This speech was delivered by BCA Chief Executive and Chair of Mental Health Australia Jennifer Westacott at the Schizophrenia Fellowship of New South Wales Annual Parliamentary Luncheon in Sydney on 2 June 2016.
Check against delivery.
Distinguished guests. Ladies and gentlemen. I would like to acknowledge the traditional owners of the land on which we are gathered, the Gadigal and Eora peoples, and pay my respect to their Elders—past and present. I would also like to thank the Schizophrenia Fellowship of New South Wales for inviting me to speak today.
I hope you’re all surviving the longest election campaign in almost half a century. Elections are always a reminder of the gulf that exists between good intentions and good outcomes. At times like this much is said about what might be—about what should be—but how often are those words backed up by actions?
I’m not just speaking of our political leaders, either.
As a society, we rarely bridge that gulf between good intentions and good outcomes. We rarely come to grips with the kind of people we are—and the kinds of people we want to become. We rarely come to grips with the nation we are—and the nation we want to become.
All too often, we fail to put our words into action. And, frankly, words are just not enough. They just cannot fully convey how it feels … To fall in love, live the lives we live, lose a loved one. They cannot. But—when backed up with intent—words are powerful.
Take ‘community’ for example.
Here is a word that has been worn thin by misuse. We probably wouldn’t have a deficit by the end of this election campaign if Treasury received a dollar every time a candidate uttered the word ‘community’ in a speech, an interview or a media release. Despite that misuse, community still contains powerful meaning.
I learned the true meaning of community when I was a teenager. My parents separated while I was studying for the Higher School Certificate. It was a disaster.
We had never been financially well off. In fact, my family had long been plagued by financial insecurity.
But I had experienced nothing like the catastrophe of that separation.
Financially, we hit rock bottom. Socially, we felt isolated. Emotionally, my mother fell into a state of despair and hopelessness. And then there was a knock on the door.
It was Canon Houston, the minister at Christ Church in Gosford. Canon Houston came inside and just talked to us. There was no judgement and almost no religion—just gentle and quiet reassurance that was later backed up with practical support.
I’ll never forget that visit.
Nor will I forget the people who helped us… people like, Norman, our neighbour who used to jump over the fence and help me mow the lawn. And that’s why I will never forget the true meaning of words that bind people together—words like community. For me, community is all about those unprompted, unsolicited and often unheralded acts of kindness that preserve our individual and collective dignity… and are the essence of our humanity. The point I am making is this: Community is about the duty of kindness.
And, ladies and gentlemen, it is time we extended that duty to the one-in-five Australians who experience mental illness every year—and it’s time we took collective and individual responsibility to do so.
And that’s what I want to talk to you about today. Now, I’m not going to hit you over the head with statistics. I’m not going to lecture you on future policy positions. And I’m not going to get political—there’s enough of that around at present. Instead, I want to talk about the ways things are—and talk about the ways things could be.
Anyone with a passing interest in the mental health system knows that, currently, we are facing a crisis—and that crisis is deepening. To be an Australian citizen with a mental illness often means being treated as a second-class citizen. Australians living with a mental illness find it harder to get a job, harder to find a place to live and harder to live the kind of life their fellow citizens take for granted.
They are often refused treatment until their health reaches a crisis point. They are discriminated against in the community and in the workplace. And they are served by a system that—despite the best intentions of governments of all persuasions—is fragmented and dysfunctional. In short, as a society we are failing Australians with mental illness.
Given that almost half of us personally experience mental illness during our lifetime, this failure just doesn’t make sense. It is a complex issue and, no doubt, the reasons for our failure are equally complex. Whatever the case, the consequences of that failure are almost too unbearable to contemplate.
For instance, according to the Australian Bureau of Statistics suicide has now overtaken the road toll as the leading cause of death for men and women aged under 45. Think about that. The road toll is the cause of immense trauma across the country—touching every city, suburb and town… but the traumas caused by suicide are even greater.
So colleagues, addressing the failings of the mental health system must be a national priority. I want to make it excruciatingly clear that this responsibility cannot be laid at the feet of governments alone.
It’s our collective failure—driven by the wrong mindsets, by stop-start approaches to reform, by poorly executed change and by stigma and discrimination. We must confront these shortcomings honestly. We must be willing to take the time to do the painstaking work to make the system better. Because, no matter how complex the systemic failure, no matter how complicated the architecture of reform might be, that failure is personal.
It is personal for the four people who died by suicide this morning, and will be personal for the four people who will die by suicide this afternoon. Individually and collectively, we have failed to extend that duty of kindness that we share to those of us who are living with mental illness. We have failed to set a target for the kind of mental health outcomes we are prepared to accept as a community and a nation. We have failed to turn our words into action.
If we were committed to more than words …We would be constantly assessing the system to find out what works and what doesn’t, we would be focused on prevention and recovery and participation, and we would be investing in research. If we were committed we would be setting meaningful targets like… reducing the national suicide rate by at least 50 per cent over the next decade; Bridging the life expectancy gap for people with a mental illness—who currently die 20 years earlier than the general population; And significantly increase the employment rate of people with a mental illness. Help people stay healthy, live a good life and get a job—surely those are targets worth aiming for.
The Federal Government’s response to the review of mental health is an important step. We need to keep taking those important steps—strengthening our collective resolve to create a truly world-class 21st century system.
