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Live. VOICE-OVER: Today at the

National Press Club, the

Australian of the Year Professor Patrick McGorry. Researcher, clinician and

advocate for reforming the

mental health system. He's the

executive director of Orygen

Youth Health, now an international model for

services treating young people

with emerging serious mental

health problems. Patrick

McGorry, with the National

Press Club address. (Bell rings) Ladies and

National Press Club for today's gentlemen, welcome to the

National Australia Bank

address. It's always a great

pleasure to welcome the Australian of the Year here

today, particularly one who has

played and continues to play

such an important social role

in this country. As you've

just heard Professor Patrick

McGorry is an eminent

clinician. He's a researcher

and, of course, perhaps in many

ways most importantly an advocate for national reform of

mental health for youth. As

was also mentioned, he's

executive director of Orygen

Youth Health, which is an

organisation internationally

recognised now for the work it

does in assisting young people

with mental health problems,

and he was really the driving

force for the creation of

headspace, a founding board

member, continues as a board

the National Youth Mental member of headspace, which is

Health Foundation. It's

estimated as I'm sure many in

this room know that in any

12-month period, one in four

young people will suffer from

some form of mental health

issue, and indeed as many as

40% of those aged 18 to 24

suffer from again, some form of

mental health disorder. It

seems not that long ago to me

really, that this society,

Australia, was one where we

weren't really prepared to talk

about these issues. They were

almost taboo if we go back a

couple of decades. Thankfully,

due to the work done by people

like our guest today, that has

begun to change. Please

welcome our speaker, Professor

Patrick McGorry. Thank you, and

thanks to the National Press

Club and the Australia Day

Council and fellow Australians,

I thank you for this

opportunity to speak today.

What is Australia's most

precious natural resource? Is

it iron ore? Is it coal? Is it

gold? Our most precious

national resource is our

health. Sadly in our country

today, a major part of our

health is sorely neglected, our

mental health. If we were a

mentally healthy, if we're

mentally healthy we live

longer, achieve more, have a better family life, more

friends and contribute to a

safer more productive

Australia. Mental health means

national wealth. Australians

increasingly understand that

mental health lies behind a

young woman's concern about her

body image, behind bullying and

youth violence and behind binge

drinking and drug abuse.

Mental health weakens

workplaces, burdening working

families and drives the

senseless loss of life from

suicide. Growing awareness

about the widespread impact of

mental health on our lives

means it's high time we meet

this challenge head on. One of

the most exciting things about

living in Australia in the 21st

century is our ability to

protect our mental health and

even to recover it when it's

lost, has never been greater. There's overwhelming support

for national action to break

the violence, end the neglect

and welcome all Australians

with mental ill-health into our

hearts and into our health

system. Australia is at the

tipping point. Our need for a

new approach to mental health

care is now matched by our

desire and our capacity to

achieve it. We owe it to

ourself and to our children.

So today I'm going to talk

about how Australia can adopt a

21st century approach to mental

health and the huge benefits in

doing so. I'm going to take

you through three steps.

Firstly to describe what a 21st

century approach to mental

health means in practice.

Secondly, outline the benefits

that we can expect from

adopting a 21st century approach and finally,

identifying what we can all do

to make a 21st century approach

to mental health a reality for

all Australians. So what

problems can a 21st century

approach solve? It has to solve

these. A 21st century approach

is about solving the problems

of needless disability and loss

of life. Our current system

supports and services our

woefully inadequate. We need a

new approach today. Today,

1,000 Australians with mental

ill-health will present in

distress to emergency

departments and be turned away

without receiving care. Today,

6 Australians will die by

suicide, many more will attempt

suicide or self-harm. Today,

1,000 years of healthy life

will be lost to mental

ill-health. This costs up to

$30 billion every year, three

times the minimum resources

rent tax. Today, Australians

are up to three times less

likely to receive quality care

for mental ill-health than for

physical ill-health. This is

health care apartheid. Today,

thousands of Australians with

severe mental illness are in

our jails, because there are no

other options and they haven't

received the mental health care

they needed when they needed

it. Today, mental E-Health

services are given the impossible task of addressing

13% of Australia's health

burden with just 6% of the

health budget. Tonight, in the

middle of Australia's winter,

thousands of Australians,

mostly young Australians with

mental illnesses will sleep

outside because we don't have

adequate number or range of

accommodation services to give

them shelter. These aren't

just numbers, they represent

the pain and anguish of real

people and real families. I've

heard directly from hundreds of

these Australians this year.

It's a heart rendering

Australian story which could be

one day your own. This has to

change. So we know that a 21st

century approach to mental

health must fix these problems

and provide real benefits to

Australians. So what will a

21st century approach to mental

health do? A 21st century

approach to mental health means that Australians understand

what it means to be mentally

healthy and are able to

recognise as they do with heart

disease and cancer the earliest

signs of mental ill-health.

