnected. But this isn’t the experience of rural people.

Each adverse event is accompanied by (usually short-term) funding announcements by governments and agencies for new Headspace centres, expanded telephone helplines, websites, counsellors, or coordinators in the most affected areas.

Sometimes there’s overlap of effort across different government departments, federal and state jurisdictions or from different disaster responses, potentially wasting resources.

For example, in NSW, the longstanding drought has recently broken. But the social and economic recovery will take longer — possibly up to five years with consistent rain as it did following the Millennium drought.

Counsellors were funded to support rural residents during the drought in 2018, with more counsellors funded in response to the bushfires. And now additional services are being offered due to COVID.

While the extra support is welcome, the fragmentation and temporary nature of the funding means rural people may not know what services are available, and accessing services becomes confusing.

What’s more, with short-term contracts, it may be the same staff moving between roles and agencies, therefore not actually adding new staff to support local rural communities. This funding instability makes it difficult to retain a stable rural mental health workforce.




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What can be done?

In the first instance, policymakers need to ask people living in rural areas what they need and involve them in the process of developing appropriate and accessible services.

Second, we need to adopt a systemic approach that examines the full range of adverse events that affect the mental health and well-being of individuals, families and communities. This means going beyond treating illness, to addressing environmental, economic, social and personal factors.

As part of this, we need people on the ground to support communities through preparedness activities such as educating people about mental health and how to access services, while stepping into disaster response and recovery as needed. Continuity and building on what already exists locally is key.

The Rural Fire Service is a good example of such a structure. It has a clear role in disaster response, but also works to prepare communities between disasters (for example, by conducting back-burning and educating about bushfire plans).

Localised support is important because preparedness and response look very different depending on where you live in rural Australia. For example, Lismore on the northern NSW coast experiences regular flooding, whereas Broken Hill in the state’s far west contends with more frequent drought, and fierce dust storms.

Third, to fully understand and plan for the diversity of rural communities, we need sophisticated data planning, collection and analysis systems. Beyond health data, we need to look at the social, economic, environmental factors which all contribute to mental health and the way people access care.

If we can do this well, local planning will become easier, more transparent and tailored to need.

Finally, rural communities need support to develop local leadership, so they’re empowered to lead local responses. This is unlikely to succeed with short-term band-aid solutions, but rather with long-term investment and strategic policy to build and sustain capacity to cope with adversity.




Read more:
Collective trauma is real, and could hamper Australian communities’ bushfire recovery


The Conversation


David Perkins, Director, Centre for Rural and Remote Mental Health and Professor of Rural Health Research, University of Newcastle and Hazel Dalton, Research Leader and Senior Research Fellow, Centre for Rural and Remote Mental Health, University of Newcastle

This article is republished from The Conversation under a Creative Commons license. Read the original article.

We’ve been tracking young people’s mental health since 2006. COVID has accelerated a worrying decline



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Zlatko Skrbis, Australian Catholic University; Jacqueline Laughland-Booy, Australian Catholic University, and Jonathan Smith, Australian Catholic University

We have been following more than 2,000 Queenslanders from their adolescence into adulthood. The aim of the Our Lives study is to investigate how young people think about their future and how they master their trajectories in a world of rapid change and uncertainty.

In 2006, our research team began tracking more than 7,000 students who began high school in Queensland at the age of 13. Since then, the study has become the largest and longest of school leavers in Australia post the global financial crisis. The cohort turns 27 this year.

Every two years, we survey this cohort about their developing aspirations and experiences in work, study, housing, relationships and family. We also explore changes in their social attitudes and mental and physical health.

We did a special survey in June 2020 in response to COVID-19. We wanted to understand how the cohort had been affected since the previous survey six months earlier, in late 2019.

Among our findings are a sharp decline in mental health between 2019 and June 2020, especially among respondents living in urban areas and those without secure work. Marriage or de facto partnerships seem to be a buffer against sharper declines seen in young people who are single or living with housemates.

A decline in mental well-being

At the age of 22, in 2015, 82% of respondents described their mental health as excellent, very good or good. This fell to 70% at the age of 26 in 2019 — a drop of three percentage points per year.

But, only six months into the next year 2020 (in June), this figure had already fallen by a further four percentage points, to 66%. These data suggest changes in the young people’s lives during the COVID-19 pandemic have accelerated the existing downward trend in their mental well-being.



How different demographics have fared

Research has indicated women are more adversely affected than men by recessions, both economically and psychologically.

In line with this, the female participants in our study displayed significantly worse mental health during COVID than their male counterparts. The proportion of 27 year old males who described their mental health as excellent, very good or good in June 2020 was 70.5% compared to 63.5% for females.