Don’t get me wrong: I know people within the existing system do wonderful work. Carers … Clinicians … Community workers … Peer workers … countless individuals make that personal connection with people experiencing mental illness—and make a difference. But, too often, they achieve successes despite the system. And those successes are too often due to extraordinary individual efforts. That’s the wrong mindset.
We don’t want it to be a heroic effort for a person with a mental illness or their carers to be receiving the help they need to improve their lives—we want it to be routine. But that cannot occur while consumers, carers and workers are captive to a system that works against their individual and collective efforts. We have to do better.
And I have to ask, are those good people the exceptions to the rule? Are those good people outnumbered by what is becoming a systemic crisis of mental illness in this country? Unfortunately, the answer has to be yes.
The answer has to be yes because there are too many stories of disastrous encounters with the mental health system to ignore. There is a need for a mindset change. After all, as too many people in this room know from personal experience, when the system fails, people suffer. Lives are ruined. Lives are lost. Potential is squandered.
I’d like to dwell on that last point—the squandering of potential—for a minute.
Mental illness does not discriminate. It strikes Australians in every walk of life. It doesn’t care what you do for a living … where you work … or what your gender is. Mental illness is bipartisan, too. It doesn’t choose between political parties.
The point I am making is that for mental illness every part of the community needs to take action—including the business community. Besides being the Chair of Mental Health Australia I am also the Chief Executive of the Business Council of Australia. The BCA is a community organisation. After all, what is business? It is …A community of 10 million people who work, a community of 5 million shareholders, and every single person who has superannuation in the country.
Essentially, our job is to help ensure Australia remains one of the most prosperous places in the world. And although our focus is on the business side of that equation, we understand the connection between the community and the economy… that you need a strong economy to support the community, and a strong community to drive the economy. This is delivered by helping every single Australian reach their potential.
The importance of that connection is driven home when you realise the size and scope of the social, technological and economic challenges we face as a country. Social challenges such as our ageing population. Technological challenges such as the creation of an economy that is increasingly global, digital and mobile. Economic challenges such as the emergence of a skills-driven services economy—as well as the creation of an Asian middle class of more than 3 billion people that will increasingly drive global markets.
With that in mind, with so much at stake for us all, this much is clear:
We must unlock the potential of every single Australian. And we cannot afford to waste the talent of its citizens with a mental illness. And, yet, we do.
I promised I wouldn’t hit you over the head with statistics, but there are a few points that need to be aired. First point: Australia has one of the lowest employment participation rates for people with mental illness of all the nations that are part of the Organisation for Economic Co-operation and Development. Second point: Mental illness among men aged between 12 and 25 costs the Australian economy more than $3 billion a year. Third point: Mental illness costs Australia around $20 billion a year. By any measure, mental health reform is in the national interest.
We cannot afford to keep squandering the potential of many of our citizens. And one of the ways that we can begin to achieve that end—and meet our duty of kindness—is to embrace the true meaning of another word worn thin by misuse:
It’s a word that, at times, is thrown around too freely—but, like community, contains powerful meaning. In essence, innovation is about people. And potential. It is about giving people the opportunity to improve—learning from the experience—and helping people keep improving. It’s about finding …New ways of working, new ways of living, new ways of being.
The good news is that governments are increasingly embracing innovation. For instance, we can all take pride in New South Wales’ Black Dog Institute partnership with Amazon Web Services to create a twitter analysis tool that measures our national mood in real time. Similarly, it is encouraging that Facebook is developing algorithms to identify suicide risk amongst its customers. It’s also encouraging that the Commonwealth is investing in a Digital Gateway in response to the National Mental Health Commission’s review of programs and services. But we cannot stop there—as a nation we have to go much further.
We must use digital disruption to transform the way every part of the system works—from professionals to consumers to carers. That’s why there is an urgent need to be more innovative and ambitious in mental health. After all, here is an area that has been at the mercy of the best intentions and the worst executions for the best part of four decades.
I’m not going to go over old territory and relay the sorry story of inadequate planning and funding that has plagued the mental health system since deinstitutionalisation, but I would ask a question: Digital disruption is revolutionising every other part of our community and economy—why can’t we use it to revolutionise mental health? Why can’t we use technology to make services meet the individual needs of individual people? Individualised or personalised service is, without a doubt, the next big thing in the corporate world … it should be in the mental health system as well.
Innovation of course if more than technology. So, if we are to transform mental health in Australia we should adopt an innovation mindset. That mindset …Would put the consumer at the centre of the system;
Would focus on the language of potential—rather than deficit; Would use technology—including Big Data—to give consumers and carers more control over their lives; Would give people who work in the system the flexibility to actually make the system work; Would accept trial and experimentation as a cornerstone of securing improvement; Would set the targets for improved mental health outcomes that we want to see as a nation—rather than targets that are easy to achieve; We would ruthlessly and honestly measure performance; And—by co-designing services with consumers and carers—we would remove the pain points from the consumer and carer journey.
If the future of mental health just becomes the refinement of programs without a fundamental mindset shift we will make little progress. Of course, we should do policy work. Of course we should implement the government’s plan.
But for lasting change, for real change…We need to adopt that innovation mindset, we need to uphold that duty of kindness, we need to, in short, help people reach their potential. It can be done. It must be done.
Before I finish, I’d like to come back to the duty of kindness. Mental Health Australia has been very fortunate to work with actor and director Steve Bastoni. Steve has made a powerful short film called The Gift that conveys more powerfully than words ever could the importance of human connection.
Let’s watch The Gift.