Currently many people don't

recognise when their mental

health is failing and don't

seek help. A 21st century

approach to mental health means

the response from family,

friends, workmates and colleagues and health

professionals is supportive and

skillful. Everyone is equipped with the knowledge and skills

to respond in a helpful way.

The same as when someone

sprains their ankle, has an

asthma attack, faints or

develops chest pain. Today

we're uncertain about how to

respond to distress and

disturbance and we naturally

turn away. Tomorrow, with the

right information and skills we

could really help. A 21st

century approach to mental

health means that Australians

feel comfortable to share their experiences of mental

ill-health to those close to

them and ask for help if they

need it. Phrases like nutter,

psycho will become

unacceptable. This is the

antidote to the poison of

stigma. A 21st century

approach to mental health

provides stigma-free mental

health care closely linked to

primary care, this includes assertive mobile teams

available 24 hours a day, just

like other Emergency Services.

Not knocking off at 9pm and

saying, " Go to the emergency

department" , just not good

enough. This will stem the

flow of Australians with mental

health into emergency

departments. The current

system has virtually collapsed

under the strain and keeps all

but the most desperate at bay.

Only one-third of the

Australians in need of mental

health care each year actually

receive it and then it's too

little too late. Often, very

late. A 21st century approach

to mental health means that

people with mental ill-health

receive high-quality physical

health too, so their life

expectancy comes to equal that

of the general population.

Currently, Australians with

serious mental ill health just like our Indigenous population

have less access to quality

health care and typically die

20 years earlier from cardio

vascular disease, cancer, as

well as suicide. 21st century

to mental health care cares for

Australian children and tackles

the key drivers of later ill

health such as social

disadvantage, child abuse and

neglect, bullying, poorly

treated addictions in the

parents. Currently there's a

serious neglect of presentative

opportunities and the key

drivers of mental ill health in

childhood and beyond. A 21st

century approach to mental

health makes available to young

Australians a stigma-free

system of care which includes

multidisciplinary expertise. It creatively uses new

technologies. Currently, our

system is weakest where it

needs to be strongest. The

peak period of onset for mental

ill health is between 12 and 25

years, yet this age group still

has the worst access to care.

21st century approach delivers

equity and equal access and

quality for mental and physical

ill health. It sets target for

reducing the suicide toll and delivers a national suicide prevention strategy on the same

scale as the campaign to reduce

the road toll, not just some afterthought, but on the same

scale as this massive effort

that we put on deck every year

to reduce the road toll.

Currently, there are well over 2,000, mostly preventable

deaths from suicide each year

and an an avoidable tragedy

every four hours. It's the

biggest killer of ages up to

age 40. This is 40% greater in

magnitude than the road toll.

Hidden from public view. Let's

bring it out into the open. A

21st century approach to mental

health ensures all Australians

with persistent serious mental

illness are able to live in a

safe and secure environment,

namely their own home. Let's

correct this great failure of

de institutionalisation. A

21st century approach to mental

health features strong investment in research,

especially research into novel

treatments. Currently only

3.5% of our national health

research budget goes to mental

health research. This is a

serious side effect of stigma

and prejudice. Although we do

have effective treatments just

like in heart disease and

diabetes, we always need to

strive for safer and even more

effective treatments and not

only drug therapies, but novel psychological interventions and

social care. So the 21st cent

approach in practice. The 21st

century approach to mental

health care may sound a world

away from where we are now, but

a growing number of Australians

have already experienced what a

21st century approach means in

practice. As one example of a

21st century approach already

available, I'm going to pick the example of the exciting

youth mental health model

emerging around Australia.

This model is built around two closely-linked components.

Headspace for young people with

mild to moderate mental

ill-health and epic, early

psychosis services for young

people with serious mental

illness. The Government, the

Coalition and the Greens have

all endorsed this model as the

template for our future. The

crucial difference between the

parties currently is how

quickly this model is made

available to the general

population. The best way to

grasp the 21st century nature

of the approach represented by

headspace and Epic is to think

of that other 21st advance the

I phone. You can all pull your

I phones at this point, if you

like. The breakthrough behind

this modern icon is that it

simply brings together in a

single platform so many of the

key tools that we need to

function in the modern world.

It's engaging, it's efficient

and incredibly popular.

Everyone wants one. Headspace

and Epic are based on the same

simple idea - the one-stop shop

where, the main applications

that young people need to

protect or recover their mental

health can be found. There's a

range of applications

available. Youth-friendly

doctors, allied health

professionals, drug and control

clinicians, educational and

vocational expertise and other

back-up programs such as

community awareness and

outreach. Every community

wants and needs one of these

too. Headspace is an enhanced

form of primary care based in

the heart of the community and

gift-wrapped in a youth-friendly environment.

Real expertise without stigma

or strings attached. There are

many young people with more

complex or severe forms of mental ill health who need

access to additional applications such as hospital

or residential care, 24-hour

home-based interventions,

access to specialised

psychiatrists or clinics.

Hence the need for an

integrated back-up system for

headspace. This back-up is

Epic, which provides more

specialised care aimed at

maximising recovery for a

serious mental illness,

especially psychotic disorders.