Read more:
Young women are hit doubly hard by recessions, especially this one


Young adults living in major city areas, where COVID cases have largely been concentrated, experienced a decline in mental health — from 68.7% in 2019 to 62.2% in 2020. But the proportion of those living in rural areas actually rose from 70.9% in 2019 to 72.2% in 2020.

By their mid-twenties, a major gap emerged in the well-being of people with and without secure work. In 2015, when participants were 22 years old, 82.4% with permanent, ongoing work rated their mental health good to excellent, compared to 68.5% in 2020. The results were 77.6% in 2015 for those who were unemployed compared to 54.1% in 2020.

  ____


Emergency welfare measures, such as the JobKeeper wage subsidy and increase to JobSeeker, may have temporarily prevented this gap from widening.

One of Australia’s top mental health experts, Professor Ian Hickie, has argued an extension to JobKeeper and greater financial support for students in post-school education and training are critical for mitigating the predicted surge in youth mental illness.



What about relationships?

Security in young adults’ housing and relationships appears to provide a key buffer against the negative psychological impacts of COVID-19. Our data show young adults living out of home, or with a partner (married or de facto) report substantially better mental health in June 2020 than those who are single and living with parents.

Young people in who were living with housemates during the COVID-19 period experienced the sharpest decline in positive mental health.



Social distancing took its toll on the Our Lives cohort during the national restriction period, with 39% reporting feelings of loneliness or isolation. There were also signs of strain and conflict in the young people’s relationships with those in their household.

Around one-quarter of the sample reported a lack of personal space or alone time, while 16% reported experiencing greater tension and conflict in the household. These outcomes increased young adults’ chances of experiencing a major decline in mental health during the lockdown period.

However, the effects of stay-at-home restrictions were not inherently negative. For many young adults, restrictions provided more time for themselves (38%) and encouraged stronger relationships with partners or family (33%). These outcomes were associated with significantly lower chances of a decline in mental health.



It’s vital young people have good access to youth mental health services in the months ahead so their mental health doesn’t continue to drastically decline. This is particularly the case for young people who may be less able to turn to parents, partners or friends for help.

Research has consistently found young people with mental health issues are the least likely to seek out mental health information and access professional help when they need it.




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As ‘lockdown fatigue’ sets in, the toll on mental health will require an urgent response


There is hope that the collective experience of social distancing during COVID-19 may have helped reduce some of the stigma associated with seeking help. If this is the case, we must seize the opportunity to learn from the experience of the young people in our cohort and the Australians they represent.

For mental health, go to Lifeline Australia on 13 11 14 or Beyond Blue 1300 22 4636The Conversation

Zlatko Skrbis, Provost, Australian Catholic University; Jacqueline Laughland-Booy, Research Fellow in Sociology, Australian Catholic University, and Jonathan Smith, Postdoctoral Research Fellow, Australian Catholic University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Social activity can be good for mental health, but whether you benefit depends on how many friends you have



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Ziggi Ivan Santini, University of Southern Denmark; Paul E. Jose, Te Herenga Waka — Victoria University of Wellington; Robin Dunbar, University of Oxford, and Vibeke Jenny Koushede, University of Copenhagen

We know having friends is generally good for your happiness and mental well-being. Likewise, keeping socially active and engaging in formal social activities like volunteering has been linked to better mental health.

But it is also possible to have (or do) too much of a good thing. In a recent study, we tracked people aged 50 and older from 13 European countries over a two-year period to explore how volunteering, education, involvement in religious or political groups, or participating in sport or social clubs influenced their mental health.

We also looked at how many close social relationships people had — the kind of relationships in which they would discuss important personal matters. We found social activities especially benefited individuals who were relatively socially isolated (with three or fewer close relationships).

For people with a higher number of close relationships, engaging in social activities did not appear to enhance mental health. It could even be detrimental for some.

Who benefits from social activities

Social isolation is a major health issue. Apart from compromising the mental health of isolated individuals, it is linked to many other adverse health outcomes, including dementia, heart disease and stroke and premature death. But people who experience social isolation can take steps to improve their situation – for example, by engaging in formal social activities.




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Among individuals who were relatively socially isolated (people with three or fewer close relationships), we found more engagement in social activities was linked to improved quality of life and fewer symptoms of depression.

On a population level, our estimates suggest if such people were to engage regularly in social activities, we would see a 5-12% increase in people reporting better quality of life and a 4-8% reduction in people experiencing symptoms of depression. This would be a substantial change to population mental health, given more than 70% of people in our sample (aged 50+, in Europe) have three or fewer close relationships.

There are many reasons being socially active is linked to better mental health and well-being. Social activities can be a way to establish new relationships, provide opportunities for social support and foster a sense of belonging within a community.

