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Mental health, poverty and life expectancy

By Tristan Ewins - posted Monday, 12 October 2015


Last week was 'Mental Health Week' in Australia. Importantly this has drawn attention to related issues such as poverty, stigma and a decades-long crisis in mental-health-related life expectancy.

According to a study from The University of Queensland and The University of Western Australia mentally ill Australians are on average dying 16 years earlier than the general population. This would include sufferers of depression, bipolar, and anxiety. The study noted that the vast majority of cases of early death actually related to "physical causes such as cardiovascular disease and cancer, rather than from suicide or accidents." Medication can certainly play a role in promoting obesity – which as noted can lead to heart disease, but also diabetes.

Also despite this, recent research has established that suicide claims approximately 2,500 lives a year. Proportionately the most likely to commit suicide were elderly men.

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What is more, regarding mental health related life expectancy, "the gap is growing". And the figure for sufferers of Schizophrenia – which is estimated to be a minimum of 200,000 Australians (some say closer to 300,000) – is 25 years. That is, those with Schizophrenia in Australia die on average 25 years earlier than the general population.

Also according to the UQ/UWA study this result was worse than that experienced by smokers, and comparable to that suffered by indigenous Australians. Indeed, research on Indigenous Australian life expectancy revealed a gap of around 10.6 years. The figure for indigenous Australia is of the highest concern and demands a significant commitment of resources. But the comparison begs the question why mental health related life expectancy does not attract the same relative amount of attention given the numbers, and given the dire plight of those involved. Indeed, both indigenous and mental health related life-expectancy warrant a very significantly increased amount of resources.

Furthermore the statistics on mental health related life expectancy have not improved in 30 years revealing gross negligence by governments of all stripes.

In early 2014 Ryan Bachelor of the Chifley Research Centre condemned apparent moves by the Abbott Government to vilify and scapegoat disability pensioners. This approach was reinforced by a disgraceful campaign by Australia's Murdoch tabloid press. Bachelor also emphasized that while the figures for the Disability Support Pension (DSP) were high (approximately 800,000 people), more recently these figures were slowly declining. The cost to the budget was approximately $15 billion in a $1.6 Trillion economy. And the proportion of Disability Pensioners with a psychosocial disorder was 31 per cent.

Considering life expectancy statistics, no – sufferers of mental illness are not 'having us on' when it comes to the Disability Support Pension. As Frank Quinlan of the Mental Health Council of Australia argued in 2014, many amongst the mentally ill want to work – but cannot do so on account of discrimination. And they are also deterred because of severe means testing of their pensions.As Quinlan explained elsewhere:

The reality of the experience of severe and persistent mental illness is that it can have a profoundly disabling impact on day-to-day living and social functioning, leaving some Australians requiring ongoing financial assistance despite their eagerness to work independently.

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It may not be so popular to draw on Karl Marx in this day and age. 'Marxism' as such has been so distorted by those who claimed to act in his name that many would not give his ideas a second thought. But Marx's maxim: "From each according to ability, to each according to need" should seem an eminently reasonable basis on which to fairly organize an economy and a society. And it is a perfectly reasonable basis on which to organize pensions, and the social wage and welfare system more broadly. This should mean an end to severe means testing, more positive incentives to find flexible work (rather than 'punitive welfare'), emphasis on fighting mental health related discrimination, and positive incentives for employers to provide suitable flexible employment.

Specifically, Disability Pensioners have trouble maintaining any kind of social existence; not only because of illness, but also due to poverty. Poverty means it is often difficult or even impossible to run a car, for instance. This impacts on ability to even search for suitable work. There's the option of public transport ; but that is not always available. This can also make it difficult to keep friends, or to find friends in the first place. Poverty also makes fitness a more difficult prospect. Again, ill health, obesity etc can contribute significantly to early death, while the mentally Ill need to work so much harder to maintain health and fitness due to the side-effects of medication. Due to poverty Gym memberships are generally out of the question. And health costs can also be prohibitive. Consider Dental and Optical just to start. This affects all pensioners, but the disabled are likely to be dependent long term with no way out.

Also many experiencing mental illness are stuck in substandard and insecure accommodation. Further, not all the mentally ill have support from Carers, and many 'fall through the cracks' into homelessness. A 2002 report had also noted:

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About the Author

Tristan Ewins has a PhD and is a freelance writer, qualified teacher and social commentator based in Melbourne, Australia. He is also a long-time member of the Socialist Left of the Australian Labor Party (ALP). He blogs at Left Focus, ALP Socialist Left Forum and the Movement for a Democratic Mixed Economy.
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