During the challenging early

years of illness when great

therapeutic tenacity and sophisticated scaffolding is

critical. Epic has been

successful in reducing the

disability, mortality and costs

of potentially serious

illnesses like schizophrenia

that it's been developed in

hundreds of locations across

the developed world. Yet

ironically in Australia, where

Epic was invented it's

available to only a fraction of

the young people who need it.

Headspace can't function

properly without this back-up

system and it's, therefore,

very welcome news that all

major political parties and the

a national health and hospitals

reform commission have recently

endorsed a national roll-out of

Epic alongside headspace. Just

as the wonder of the iPhone was

made possible by engineering,

the 21st model of mental health

represented by headspace and

Epic is based on the cutting

edge understanding of young

people and their mental health

and a solid evidence base to

boot. What are these

distinctive innovations? Well,

let's start with the youth

focus. Traditional Mental

Health Services have been

divided for services under 18

and over 18. This makes no

sense. We know that the

emerging adult phase of 12-25

years is distinct from early

childhood and from older

adulthood. Headspace and Epic

focus on this age range within

a youth-friendly culture that

can engage young people. Early

intervention is the key

principle which means as soon

as problems emerge they're

responded to. Early

intervention is established in

general medicine but in mental

health, it is only now breaking

into the mainstream. New

technologies are Internet-based

information and therapies are a

feature and headspace and Epic

seek to work in a collaborative partnership with other services

like Reach Out and Young Beyond

Blue. The approach of

headspace and Epic is wholistic

and multidisciplinary with a

range of health and other

professionals involved,

including GPs, psychologists,

other Allied Health

professionals, drug and alcohol

counsellors and vocational

educational programs. Families

are welcomed and supported as a

key resource in a young

person's recovery. Youth

participation is a hallmark.

Headspace and Epic are service

s that innovate new ways of

being accountable to young

clients and inkoorpting their

ideas in further service

improvements. Finally,

headspace and Epic are

optimistic of a recovery focus. There's real faith in the

resilience of young people,

while ensuring they still

receive the most expert help

when they need it. The need for help doesn't mean you're

not resilient. The aim is to

provide some of the extra

scaffolding and specific

interventions that so many of

our young people need to resume

healthy and fulfilled lives.

There are 30 locations for

headspace around the country,

soon to be increased. There's

still only one Epic, now

broadened to cover severe mood

and borderline personality

disorders and known as Origin.

What does all this redesign

mean for a young person who

needs help? Let's look at the

story of Jack, a 19-year-old student who's become more

withdrawn and flat in recent weeks. He's worried about

himself, but it's his friends

who press him to open up and he

shares his experiences of deepening depression with them.

After getting online and

gleaning key information from

websites like Reach out Beyond

Blue and headspace, Jack talks

with his mother and sister and

makes an appointment at the

local headspace. He feels at

home when he turns up for his

first visit and is really

encouraged by the friendly

welcome from the young

reception staff. And the youth

access team who he meets on

arrival. The decor and the

general vibe of the place, it

really is the vibe. He sees a

GP who seems to know how to put

him at ease, even though Jack

doesn't really feel like

talking much. He sees a young

psychologist at the same visit

and he's offered a series of

counselling sessions. It's

agreed he doesn't need

medication at this stage. He

gets advice on the use of drugs

and alcohol and an appointment

is made for him to see the

vocational expert who plans to

help him hang in there with his

studies, with which he's been

struggling in recent months.

Despite all these efforts, Jack

finds himself sliding deeper

into depression and after eight

weeks in, consideration is then

given whether he might benefit

from a trial of

anti-depressants. Because he's

developed warning signs of psychosis in that time he's

assessed at headspace by a

psychiatrist linked to the

integrated specialist Mental

Health Service. He recommends

trying anti-depressants, fatty

acids or fish oils and some cognitive behavioural therapy

in an evidence-based effort to

turn things around. This

course of action begins to work

and within a couple of weeks

Jack has turned the corner and

is on the road back. He and his family and friends know

this is a risky period and he's

monitored very carefully with back-up from the home treatment

team for any suicidal risk

which actually can occur

sometimes paradoxic ally as young people are on the

improve. He doesn't end up

needing hospital care, but if

that had been necessary it

would have easily been arranged

within the headspace linked

youth mental health system.

This is a snapshot of the

immediate future for Australia,

a future which is now in place

in some parts of the country,

but it's within easy reach of

the whole society. It doesn't

depend on new advances and

treatment, just political will

and funding. It contrasts

starkly with the many tails of

misery and tragedy I've heard

this year. -- tales. There

are many tasks facing us, of course, in mental health

reform. As well as stemming the tide through early

intervention, we must ensure that those who have already

been swept away are rescued. I

met such a person a few weeks

ago. A hugely impressive man

of 42 years who was working in

a vocational recovery program

in Melbourne in paid

employment. He was handsome,

personable, tall and athletic.