People clearing weeds
Social activities can increase a sense of belonging within a group.
Shutterstock/Syda Productions

‘Too much’ social activity

While research so far has suggested having more social relationships is always better, our study indicates this may not be the case. Just like too much physical activity can compromise mental health, too much social activity can also backfire.

When we looked at how the study variables (quality of life, symptoms of depression) mapped against our two variables of interest (number of social activities, number of close relationships), we found U-shaped curves. That is, poor mental health at low levels of social activity, good mental health at moderate levels of social activity, and again poor mental health at high levels of social activity.




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Depression appeared to be minimised when people reported having four to five close relationships and being engaged in social activities on a weekly basis. Any more social activity than this, and the benefits started to decline, disappear or turn negative.

This downturn was particularly clear among individuals reporting seven or more close relationships. For these very busy people, engaging in social activities was linked to an increase in depressive symptoms.

Woman under stress.
Too much social activity can backfire and lead to exhaustion.
Shutterstock/Maksim Shmeljov

People typically report having an average of five close friends. Extroverts tend to report having more friends, but pay the price of having weaker friendships.

Because our social capital (essentially the time we have to devote to social interactions) is limited and roughly the same for everyone, extroverts in effect prefer to spread their social efforts thinly among many people. This is in contrast to introverts who prefer to focus their social efforts on fewer people to ensure those friendships really work well.

This trade-off is at the core of our capacity to engage in social activities. If you engage in too many, your social time is spread thinly among them. That thin investment might result in you becoming a peripheral member of numerous groups in the community rather than being embedded in the social centre where you can benefit from the support of your connections.

Another possibility is that too much social activity becomes a stress factor. This can lead to negative outcomes, such as social over-commitment, emotional and cognitive exhaustion, fatigue or feelings of guilt when social relationships are not properly nurtured because of limited time.

This raises another important consideration, albeit one we were not able to investigate empirically in our study. Family is an important part of our social world, not least in terms of the emotional and other support it provides. Devoting too much time to community activities means less time for family. That bottleneck might well prove to be detrimental to well-being because of the strain it could impose on family relationships.

So what’s the take-home message? Perhaps just this: if you want to live a happy and fulfilled life, be actively social — but do so in moderation.The Conversation

Ziggi Ivan Santini, Postdoctoral associate, University of Southern Denmark; Paul E. Jose, Professor of Psychology, Te Herenga Waka — Victoria University of Wellington; Robin Dunbar, Professor of Evolutionary Psychology, Department of Experimental Psycology, University of Oxford, and Vibeke Jenny Koushede, Head of the Department of Psychology, University of Copenhagen

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Distress, depression and drug use: young people fear for their future after the bushfires



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Amy Lykins, University of New England

This week, the bushfire royal commission is due to hand down its findings. Already, the commission’s officials have warned the status quo is “no longer enough to defend us from the impact of global warming”.

Australia’s young people appear to know this all too well. Preliminary findings from our recent research show many young people are worried about the future. And those directly exposed to the Black Summer bushfires suffered mental health problems long after the flames went out.

Young people with direct exposure to the bushfires reported significantly higher levels of depression and anxiety, and more drug and alcohol use, than those not directly exposed.

It’s clear that along with the other catastrophic potential harm caused by climate change, the mental health of young people is at risk. We must find effective ways to help young people cope with climate change anxiety.

Concern about the future

Our yet-to-be published study was conducted between early March and early June this year. It involved 740 young people in New South Wales between the ages of 16 and 25 completing a series of standardised questionnaires about their current emotional state, and their concerns about climate change.

Our early findings were presented at the International Association of People-Environment Studies (IAPS) conference online earlier this year.

Some 57% of respondents lived in metropolitan areas and 43% in rural or regional areas. About 78.3% were female, about 20.4% male and around 1% preferred not to say.

Overall, just over 18% of the respondents had been directly exposed to the bushfires over the past year. About the same percentage had been directly exposed to drought in that period, and more than 83% were directly exposed to bushfire smoke.

Our preliminary results showed respondents with direct exposure to the Black Summer bushfires reported significantly higher levels of depression, anxiety, stress, adjustment disorder symptoms, and drug and alcohol use than those not directly exposed to these bushfires.

A banner reads: Sorry kids, we burned your inheritance
Many of the respondents were clearly concerned about the future.
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Many young people were clearly concerned about the future. One 16 year old female respondent from a rural/regional area told us:

From day to day, if it crosses my mind I do get a bit distressed […] knowing that not enough is being done to stop or slow down the effects of climate change is what makes me very distressed as our future and future generations are going to have to deal with this problem.

