By Melissa Bourchier (Psychologist)
The 10th of October is World Mental Health Day.
Awareness campaign days such as this, as well as World Suicide Prevention Day (10th of September) and R U OK Day (the second Thursday of September) (see some others listed below) aim to increase awareness of mental health issues, and reduce the stigma around mental illness.
This year, the World Health Organisation (WHO) is using World Mental Health Awareness Day to petition for increased support regarding mental health in the workplace. They acknowledge that workplaces, employers and managers have a role in supporting employees who may experience mental disorders; and that workplaces can have a hand in preventing mental disorder. Mental Health Australia (https://1010.org.au) are using the day to draw awareness to the stigma attached to mental illness. The aim is to use facts instead of stigma and opinion to break down stigma based barriers that prevent people from seeking support; and to encourage people to seek support when needed.
Approximately one in five Australian’s (20%) will experience a mental illness within the next 12 months. Almost half (45%) of Australians will experience a mental illness at some point in their life. 25% of young people (16-24 years of age) will experience mental illness. 15% of people over 60 years of age will experience depression. The most common mental illnesses are anxiety disorders, depressive disorders and substance use disorders. While many people will experience disorders, more than half (54%) will not access treatment of any type. This may be due to poor recognition and inaccurate diagnosis of mental illness. It may also be due to fear of what treatment may mean, misunderstanding as to what a diagnosis means, and also fear of judgement.
However, research also tells us that treatment can be very helpful. 75% of people admitted to mental health inpatient services see dramatic improvement. A wide range of studies also indicate that various talk therapies, behaviour therapies and medication based therapies see dramatic improvements for most people.
Some indicators of mental illness include:
– Social withdrawal
– Decreased academic or work performance
– Increase alcohol or drug use
– Changes in sleep (difficulty sleeping, excessive sleep, broken sleep)
– Difficulty controlling emotions (swinging between emotions, difficulty calming, or experiencing particular emotions for long periods of time) (anger, irritability, anxiety, feeling down; or even extreme and over-the-top, disproportionately ongoing excitement and mania)
– Hopelessness for the future; diminished capacity to experience pleasure and enjoyment
– Lack of motivation; lowered energy levels
– Difficulty with concentration and memory
If you notice that someone in your life has changed their behaviour, or may be experiencing some of the above, talk to them. Ask them: R U OK? (https://www.ruok.or.au) Tell them that you’ve noticed something might be going on for them. Don’t be afraid to talk about mental illness; and don’t be afraid to talk about tough experiences. Start the conversation.
Often, your friends, colleagues, or loved ones, worry about upsetting the people around them, leading to avoiding the conversation, changing topics, making light of things, or getting defensive. So think about how to manage your own feelings when approaching the conversation. Listen and respond calmly; and especially avoid judgement. If your daughter tells you she is caught up in a break up even though you thought they’d only been going out for a few weeks: it’s important to her. If your brother tells you he’s been feeling under pressure on social media: it’s important to him. If your partner tells you they’re concerned about work stress and there’s no one there to talk to about it: it’s important to them. If a colleague tells you they lost their licence because of driving under the influence: it may be more than one night out. Minimising these experiences (saying ‘Don’t worry about it’, ‘It’s OK’, or ‘You’ll be alright’) may shut down the conversation.
– Instead, ask more questions (‘How are you feeling about that?’) and repeat back what you heard or understood (‘so, you’re saying that…’) to show that you are listening and that your goal is to understand.
– Ask what they’ve done to get through this so far, and what have they done in similar situations in the past.
– Ask how you can support them.
After your initial conversation, remember to check in again. The follow up conversation will help you understand if the problem and the person’s experience is more ongoing than you, or they, noticed. It will also help establish whether they’ve found a way to manage what’s going, to make changes, or to get support or professional help.
Support the person to access professional support. It may help you to know what might happen if they contact a psychologist. At Vida Psychology, our reception team will book an appointment. In the first appointment, the psychologist will talk about confidentiality and consent as well as how they work as a therapist. In that first session the psychologist will ask about what has been going on for the person, what has brought them the therapy and how they have been feeling. The psychologist will also ask the person to set some goals about what they would like to achieve by coming to therapy. When the psychologist has a clear sense of what is needed to develop a treatment plan, they will then proceed with therapy. This beginning process may take a few sessions, but it is very important to develop a clear picture of the person coming to therapy and to identify in what ways they can help achieve the person’s goals.
It may help the person to go and see their GP. The GP will ask how long things have been going on, how this has affected sleep, concentration and memory, supports already in place and supports the person might like to access. They may give the person a questionnaire to help them assess how to help. With some specific mental illnesses, the GP can provide a Mental Health Treatment Plan (or Mental Health Care Plan) to help the person receive a Medicare rebate for up to 10 sessions per calendar year with a psychologist. This rebate will cover part of the fees per session. Both GPs and Psychologists will ask about, and talk about, health lifestyle factors such as sleep, diet and exercise, that are beginning points that will help a person feel better.
This World Mental Health Day, Mental Health Australia asks you to make a promise to yourself. Some ideas about what this might look like include:
– Promise to start a conversation with someone about their mental health o RUOK?
o What are your thoughts on mental health and mental illness?
o Have you ever known anybody who has been anxious or depressed, or seen a psychologist?
– Promise to start a conversation with someone about your own mental health
o I’m not OK at the moment
o I need some help
o I’ve been using some strategies to promote my mental wellbeing
– Promise to do something to look after yourself
– Promise to support a group who feel marginalised
– Promise to promote mental health and decrease the stigma around mental illness
Some websites to help you get the conversation going include:
- The R U OK?Day website: http://www.ruok.org.au/how-to-ask#/
- The Headspace ‘How to start the conversation’ page: http://headspace.org.au/friends-and-family/?category=14
- The Black Dog Institute’s fact sheet: https://www.blackdoginstitute.org.au/about-us/publications-and-resources/fact-sheets
Some mental health awareness days in Australia and around the world:
30 March, Annually – World Bipolar Day
Second Week May, Annually – Schizophrenia Awareness Week
Second Week June, Annually – Men’s Health Week
July, Annually – NAIDOC Week
Second Thursday of September, Annually – R U OK? Day
10 September, Annually – World Suicide Prevention Day
October, Annually – BPD Awareness Week
October, Annually – Anxiety and Depression Awareness Month
10 October, Annually – World Mental Health Day and National Mental Health Week November, Annually – Perinatal Depression and Anxiety Awareness Week November, Annually – Movember – Men’s Health Awareness
References:
- Australian Bureau of Statistics. (2009). National Survey of Mental Health and Wellbeing: Summary of Results, 4326.0, 2007. ABS: Canberra.
- Department of Health and Ageing. (2013). National Mental Health Report 2013: tracking progress of mental health reform in Australia 1993 – 2011. Commonwealth of Australia, Canberra.
- Wilkinson P., Izmeth Z. (2016). Continuation and maintenance treatments for depression in older people. Cochrane Database of Systematic Reviews 2016, Issue 9.
- Cox G.R., Callahan P., Churchill R., Hunot V., Merry S.N., Parker A.G., Hetrick S.E.. (2014). Psychological therapies versus antidepressant medication, alone and in combination for depression in children and adolescents. Cochrane Database of Systematic Reviews 2014, Issue 11.