He told me that six months

earlier he had been 50 kilos

heavier, sleeping 20 hours a

day on large doses of

medication, and living with his

elderly mother. A change of

medication, a fitness program

and someone who cared enough to

connect him with a vocational

recovery program known as the

Madcap Cafe in Melbourne -

great name - and his own

resilience, changed his life.

This man had been ill with

schizophrenia since age 19 and

he spent two decades on the

scrapheap. And, at times,

homeless. There are two

lessons in this story of

awakening. There is hope for

everyone affected by mental ill

health. We should never give

up. Secondly, how different

would his life have been if he

had had access to early

intervention and quality care

from the outset? OK, so what

can we do? Well, for all

Australians we can challenge

and defeat stigma whenever we

encounter it. It's vital that

every Australian touched by

mental ill health share these

experiences in an open and

unashamed way. That's the

first step. In fact, we can

all talk openly about mental

health and mental ill health

with family members, friends

and colleagues. I might say at

this point, the media has done

a wonderful job in the last few

months in bringing this issue

to the fore and opening up this

discussion. We can do a mental

health first aid course to

increase skills and confidence

about responding to the mental

health needs of the people

around us. We can donate

money. I call on

philanthropists big and small to support mental health

research, innovation and

advocacy in Australia. We can

organise and go on marches,

like the huge one last

Australia Day organised by a

bereaved mum who had lost her

son through suicide and if you

and your family have already

been let down by our

beleaguered mental health

system, take action, and let

people know why you want a 21st

century mental health system.

Headspace, Epic and other

innovative models for all ages

accessible in your community.

Write to the papers, ring

talkback radio, arrange to meet

your local MP, form a local

action group. Grill a local candidate on the mental health policies and even consider

running for election yourself.

Whatever you decide to do, take

the first step today. Perhaps

by joining the 100,000

Australians who have already committed to action for mental

health at www.get up.org.au.

Now for those of us working in the Mental Health Services, we

have a critical role to play.

The most useful thing we can do

is to be open to innovation and

change. We also need to stay

united and it's great to be

able to say that over 60

organisations signed a recent

letter in protest following the

COAG meeting to the former

Prime Minister. This kind of

unity is unprecedented in the

mental health field and we

received great support from the

whole health sector on this

issue. Most people choose a

career in mental health because

it's an opportunity to express

compassion, to help people

going through tough times to

pick up the pieces and reclaim

their lives. For many people

in our field, working in a

crisis-ridden system built on

the war-time system of triage

is a bruising experience. It

often means the quality of care provided is not as it should

be. We need regeneration and

renewal. So as the Australian community and the Australian

governments immobilise behind a

new vision of mental health

it's an opportunity for all of

us who work in mental health to

deliver the quality care we

desperately want to provide.

We should seize this

opportunity and work with governments and the community

to create a world-class, 21st

century model of mental care

that becomes the envy of others

around the world. We need to

recruit from the gifted and

talented and to compete for

them aggressively. I encourage

Australians to actively consider a career in mental

health, train to become a

social worker, psychologist, occupational therapist, nurse

or doctors. I say to medical

students - I spoke at a

national conference the other

day - medical students and

young doctors, consider a

career in psychiatry and you

will help create the future,

not burn out at 50. Psychiatry

is the best focus for altruism

and a fulfilling life in the

medical profession by a country

mile. OK, now to our political

leaders. They're not immune

from the threat of mental ill

health. A substantial minority

of politicians just like the

rest of us, have experienced

mental ill health. Through the

courage of people like Geoff

Gallup, Andrew Robb and John

Brogden to name three, we have

role models as well as

champions for progress. They

all found it help to get the

expert help they needed until

pretty well late in the piece. Many other politicians have

been supportive, but mental

health needs champions at the

very top. There are three

immediate steps that our

political leaders can take to

kickstart a process of national

transformation on mental

health. Firstly, commit to

ending the second-class

service, the apartheid in the

health system for Australians

with mental ill health. All

governments should make their

core policy goal in mental

health ensuring that

Australians have the same

access to quality care for

mental health as they do for

physical health by 2020.

Secondly, make immediate, and I

mean immediate, good-faith

investments in proven models of

care in which the government and governments have full

confidence, and I've given you

some examples of those. When

mental health was locked out of

health reform at COAG it was an

example of " a good government

having lost its way". There's

now a great opportunity for the

new Prime Minister to restore

faith by making immediate

mental health investments aimed

at improving services, reducing

suicide and creating new

knowledge. We have a new full

forward with a safe pair of

hands. Kick the goal Julia,

the crowd will go wild. The

Government can and should

invest in an additional $500

million per annum from next

year in improving services by

supporting the implementation

of mental health

recommendations of the national

Health and Hospitals Reform

Commission and can and should

supplement this with an

additional $140 million per

year from next year for

research, innovation and

additional suicide prevention

measures. The third area is to

work collaboratively to develop

a continuous 10-year reform and

investment plan. All

Australian governments working

together and in partnership

with the mental health sector

need to finally face up to this

national responsibility. They

should develop a target-driven,

fully-funded reform program

that addresses the five key

areas of leadership, funding,

access, skills and standards.