Another 24 year old female respondent from a rural/regional area said:

It makes me feel incredibly sad. Sad when I think about the animals it will effect [sic]. Sad when I think about the world my son is growing up in. Sad to think that so many people out there do not believe it is real and don’t care how their actions effect [sic] the planet, and all of us. Sad that the people in the position to do something about it, won’t.

Young people directly exposed to drought also showed higher levels of anxiety and stress than non-exposed youth.

‘I feel like climate change is here now’

Those with direct exposure to bushfires were more likely than non-exposed young people to believe climate change was:

  • going to affect them or people they knew
  • likely to affect areas near where they lived
  • likely to affect them in the nearer future.

Both groups were equally likely — and highly likely — to believe that the environment is fragile and easily damaged by human activity, and that serious damage from human activity is already occurring and could soon have catastrophic consequences for both nature and humans.

One 23 year old female respondent from a metropolitan area told us:

I feel like climate change is here now and is just getting worse and worse as time goes on.

One 19 year old male respondent from a metropolitan area said:

I feel scared because of what will happen to my future kids, that they may not have a good future because I feel that this planet won’t last any longer because of our wasteful activities.

When asked how climate change makes them feel, answers varied. Some were not at all concerned (with a minority questioning whether it was even happening). Others reported feeling scared, worried, anxious, sad, angry, nervous, concerned for themselves and/or future generations, depressed, terrified, confused, and helpless.

One 16 year old female respondent in a metropolitan area told us:

I feel quite angry because the people who should be doing something about it aren’t because it won’t affect them in the future but it will affect me.

Though they were slightly more upbeat about their own futures and the future of humanity, a significant proportion expressed qualified or no hope, with consistent criticisms about humanity’s selfishness and lack of willpower to make needed behavioural changes.

One 21 year old female respondent from a metropolitan area said she felt:

a bit dissappointed [sic], people have the chance to help and take action, but they just don’t care. I feel sad as the planet will eventually react to the damage we have done, and by then, it will be too late.

A young woman in a mask looks down.
Many participants listed COVID-19 as an extra stressor in their life.
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Extra stressors

Many participants listed COVID-19 as an extra stressor in their life. One 18 year old female said:

Slightly unrelated but after seeing all of the impacts on a lot of people during the COVID-19 pandemic, all of my hope for humanity is gone.

A 25 year old woman told us:

Due to the fact of this COVID stuff, we are not going to be able to do a lot of activitys (sic) that we did before this virus shit happen (sic).

A 16 year old male said:

At present with how people have reacted over the COVID-19 virus there is no hope for humanity. Everyone has become selfish and entitled.

Irrespective of bushfire exposure, respondents reported experiencing moderate levels of depression, moderate to severe anxiety and mild stress. They also reported drug and alcohol use at levels that, according to the UNCOPE substance use screening tool, suggested cause for concern.

What does this mean?

We are still analysing the data we collected, but our preliminary results strongly suggest climate change is linked to how hopeful young people feel about the future.

We are already locked into a significant degree of warming — the only questions are just how bad will it get and how quickly.

Young people need better access to mental health services and support. It’s clear we must find effective ways to help young people build psychological resilience to bushfires, and other challenges climate change will bring.

University of New England researchers Suzanne Cosh, Melissa Parsons, Belinda Craig
and Clara Murray contributed to this research. Don Hine from the University of Canterbury in New Zealand was also a contributor.


If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.The Conversation

Amy Lykins, Associate Professor, University of New England

This article is republished from The Conversation under a Creative Commons license. Read the original article.

When too much news is bad news: is the way we consume news detrimental to our health?



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Evita March, Federation University Australia

Humans are curious and social creatures by nature. The news helps us make sense of the world around us and connects us with our local, national and international community. So it’s no wonder we’re drawn to it.

Objective, legitimate news also keeps us informed, empowering us with knowledge to make balanced decisions.

But the way we consume news has been profoundly altered by media developments. As news outlets have adapted to media trends, the way people watch, read and listen to news has changed. And these changes aren’t without consequences.

The way we consume news matters

The increase of online news, particularly when presented via social media platforms such as Facebook and Twitter, has affected how we access and consume our news.

When news was delivered via traditional one-way outlets such as television and radio, we were passive receivers. But on social media platforms, we’re active consumers. We sculpt and cultivate our news through immediate feedback, such as reacts or shares.

There’s evidence this might not be especially good for us.




Read more:
Australians are less interested in news and consume less of it compared to other countries, survey finds


Amid an unfolding crisis such as a pandemic, news presented via one-way outlets might be less damaging than news consumed online. In early months of COVID-19, researchers found news consumed online and via social media was associated with increased depression, anxiety and stress. The effects weren’t as bad when news was consumed via traditional media such as television and newspapers.

