Welcome to the age of insecurity
Welcome to the age of insecurity
Monash Life | Thriving Communities | So how are you really? | 2 minute read
Professor Anthony Harris, Director of the Centre of Health Economics, says that the mental health impact of Covid is still being felt – and will continue to be felt for some time to come.
“How are you really?” is a question we should definitely be asking ourselves – and the people we care about. But it’s also one that businesses are asking their teams on a more regular and genuine basis.
If you’re not well, you can’t work – and if you can’t work, productivity suffers. But while that’s a given in terms of physical health, what’s historically been less obvious is the link between productivity and mental health.
This is now changing, with a recognition that if we protect people’s mental health, economic activity thrives as a result. “Economists have got better at establishing the causal link between the two,” says Professor Anthony Harris, Director of the Centre of Health Economics.
“There is a lot of research on how the impact of changes in economic activity – such as the Covid pandemic or job losses from a recession – contribute to mental and emotional health and to future economic output and productivity.”
Last year’s nationwide Productivity Commission Mental Health Inquiry estimated the cost of mental ill-health and suicide to Australia is more than $200bn a year – with an annual cost to Australian workplaces of between $40bn and $70bn through low productivity and absenteeism.
But Harris says research is still needed to understand exactly how significant and how long lasting the impacts are – and therefore where the funds should go to prevent and alleviate the problems.
“Research into mental wellbeing tends to suggest there is generally a homeostasis,” he says. “People are buffeted by various downturns, but most tend to be resilient and generally return to the level of mental health they had before. For some, this is short term, while for others there can be a long-lasting impact.
“A lot of the current treatments for mental health conditions tend to be short term – for example, you get a limited number of cognitive behavioural therapy (CBT) sessions. That’s good for many people – a short-term solution to a short-term problem – but because these therapies are not ongoing, people who suffer more complex or longer-term effects may struggle. We don’t know the cost benefit of investing in longer-term therapies.”
This issue is highlighted by the Covid pandemic, whose full legacy for the mental health of future generations won’t be known for decades. “When the pandemic was with us, we didn’t have really effective surveys, and the picture is more unsettled still in the long term,” says Harris.
“We don’t know the long-run, intergenerational effects of events such as Covid and the long shadow it might cast on long-term mental health – from its effects on social isolation and lost schooling to individual economic losses. It seems likely that these will have some impact on mental health – and therefore productivity – for many decades to come.”
The obvious way forward in the face of this kind of uncertainty is to invest in resilience and prevention, through early intervention and comprehensive integrated mental health services.
The Productivity Commission has put forward 21 broad recommendations and 103 action points, including: prevention and early intervention; reforms to mental healthcare; initiatives to improve quality of life; recommendations for mentally healthy workplaces; and a request for a new national mental health and suicide prevention strategy.
“Value for money is often greater in effective prevention and early intervention,” says Harris. “Primary care initiatives to detect and treat mild and moderate mental illness, such as the Better Access Scheme, are good examples.
“There are gaps, however, and much remains to be done to address more severe mental illness, where services are patchy around the country.
“The report and our own research show a strong link between mental health and productivity, providing an additional investment rationale for better, more integrated mental health services.”
But despite the recommendations of the Commission, Harris is concerned that the political will may not be sufficiently strong to spend the necessary money to implement them.
“Covid was an urgent crisis that needed addressing, so there was huge sudden investment – for example, we extended the number of occasions you could see a psychologist.”
But that was a temporary fix, he says, for what was seen as a temporary problem. It demonstrated that our health care system is flexible in as much as people are focused on the immediacy of it – making it work in the moment – but agreeing and paying for long-term solutions is more challenging.
“There is still an inconsistency in funding across regions and population groups that are not seen as a priority,” says Harris. “If you don’t have access to Medicare, you’re in a group that’s out of the system and not seen as a priority, even though these groups still affect Australia’s general productivity.
“A lot of groups in society would see a huge surge in productivity if they had better access to services, but fundamental health reform is notoriously difficult in this country – we were one of the last OECD countries to get a national health framework and our last major health reforms were in 1973.
“Improving mental health is an investment that will require money, but it is not just about paying for more doctors, psychologists, nurses and psychiatrists. It is also about how we organise what is delivered.
Typically, when the national government of any party wants to reform how services are organised, there’s always pushback – there are lots of powerful conflicting interest groups.
So, while the link between mental health and productivity is there, and recognised, and we have consistent recommendations from many commentators, including the Commission, on paths forward, it’s not clear that we are ready yet for the kind of wholesale systemic reform that is required.”
Professor Anthony Harris is Director of the Centre of Health Economics.
So how are you really? Professor Harris’s top tip:
- Maintain a good circle of friendships. “Research by some of my colleagues at the Centre for Health Economics has shown that mental wellbeing is typically related to the quality of your relationships and friendships – so I’d say keep your friends close and your intimate friends even closer.”