Leadership. We need sustained,

committed leadership that's no

longer afraid of setting

priorities and targets for all

levels of government. Funding.

We need to progressively move

mental health funding towards

its share of the health budget.

By 2020, mental health funding

needs to be double as a

proportion of the health budget

of what it is today. We've

just seen that there is a

political imperative, then

money will be found. Several

examples. For acute hospitals,

to take the mining tax off the

agenda and to diffuse the

asylum seeker issue. Mental

health is now a political

imperative. Middle Australia's

anxious about that too. The

Prime Minister is sensitive to

Middle Australia's mood. She's

made it clear that the asylum

seeker issue is actually driven

by real pressures in the outer

suburbs driven by urban sprawl,

unplanned growth and lack of

services, rather than by fear

of what is really a handful of

desperate people. The lack of

services is nowhere greater

than in mental health. Middle

Australia doesn't have Jeff

Kennett's phone number, or

mine. On access, we need a

plan to ensure every community

has access to this 21st century

model of mental hel. Why

should some communities have

access to 21st century care

like headspace and Epic, and

others not? Why should they

have to wait? The 21st century

is here. Skills. We need to

develop the skills and numbers

of the mental health workforce

and enhance our knowledge of

what works by supporting

research, not on this nyfl 3.5%

level, and on innovation.

Money will solve this problem.

And finally, standards. We

need to set quality standards and establish accountability

frameworks, including

accountability to the service

users. Since I was honoured in

Australia as Australian of the

Year, I've been bombarded by

email, phone and letter with

people's individual stories of

tragedy, struggle and desperate

pleas for help. Australians

from every walk of life, from

every section of the media and

from within the bureaucracy and

all political parties, have

encouraged me and urged me to

continue to advocate as

strongly as I can for urgent

and sustained action. To give

a voice to people with mental

ill health and help Australia

find its voice. This is

happening and it can't be

stopped. I'll continue down

this path this year and on into

the future and I know that the

true believers of the mental

health field and hundreds of

thousands of Australians will

be walking with me. This is

not an issue that polarises

Australians. It unifies us in

common purpose. It's a classic

example of the fair go. So to

summarise, a 21st century

approach to mental health will

mean you and your family will

have access to knowledge, understanding, assessment,

quality care when you confront

mental ill health. A 21st

century approach to mental

health is urgently required by

millions of Australian families

who are unable to access the

mental health supports they

need, and it will deliver

significant economic and social

benefits to all of us. Mental

health is national wealth, not

just a bigger GDP but a bigger

GHI, global happiness index.

Lives will be saved and there

will be many fewer bereaved

parents and a happier more

productive Australia. A 21st

century approach to mental

health is achievable through a 5-point plan on leadership,

funding, skills, access and

standards, with the aim of

ending unequal access to

quality care between mental and

physical ill health by 2020. A

21st century approach to mental

health care can be kickstarted with an initial Australian

Government investment of $500

million per annum in enhancing

services and $140 million per

annum in new knowledge creation

and suicide prevention. A 21st

century approach to mental

health starts with you. So

start taking action to achieve

it today. In conclusion, 21st century approach to mental health will transform

Australia. It will transform

our understanding of ourselves,

our family lives and the fabric

of our communities. We can do

it, we will do it, so let's get

started now. Thank you. APPLAUSE

Thank you very much. Time

for questions from the media

and the first one from the

'Sydney Morning Herald'. I'm

from the 'Age' and the 'Sydney

Morning Herald'. When you were

named the Australian of the

Year I thought, well that will

lock in the sort of funding

increase that you needed by

this Government, and then I saw

that you met the Prime Minister

once or twice, I thought "Well,

that will be sure to mean a

good funding boost for Mental

Health Services". Why do you

think that didn't happen, and

do you have any thoughts about

how Julia Gillard might respond

to the sort of appeal you've

made today? I think I've

already alluded to that in my

talk, but just to go back over

it, I think one of the reasons

that our political leaders

haven't... I think they haven't

realised the power of this

issue in the community. When

the polls are assessed and taken, it's something that

hasn't cut through until more

recently, so they've underestimated the extent to

which the Australian public

expect action on this issue.

They don't argue with the need

or the logic or even the policy

settings. I think as I said, there's bipartisanship

agreement on the policy

settings, but it's the urgency

that hasn't cut through.

That's changing. It certainly

wasn't present in the early

part of the year and I think

COAG did go off track. It's

lopsided what was announced in

COAG $7.4 billion into acute

health and may be $100,000 into

mental health. They

underestimated and reaction of

the field. I've never seen the

sector more stunned, outraged,

furious than in the last few

months culminating in John

Mendoza's resignation. There's

no point shooting messengers.