This isn’t limited to the pandemic. After the September 11 attacks, young people who consumed news via online sources experienced more PTSD symptoms than those using traditional media. This effect was attributed to more graphic images online, and the possibility for extra exposure as people could watch the footage repeatedly.

Where do we source news?

In an average week, more Australian news consumers source their news online (53%) than via print (25%). But perhaps surprisingly, television is still the most popular mode of news consumption. This year, 63% of Australians said they watched television news in an average week. Nevertheless, we’re far more actively engaged with our news than we once were.

Person viewing news on phone and laptop
Information is more accessible to news consumers than ever before — and graphic and repeated exposure could be bad for our mental health.
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Access to news is also radically different. The ability to consume news 24/7, via an almost endless variety of sources, has prompted experts to encourage us to moderate our news consumption.

Our bad news bias — not good news for our well-being

During times of crisis, we’re more drawn to news. In fact, Australians’ consumption of news significantly increased in 2020. During the 2019–20 bushfires, the percentage of heavy news consumers (people who consume news more than once a day) increased from 52% to 56%, and increased to 70% during the COVID-19 pandemic peak.




Read more:
Twitter’s plan to help young people not get too overwhelmed by bad news doesn’t go far enough


Unfortunately, the impact of news on our well-being is also particularly salient during a time of crisis. Multiple studies have found the more we consume news during or after a tragedy, crisis or natural disaster, the more likely we are to develop symptoms of post-traumatic stress disorder (PTSD).

Why are we so interested in bad news, anyway? University of Queensland psychologist Roy F. Baumeister and his colleagues have noted bad is stronger than good. Humans have a “negativity bias”, whereby we pay more attention to negative information than positive.

“If it bleeds, it leads”

Journalists are said to capitalise on our negative bias to capture our attention. Some news sources have learned this lesson the hard way. When a city reporter from an online Russian news website decided only to report good news for a day, they lost two-thirds of their readers.

The problem is, this negativity bias in the news can make the world appear worse than it truly is.

If the news distresses you, try to remember sometimes publications manipulate our powerful cognitive biases to capture our attention.
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The repeated presentation of information can create cognitive distortions, meaning we’re likely to interpret newsworthy problems, like violent crime, as more prevalent than they really are.

This negativity bias might also explain the tendency to focus on ‘doom and gloom’ stories on social media, referred to as doomscrolling.

Research published this year showed when we perceive the daily news as negative, we can feel less positive overall. So it’s no wonder increased news consumption can impact our well-being.




Read more:
Google News favours mainstream media. Even if it pays for Australian content, will local outlets fall further behind?


Those who use social media largely for news, instead of social networking, show increased anxiety and depression. These results highlight the importance of being strategic about how you use social media, particularly during times of crisis.

How can we take control of our news consumption?

First, it’s important to be aware your news consumption via different sources can look very different. Traditional media tends to focus on the facts, whereas stories, rumours, and human interest pieces are prioritised on social media.

Empower yourself with the knowledge that, as humans, we are subject to bias. The media and those producing the news know this. These biases, which make us wonderfully human, also make us wonderfully biased to the information we receive.

Our biases mean we’re more likely to be impacted by negative news and more likely to believe what we see is more prevalent than it truly is.




Read more:
How fake news gets into our minds, and what you can do to resist it


That’s certainly not to say no news is good news. News is powerful, and helps us stay connected and informed. But in a world where we’re surrounded by news 24/7, it is important we are aware of our cognitive biases and the distortions they create. Let’s take control of our news consumption rather than allowing it to control us.The Conversation

Evita March, Senior Lecturer in Psychology, Federation University Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Greater needs, but poorer access to services: why COVID mental health measures must target disadvantaged areas



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Graham Meadows, Monash University; Brett Inder; Frances Shawyer, Monash University, and Joanne Enticott, Monash University

COVID-19 outbreaks and the resulting lockdowns, particularly in Victoria, have adversely affected many people’s mental health.

Social isolation, financial stress, and anxiety about contracting COVID-19 can all contribute to psychological distress. For some people, these experiences may trigger mental disorders, such as depression.

People in lower socioeconomic groups are likely to be in particular need of mental health support in the face of the pandemic.

While federal and state governments have rightly boosted mental health services, we need to ensure these services reach those who need them most.

‘Better Access’ doesn’t guarantee access for all

The “Better Access” scheme entitles people to Medicare-subsidised sessions with a psychologist, occupational therapist or social worker, including via telehealth.

Recognising the mental health consequences of the pandemic, the federal government has increased the number of psychological therapy sessions subsidised under Better Access from ten to 20 sessions per year.

Well before COVID-19, we knew socioeconomic disadvantage was associated with poorer mental health. Our earlier research has shown very high psychological distress is much more common in the most disadvantaged fifth of Australian areas than in the most affluent fifth.

