For Victorians like me experiencing yet another mass lockdown, the prospect of the COVID19 pandemic being behind us feels like a remote and distant proposition.
But let’s for a moment imagine that we are gazing back on this period of profound disruption and uncertainty. How will we reflect on this moment in history?
Perhaps the most succinct and accurate summary of the past year is that we, as a community, have accepted the need to change every aspect of our lives in order to keep people out of hospital.
That’s it. Sounds pretty simple, doesn’t it? Of course, in reality it has been far from straight-forward. But this approach -- a preventative health approach -- is at the very heart of our response to COVID19. All the sacrifices we have made have been done to prevent illness, limit hospitalisation and, ultimately, minimise mortality.
Back in those terribly uncertain early days, the health advice presented to political leaders and granted wall-to-wall media coverage was quickly adopted. Victorians quickly understood that, to stop this easily transmitted, deadly virus from moving through our community unchecked, we had to keep our distance, wash our hands, wear masks, work and learn from home and, most agonisingly, stay away from the most important and loved people in our lives.
This approach, a textbook preventative health response if ever there was one, has been profoundly successful. Yes, there has been tragedy -- we need only recall the devastation experienced in aged care last year to know what happens if we slip up -- but without question, preventative measures to lock down and maintain social distancing have saved lives. As many as 16,000 nationally, according to the University of Sydney.
And of course, we don’t have to look very far to see the consequences of failing to “get ahead” of the virus. Australia’s mortality rate, at 36 deaths per million people, is among the best in the world and has far outperformed nations whose approach has been to delay, deny or let it rip. The UK, Brazil and Sweden are experiencing rates of death between 39 and 60 times worse than ours.
So, if it is possible to imagine a post-pandemic future where we are able to define this historic moment as one where we successfully applied preventative health measures, how do we assess our current approach to the mental health crisis?
As is the case right now with infectious diseases, awareness of and funding for mental health has never been higher. This budget season has seen the federal and Victorian governments each claim “historic” commitments, while not-for-profit services like Smiling Mind have experienced record levels of demand since the pandemic struck.
This, however, is where our approach to the health crises differ. In mental health very little of the billions committed by governments supports the prevention of mental illness. As the Brain and Mind Centre’s Dr Sebastian Rosenberg points out, just 11% of the total funding on mental health in the federal budget was committed to prevention and early intervention, with the vast bulk of funding directed to addressing mental ill-health after problems are already being experienced.
This approach seems reasonably set in stone, too, considering that the National Preventive Health Strategy’s current aim is to dedicate only 5% of the national health spend to prevention programs by 2030.
Would we be better off adopting the same approach as we have throughout the pandemic, of directing money into areas that keep people out of emergency departments and GP clinics?
Again, a comparison with the current COVID situation helps. Just as we now know that wearing masks, washing hands and keeping our distance stops people becoming infected with COVID19, there is much to be gained by funding programs that develop good mental health behaviours and skills in people so they are able to cope during the difficult moments we all experience in the course of our lives.
Good physical and mental health is good economics, too. As we learnt last year, the first step towards opening up the economy is getting a handle on the virus. So too is this the case with mental health, with our current crisis-focussed approach costing the Australian economy $220 billion every year according to the Productivity Commission while mental health prevention and promotion approaches have demonstrated success at reducing stigma and improving cost-effectiveness.
Victorians have benefited enormously from the incredible work done in preventative health in recent decades. Compared to our parents' generation, we are better protected from deadly cancers, enjoy better physical health and travel more safely on the road. Now, in the wake of a global pandemic where the government’s focus on health prevention has saved thousands of lives, it is time to ask ourselves: why don’t we start taking the same approach to our mental health?