There will be many more to take

their place. We have had a

circuit breaker and hopefully a

game-changer on this and

hopefully the Government will

be able to do the right thing

on this issue. I certainly

think that Julia Gillard, we've

got a lot of confidence that

she will actually step into the

breach actually and support her

Health Minister to actually

close this gap. Julia Gillard

has an understanding of the

mental health field. She's

visited our young Mental Health

Service on two occasions when

she was Shadow Health Minister.

I'm confident she gets it.

We'll have to see how it all

plays out. She's obviously had

a few other issues to deal with

before she gets to this, but

we're looking forward to

discussing this issue. You

alluded to several politicians

who've gone public with their

mental health issues. Some people, of course, would say

you'd be crazy to go into

politics, which brings me to

our previous Prime Minister. A

fortnight ago today was his

last day as Prime Minister and

we've seen journalistic

analysis and commentary before

with David Marr talking, saying

he's driven by anger and we've

seen commentary since then, and

it seemed he had behavioural problems, he lost contact with

political reality, he had a dysfunctional relationship with

his peer group insofar as the

caucus. I wonder if from your

point of view, you have any

insights into his prime

ministership, and its demise,

and what kind of... how should

he deal with the change in his

life that's now occurred? I

don't know if you saw 'Q&A' a

week or two ago, there was a

huge discussion about this

issue then. I don't think it's

appropriate to actually

speculate on people's

personalities or private lives.

All I can say is from what I've

read about the Prime Minister's

life, the former Prime

Minister's life, he showed a

fair bit of resilience

actually, and other than that I

wouldn't like to say anything

further. It is a tough life in

politics. It's very stressful,

so maybe the rates of mental

ill health are even higher than

in the generally community

because of the pressures and

scrutiny they're placed under. I understand that most

politicians are trying to do

the right thing. I just want

to help them. I want to help

they will do the right thing on

mental health. For anyone,

though, that finds themselves

in a position, be it in public

life as an academic, or a

business person who's pulled

down so publicly and who has so

much taken away from them where

they've invested a lifetime if

you like, I mean, that must

have some impact? I know

obviously my question infers

that I'm talking about Kevin

Rudd, but more generally what

should someone do - and I think

the point that Simon's trying

to raise - what should someone

do if they find themselves in

that position? I think the

Australian public empathised

quite strongly with the former

Prime Minister actually, for

those very reasons. It's an

example of what we're here

today to talk about, that if people do go through tough

times, if we can put it that

way, or if that unbearable

stress does get on top of me, they should basically share

their feelings, draw on the

support that's around them and

most people do get through with just those simple things being

in place. If they're not in

place, then obviously you've

got a fair way to fall. But,

you know, sometimes people do

need help and some politicians

actually have acknowledged

that. So it is a high-risk

occupation you could say, but

there are lots of other ones,

too. We now have a bipartisan

commitment to offshore

processing of asylum seekers.

You've previously said that

locking people up, asylum

seekers up in remote areas is

injurious to their mental

health. What's your view of

the Gillard Government's

solution? I've been invited by the Australian Government in

the next week or two to visit

Christmas Island and I think

that's a great opportunity to

actually get a first-hand look

of how these sorts of policies

are working, particularly from

a mental health point of view,

which is my focus. And as you

say, prolonged detention and

particularly the TPV process

which created just such massive

uncertainty and isolation in

people, that the clear-cut

research evidence now to show

that those were very harmful to

people's mental health. So I

know that the department has

tried to ensure that those

issues are addressed, but

that's what I'll be looking at

and rather than commenting in detail at this stage, I'd

prefer to wait until I've got

something more substantial to

say on it. Can you justify for

us the emphasis on funding for

youth psychosis and other

serious mental health issues

for young people when other

areas of the mental health

system, such as Mental Health

Services or services for older adults are also neglected? Thanks, it's a great

question. Well, it's very straightforward. First of all,

there are a lot of things that

have to be done and I've

acknowledged that. We need a

10-year reform framework and

it's not a question of just

doing one thing. However, 75%

of mental health problems do

appear before the age of 25

years and we have a very solid

evidences base that by focusing

on that peak period, that surge

of people that occurs from

puberty through to the mid 20s,

we can actually shrink the

burden right through the

decades of adult life. So it's

a question of turning off the

tap, or stemming the tide. Now

obviously as I said, we've got

to pick up and look after all

the people that have been

washed away in the past and

catch up, so it's not a

question of ignoring one group

by focusing on another. We've

got to do a number of things,

but clearly if we have a finite

amount of funding, we've got to

get the best bang for our buck.