But for reasons including out-of-pocket costs and service locations, we’ve found people in poorer areas receive fewer Better Access treatments.

A female doctor speaks to someone on her laptop computer.
Better Access sessions can be delivered via telehealth.
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In Victoria, as in other parts of the world, COVID-19 has taken a higher toll on people in disadvantaged areas.

Not only have poorer areas suffered disproportionate numbers of COVID-19 infections, but they also seem to be enduring greater associated social and economic hardships such as job losses.

And if people in these areas need extra mental health support, they may find they’re under-served by the existing system.




Read more:
When it’s easier to get meds than therapy: how poverty makes it hard to escape mental illness


Three concerns

The expansion of Better Access may in fact deepen the inequity around access to these services.

1. Access to providers

The supply of therapists has not suddenly increased, so neither has the availability of treatment sessions. The increased number of allowable sessions will largely benefit people who already have access to treatment — and who are less likely to come from disadvantaged areas.

With scarce provider time, this potentially means fewer available sessions for those in disadvantaged areas.

2. Gap fees

Telehealth items continue to allow uncapped co-payments (gap fees). Whatever principled commitments practitioners may have to bulk billing, it makes financial sense to want to attract clients who can afford to pay.

So there may be better access for people with greater financial resources.




Read more:
Budget funding for Beyond Blue and Headspace is welcome. But it may not help those who need it most


3. A digital divide

Telehealth items, including video mental health consultations, may be less accessible in disadvantaged areas because of poorer access to technology, including reliable internet connections.

Those in disadvantaged areas may also be living in overcrowded conditions, and therefore have less privacy to use telehealth.

Where is the need greatest?

The Index of Relative Socioeconomic Disadvantage (IRSD) summarises a range of information about the economic and social conditions of people and households in Australia.

It can help planners direct resources to more disadvantaged areas — which, as we’ve shown, is particularly important for mental health services.

Our new paper offers a model for policy-makers to apply what we know about the IRSD and poorer mental health to planning and monitoring mental health services.

We created a spreadsheet using area IRSD scores to estimate mental health resource needs for different areas.

In Melbourne, for example, we estimated more disadvantaged parts of the western suburbs have a need around 2.5 times greater than parts of the eastern suburbs.

We used Victoria as an example, but this model could easily be adapted for use elsewhere.

How can we make services in Australia more equitable?

We hope our research will complement other Australian tools so the influence of disadvantage on mental health-care needs can be more consistently and transparently taken into account when designing mental health services.

State-based mental health services are often funded by areas, such as those for adults with serious mental illnesses in Victoria. So getting the funds to where they’re most needed is possible for state and territory governments.

But with services such as Better Access, which are funded by Medicare item rather than by geographic area, we will need new ways to ensure they’re distributed equitably.

A young woman has her head in her hands.
COVID-19 has taken a toll on Australians’ mental health.
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A thought experiment

The government could encourage a practitioner using telehealth to ensure 40% of these services get to people living in areas in the lowest 40% according to the IRSD.

The government could also implement an overall bulk-billing target of, say, 50%. Disincentives could follow if the provider falls short of these targets.

For example, a provider would receive commonwealth funding for all services provided if they achieved the 50% target. If not, they would receive funding for all bulk-billed consultations, plus the same number of co-payment services.

So, if a provider only bulk bills 40% of their clients, 80% of their services would receive funding. Similar mechanisms may operate for IRSD targets.

Such a move would likely face opposition, including from practitioners who might find it difficult to change their referral and charging practices. For some, at least initially, their income would suffer. So it could be challenging to introduce.




Read more:
Social housing, aged care and Black Americans: how coronavirus affects already disadvantaged groups


This is just a draft proposal and the details, including specific targets, could be refined in discussion with professional bodies. The model in our paper could be used to assess if changes succeed in improving equity.

But something like this could see people with the greatest mental health needs, particularly those in the most socioeconomically disadvantaged areas, better able to access services.The Conversation

Graham Meadows, Professor of Adult Psychiatry, Monash University; Brett Inder, University Professor; Frances Shawyer, Research Fellow, Monash University, and Joanne Enticott, Senior Research Fellow, Monash Centre for Health Research and Implementation (MCHRI), Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

A question for the treasurer: how do you treat mental health without measuring well-being?


Carla Liuzzo, Queensland University of Technology

Treasurer Josh Frydenberg mocked the idea of a “well-being budget” as “laughable” back in February. He’s got less reason to laugh now.

According to an Essential Research poll last week, 78% of Australians agree the pandemic has exposed flaws in the economy and there is an opportunity to explore new ways to run things. A well-being budget might be just the ticket.