We've got to invest in highly

cost effective strategies and

there's nothing more cost

effective. Everyone perhaps has

sympathy for young people who

suffer from the least serious

to the most serious problems

with mental health, but the

reality is that we know that

for many people, or at least

it's my understanding, for many

people who suffer from mental

health, this can, in fact,

encourage them to use illicit

drugs. People who use illicit

drugs can, in fact, generate

mental health problems and some

of those people - I'm not too

sure of the proportions, I

wouldn't know - go onto become

drug addicts and the reality is

there's much less sympathy for

people in our society with drug

addiction. There can be a view

that they've brought it on

themselves. What do you say to

people with that view? Well,

that's been one of the problems

more generally in mental

health, actually. A judgmental

attitude borne of ignorance

really, which we're trying to

correct. But you're quite

right in the sense that having

emerging, even mild mental

health problems like

depression, anxiety as you move

through adolescence places you

at great risk of developing

drug and alcohol problems. It's

a huge risk factor. If you

have an untreated depression or

anxiety disorder in early

adolescence, then your risk of developing alcohol and other

drug problems goes up by

probably five or six times. So

it's a huge driver of the drug

abuse and drug dependence and

alcohol dependence too.

Probably alcohol as much as

anything, that we see in later

stages of life. Of course it

works the other way, too.

Excessive use of alcohol and

use of illicit drugs creates

other mental health problems,

too. So it's chicken and egg

in some cases, too. This is

why we must integrate the care

of some of those sets of

problems in the one area. This

is why headspace with its

one-stop shop with expertise in

both areas is the way forward.

We need to also integrate our Drug and Alcohol Services with

our Mental Health Services in a

specialist area, too. You've

been remarkable successful in

bringing these issues to the

fore since January, but I

wonder if you think the

community awareness of them is

really as high as you would

hope? I mean, I can understand

that the mental health sector

was outraged or shocked or

whatever you choose to describe

it about the funding

arrangements earlier this year,

but some of the statistics you

quoted today would shock a lot

of people, particularly people

who still have predominant care

of quite young children,

teenagers. What should people

be looking for and how should

they be made more aware of

problems that arise? The people

affected probably don't

recognise them first, but

others around them

might? Great, thank you Ken.

First of all, I think Beyond

Blue has done a wonderful job

in making the progress we have

made. There's a hell of a long

way to go and the focus has to

be way beyond just depression.

Depression's only one part of

the mental health spectrum, so

we need a continuous national awareness campaign around

mental health, literacy and

awareness and information,

exactly as you say. That's one

of the things on the list

within that 500 million that

we've put together, which the

Government needs to do. That

will have a huge effect judging

on the success of Beyond Blue

to date. So that's vital. In

the meantime, the sort of

things people have to look for

- obviously, we don't want to

just medicalise every brief

period of stress in people's

lives and we've got to set the

boundary at the right level,

but we're so far away from that at the moment. The sort of

things that people need to look

for are persistent distress,

impairment at work, or in

vocational activities, impaired

relationships. If your

relationships are going

pear-shaped and it's been

driven by mental ill health

that's another thing to look

for, so they're quite generic

sort of warning signs if you

like that something's not quite

right. And then we've got to

look behind that and arrange

for assessment, and people have

to know, as you say, how to

look inside and reflect and

recognise. But also we can

look out for each other here.

It's often hard to notice if

you're sinking into a

depression or withdrawing and

developing psychotic

experiences you may not notice

that as well as the people

around you and if - what my

colleague in Melbourne has done

great work in this, mental

health literacy and first aid.

We can empower the public to

actually be on the front foot

and actually nip things in the

bud, pre-empt all the

collateral damage we see. It's

a do-able thing. We have got a

big task in front of us. This

is why we say it's a 10-year

strategy. We can't just a

flurry of activity in the

lead-up to the election and

forget about it later. This is

a national campaign, a national

movement really, for the next

decade. You spoke about the

strong link between alcohol and

drugs and mental health. I'm

just thinking about the

incidents we've seen this week

in the football with sleeping

pills and I heard one interview

where a Football Club said it's

common practice to take sleeping pills to come down

after a match. We've seen

images of people handing out

the caffeine Nodos match,

junior match by the handful.

They often get talked about as

role models. Wondering what

your views are? As a political

issue, as a back-up question,

is the whole issue about

Scientology and its

anti-psychiatry sort of

position, there's inquiries

that are being urged in

Canberra into those sorts of

issues. Wondering where you

stand on that? Sure, thank you.

The issue of drugs in sport and

role models. Obviously it's

not a good look what we saw in

the media, but what I'd stress

is the great role models we

also have in the sporting arena

and in football, as well.