In February, Frydenberg dismissed a well-being budget as “just another word for Labor’s higher taxes and more debt”, after the shadow treasurer, Jim Chalmers, committed the heresy of saying gross domestic product was, on its own, a deficient economic measure, and countenanced “a version of New Zealand’s well-being budget, which redefines what success means in terms of economic outcomes”.

Frydenberg joked about Chalmers being “fresh from his ashram deep in the Himalayas, barefoot, robes flowing, incense burning, beads in one hand, well-being budget in the other”.

But now, with the federal government changing its tune on many things, such as debt, it might be a good time for Frydenberg to change his mind on this.

Well-being measures, for one thing, could greatly assist the Australian government in budgeting to improve mental health and prevent suicides – things Frydenberg said in his budget speech are national priorities.

It’s impossible to address the nation’s mental crisis just through the blunt tools of economic growth and money for band-aid services. If a bigger income was the main means to mental well-being, after all, James Packer would be happier.

Mental health is a complex problem, with complicated causes, requiring a sophisticated response. To do that, developing measurements of well-being can only help.




Read more:
Budget funding for Beyond Blue and Headspace is welcome. But it may not help those who need it most


Measuring what’s worthwhile

There is no universal definition of well-being economics, but essentially it is an economic perspective that acknowledges gross domestic product – the monetary value of all goods and services produced by a country in a given period – as an all-too narrow metric for building a prosperous, sustainable, human-centred economy.

GDP is useful, as Chalmers acknowledged in his February speech:

It does still provide a powerful insight into the current state of the economy, and is useful for historical comparisons. […]

More broadly, growth matters to the jobs and opportunities created in our society. A healthy, growing economy can make people more comfortable with farsighted social and economic policy changes as well.

But GDP does not, as Chalmers said, paint the whole picture. He quoted Robert Kennedy, who said GDP measured everything “except that which makes life worthwhile”; and Nobel-winning economist Joseph Stiglitz: “If we measure the wrong thing, we will do the wrong thing.” So his point was hardly fringe.

Indeed even the architect of GDP as an economic measure, economist Simon Kuznets, warned against putting too much emphasis on it, and of the dangers of it subverting the normally “valuable capacity of the human mind to simplify a complex situation in a compact characterisation”.




Read more:
Redefining GDP and what we mean by growth


New Zealand’s well-being budget

The first country in the world to introduce a well-being budget was New Zealand, in May 2019.

The main difference of The Wellbeing Budget to previous budgets was how it allocated resources to five priority areas: mental health; child well-being; Māori and Pasifika well-being; productivity; and environmental sustainability.

The traditional budget process tends to consider priorities on a yearly basis. This guides governments to put more money into short-term goals and less into initiatives with long-term returns. To overcome this bias, New Zealand’s Treasury created an assessment framework that considers the merits of projects according to 60 different measurements (covering economic, social and environmental impacts).

The intention is to ensure the budget doesn’t neglect to invest in long-term initiatives that can prevent problems, rather than being caught in a cycle of pumping money into alleviating the symptoms short-term.

In mental health this means more emphasis on policies that keep people well, rather than on providing help only once they are very unwell – the type of “defensive spending” dominating the Australian government’s priorities in mental health in last week’s budget.




Read more:
New Zealand’s well-being approach to budget is not new, but could shift major issues


Building back better

The Australian Capital Territory’s Labor government has already replicated New Zealand’s model in its own Wellbeing Framework.

In February Chalmers indicated a desire for federal Labor to take a well-being budget to the next election.

ALP leader Anthony Albanese’s response to the federal budget on Thursday night gave few signals the Labor Party will do so. Though he criticised the government’s short-term GDP growth focus, the word “well-being” did not pass his lips.

But popular opinion suggests both parties should be putting well-being measures on the agenda. Already more than 30 countries measure “life satisfaction”. Support for well-being economics should transcend party lines, as it does in countries such as Britain.

If the Australian government is to “build back better”, it’s hard to see how a well-being budget could possibly hurt.The Conversation

Carla Liuzzo, Sessional Lecturer, School of Business, School of Creative Industries, Queensland University of Technology

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Budget funding for Beyond Blue and Headspace is welcome. But it may not help those who need it most



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Louise Stone, Australian National University and Christine Phillips, Australian National University

The COVID-19 pandemic has ushered in more anxiety and depression, raised rates of bipolar disorder and other psychoses, and left many Australians stricken with grief. And we will, devastatingly, lose more Australians to suicide.

Meanwhile, many people are facing job losses, financial hardship, isolation and some are suffering long-term symptoms of COVID-19 or other chronic illnesses.

At first glance, it’s fitting the 2020-21 federal budget, unveiled on Tuesday, includes A$7 million for mental health organisations Beyond Blue, Headspace, Kids Helpline and Lifeline.

Look more closely, however, and some concerning patterns emerge. The commitment to mental health is channelled through these services, which provide a narrow spectrum of care. These organisations favour people who are resourced, resourceful, literate in English, urban, and have more easily treated conditions than those with complex or multiple chronic illnesses. In fact the people with the deepest need tend to receive the least care.

These services aren’t suited for those with complex needs

People with mental illnesses aren’t all the same. Mental health concerns range from grief and loss, to chronic severe schizophrenia, to depression and anxiety, and many of these conditions overlap. Many people have also survived considerable trauma, and this has a deep and lasting impact on their health and well-being. Others live with disability, homelessness, chronic pain, domestic violence and poverty.

Professor Ian Hickie, who was a founding director of Headspace, says:

The Headspace model was never set up to deal with more complex presentations, people with impairments already established, those who had complex mixes of anxiety, depression and substance misuse.

As clinicians with a particular interest in mental health, we are wary of the “single illness fallacy” — one person, one illness — that underpins many of Australia’s current mental health policies. People with ongoing or serious mental illnesses almost always suffer other physical conditions which compound their mental illness, and die decades earlier than the average Australian. They deserve support.

Many people with disabilities also encounter difficulty in accessing appropriate care for their needs. One example, among many, is that in the ACT, public child and adolescent mental health services exclude patients with autism or attention deficit disorder.

Patients describe being too complex or not complex enough for services, and a little like Goldilocks they have difficulty finding a service that is “just right” for their needs.




Read more:
Three charts on: why rates of mental illness aren’t going down despite higher spending


Doubling Medicare-subsidised sessions won’t help those who receive no care

People who commonly don’t receive adequate care include those who are homeless, poor and unemployed, as well as Aboriginal and Torres Strait Islander people, and those on temporary visas. All tend to have higher rates of mental illness than the general population.

All people with mental distress and illness should be able to access mental health care. In theory, this is the basis of the federal government’s Better Access program, which allows people to access ten Medicare-subsided sessions per year with a psychologist or psychiatrist. It’s a useful initiative, but only for those who can afford the co-payments and live in areas where psychologists are available.

The budget’s commitment to extend the program to 20 sessions, at a cost of more than A$100 million, is welcome. But it doesn’t ensure equity. It also puts considerable strain on the psychology profession, which is already overloaded, especially in rural areas.

Like Headspace, Better Access risks excluding people with complex conditions or unstable mental illnesses. Those who are on the margins of society, and rely on the social safety net or charity, are unlikely to use this model of care.




Read more:
When it’s easier to get meds than therapy: how poverty makes it hard to escape mental illness


How do get the best value for our mental health services?

It’s hard to see the value-add of a narrow mental health response that funds a set of services which can only care for people with mild to moderate distress, while ignoring the people with the greatest disability.

The value-based care movement argues there are four elements that create value for people. Services should:

  1. provide outcomes that matter to the person receiving the service. We need to decide whether every dollar spent on clinical treatment of mild to moderate depression and anxiety could be better spent on housing, trauma therapy, employment or other forms of social care

  2. alleviate suffering. People should be able to form close and continuing relationships with clinicians, so their story and needs are known and trust can develop. The evidence for this relationship-based care is deep, but often services use multiple teams with health professionals who change frequently. We need to understand that continuity often matters to people and developing trust helps reduce distress

  3. create calm, which means addressing the chaos people experience trying to access services. The experience of telling your story multiple times to multiple providers, and then finding the service won’t accept care, is traumatic and unnecessary

  4. be cost-effective for the whole population who need mental health support, not just for the patients each service chooses to treat.

We need each of these government-funded services to report against these outcomes, including recording those people who are directed away from the services and essentially denied care.

Policies should be driven by data

We know little about the wider mental health needs of the Australian population. Our most recent national mental health survey was back in 2007. We know a lot about patients who present to services, but little about patients who don’t.

The largest providers of mental health care in the country, GPs, are invisible in the budget. Their patients, who have no other option for mental health care because they are too poor, too rural, too unwell or not unwell enough, are invisible in policy. Our only data from GPs is billing and prescribing data; hardly sufficient to understand the unmet needs of the Australian population.

If we are to meet the needs of all Australians, not just those who can access and afford care, we need more data. Offering simplistic solutions to complex problems means there are larger chasms for people to fall through.The Conversation

Louise Stone, General practitioner; Clinical Associate Professor, ANU Medical School, Australian National University and Christine Phillips, Professor, Social Foundations of Medicine, Medical School, Australian National University

This article is republished from The Conversation under a Creative Commons license. Read the original article.