People like Nathan Thompson who

actually played a huge role in

I suppose making the mental

health issue more open and

discussed in a better way,

including the drug and alcohol

issues, as well. So it's not

all bad news there. Coming

back to the Scientology issue,

I would just say that any

campaign that makes it more

difficult for people to get evidence-based and effective

help for their mental health

problems has to be watched very

carefully. I was interested,

you've mentioned several times

the lack of services directed

to younger people. Why is

this? Hasn't this been

something that we have known

forever? Or is it a phenomenon

that has become more marked in

modern society, that younger

people are getting into these

fraught states? I wish I could

have showed you some of the

slides. It wasn't possible

today, but there's one slide

that shows this, a picture is

better than a thousand words,

but it shows this surge of

mental health from puberty

through to 25, where all the

major disorders of, mental

disorders of adult life appear

in young people and when I've

shown that slide, I've shown it

hundreds of times now, people

are just amazed. It's something they did not know and

it's the big mistake we made

when we mainstreamed our mental

health system into our general

health system. The pattern of

illness in general health is in

little children up to about 12,

and over 50. In the middle

we're pretty healthy, but we're

not mentally healthy. That's

the peak period in the life

span for mental ill health. So

the engineering of a health

system is back to front in a

way. It's not as easy to

integrate as we originally

thought. But people have to

understand that pattern of

illness and disease across the

life span, and they also have

to understand the culture of

young people, so they're not

just going to go for child-orientated services or

services orientated towards

middle-aged people. They won't

engage, they're not comfortable. That's the

reason, and I don't think

people have known that. So the

main thing really is to get

this message across. People

find out about it when their

teenage kids or their young

adult kids hit this wall and

experience problems and they go looking for help. These are

all the letters I get. The

emails and the phone calls.

They can't find it. They ring

up Jeff Kennett and he says

"I'm sorry, I don't know who

you can go to". That's why we have this massive construction

task on our hands which both

sides of politics have

committed to. Admittedly, at

the moment at different rates,

but they recognise it. They

have got the message and I

think it's something we didn't

really know as a community until recently and it is getting worse, coming back to

the second part of your

question. It's getting worse.

Decade by decade we do measures

and the mental health people of

worse. There's something going

wrong with our world and

they're showing it up, they're

the miners' canaries. We've

got to get to the bottom of

that, too. I've asked him my

political question, now I can

ask him my science question.

All of the questions have been

about primary health care,

service delivery. When you

appeared before the Senate

committee last month you talked

about the lack of research in

that area, and a failure... I

think you called it mental

research platforms. Are you

critical of the ARC, bodies

like that, in terms of how they

decide where the money goes? Or

are you more generally seeking

more money for medical research

so that mental health could get

more? I think it's a structural

problem. The result it's delivering is clearly quite

unsatisfactory to us as a

nation. It's 13, 14% of the

burden of disease. It's

actually 36% of the burden of

disease up to about the age of

44, so it's a massive public

health problem which we're

devoting pathetic amounts of

money to, 3.5% of the NHMRC

budget. Is it their fault? I

don't know. The result's not

good. I think we may need a

different structure. We certainly need affirmative

action to restore that balance,

same as we need in the health

services side. It's even worse

in research I think is the

point I was making. It's even

worse and I think it's also an

effect of residual stigma, the

effects of it. It's not

important, it doesn't rate, and

maybe the decisionmakers in

these areas have been protected

in the same way from the

experience of the community as

the politicians have. They

haven't actually realised how

big a problem it actually is.

They look at the figures, but

figures don't really impact in

the same way as 15 people

outside your electorate office

do. You said that mental health problems are on the

increase. There's a higher

prevalence now because you said something's gone wrong in the

world. Can you flesh out a bit

what you think might be behind

this increased prevalence?

Briefly on prevention, there's

talk of intervention and

treatment, what about

prevention, what can people do

to keep their mental HealthScopy? Great questions.

The evidence is really around

this teenage and young adult

period in terms of increase,

so, I think intervention is

really important, but some of

it's hard to do, because the

big risk factors for mental

disorders, especially the

long-lasting ones of adult life are actually things like child

abuse and neglect. If that

disappeared tomorrow, we'd have

30% less cases of mental

illness in adult life, so

that's a huge risk factor.

It's like I suppose the high

cholesterol of mental health,

or the high blood pressure.

It's big risk factor, but it's

a hard one to knock off, isn't?

It people are trying to do that

and our systems of child

protection and so on aren't working particularly well

either. So that's one of the

preventative strategies we need

to focus on. There are other

ones, though. When children

are living with mentally ill

parents, those parents need a

lot more help than they're

getting at the moment to look

after the kids. That's a more

ofocal one, but we do need to

focus on prevention and involves an early childhood

focus and then through the

middle years of childhood. So

prevention's really important

in that stage and then when do

we see the surge of new cases

occurring? After puberty. It's

a matrix of things we need to

be doing. One quick question,

is society simply too pressured

today? I wish Richard Eckersley

was here, he's thought deeply

about why this rise in mental

health is occurring. To be

honest, no-one knows yet, this

is another area for ch research. Candidates have been

thrown up, the increase in

family breakdown, the wider

ability of drugs and alcohol -

those sorts of things, I

suppose. The society is much

less cohesive than it used to

be. You probably don't see the

same level of mental ill health

in young people in more

traditional societies. So

those sorts of things have been

speculated about, but that's

another area. We need to get

to the bottom of that too. The

level of youth violence and I

think alcohol is a huge issue,

so all of these things need to

be better understood. While

we're trying to understand

them, we've got to do something

to help these young people and

everyone affected by mental ill

health. We can't just wait

until we actually understand

what the drivers are, but we do