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Speaker: Ms Robyn Kruk AM, Chief Executive Officer, Australian Mental Health Commission Our National Investment in Mental Health - transcript

MS KRUK:  Can I say there's really no better way to indicate what sits behind the establishment of the Commission.  It's people like Dee with lived experience, it's people like Pat McGorry that are the major fighters that have actually got attention to mental health, have got discussions that are recurring such as this one, but also lead very much on to what I want to touch on today.

Norman and Pat refer to the fact that the Commission has only recently been set up, and Dee actually opened the Commission on the 1st of January this year, and that very much signified the significance that we pay to people with lived experience and their carers and families and supporters as well.  Dee is class.  You know, she's such an amazing person, and the story that she tells is actually what we are striving to do in terms of producing a report card on mental health and suicide prevention.  Because, that sounds like a particularly dry, bureaucratic sort of venture - and doesn't Robyn look like a bureaucratic sort of person - - yeah, I am, you know, unashamedly.

But, the report card is unashamedly a chance to look at mental health in the broader context, not just about illness, and I really do echo Pat McGorry's words.  The theme the report card will take, is very much looking at the concept of a contributing life, a safe place to actually go back to; the opportunity to actually participate in community, whether you actually do that in a paid sense or an unpaid sense, but actually to be part of a broader community, and to be recognised in that; to enjoy good health.

The figure that always strikes me - and Pat picked it up as well, too, we tend to put people in boxes.  You're either physically sick or you're mentally ill.  There is such a strong correlate between those, and some of that data will come through in our report card, which will come out later on this year.  One of the starkest facts: if you currently experience mental illness, particularly severe mental illness, you are likely to live between 15 to 20 years shorter than someone actually who doesn't experience mental ill-health.  Why is that?  Because at the moment, if you have mental illness, that overshadows it.  So, say, for instance, if I experience a migraine and go into a doctor, he or she will normally offer me some form of treatment for that, and probably hopefully also look at some underlying causes.  Someone experiencing having mental illness going with a similar symptomatology, the doctor is more likely to say that may actually have something to do with your mental illness, so that overshadowing effect.

The report card is aiming to look very much at the concept of a contributing life, and hence I was so keen when Paul asked me to speak at your conference today, because workplace is such an important one - home, housing, health, the ability to contribute, the importance of connections between carers and families, the concept of a contributing life.

Look, I think Dee's experience highlights many things.  What really struck me - and it still can I say, I can't watch it without becoming quite emotional, too - is that Dee was a carer, Dee is a carer, and Dee said to me quietly, Rob, can we not make, you know, too much of this, because my employer doesn't know that I'm a carer.  It's something I've actually kept from them.  Now, what that indicates is a number of factors that I think Pat and Norman actually touched on.  The statistics are pretty stark.  In every year, one in five; in a lifetime, one in four.  If you were a betting person, you don't need to do the numbers.  Either the odds are pretty strong that everyone in this room, myself included, is very likely to either be a carer of someone who is experiencing mental ill-health, or actually have that direct experience. So, that's a very stark set of circumstances.

So, in your own work place as it is now actually more readily acknowledged to have a discussion about carers and the need of carers, there are a whole range of carer issues and carers requiring support that are largely, in many instances, still invisible.  Where Dee is so incredibly impressive - - when Professor Allan Fels, who was the Chair of my Commission did an address at the press club, she was very keen for her story, her experiences, to actually highlight some of the challenges that families, carers and supporters face, those with lived experiences face, but also to touch in a very personal sense, at the power of that stigma and the potential damage that that stigma can do.

So, that's starting point.  Can I also touch on - and I think Norman touched on it as I think we were talking this morning - Dee is very proud to tell her story.  That is actually part of her ability to contribute to change, and ongoing change in mental health services more generally.  I want to touch on a couple of things in explaining the report card.  The Commission is only little.  The Commission's focus is, as Pat has touched on, to actually paint a true picture of mental health services, not just access to acute services, but is there housing available?  What is our success rate in relation to employment?  What are some of the make or break factors, and where do people actually get lost?  Allan and I recently visited a clubhouse.  Most of you might have read about that model in Hobart.  An excellent facility.  It has a lot of people with a very long history of homelessness, a lot of people with quite a strong history of severe mental ill-health.  What was quite profound was when I talked with them, we had lunch together, we were chatting in the kitchen.  They all said, actually, having a home was the most critical thing.  They said, Rob, no sort of drugs can ever actually give me a home.  It's all part of the same equation.

The second message that came through most clearly in there was the pride in terms of actually having access to employment.  So, hence the concept of a contributing life.

I want to move on quite quickly in terms of why the workplace is so incredibly significant, and in Pat's and Norman's discussion, I think it covers a lot of territory that I do not need to recover, but a couple of clear messages: it matters personally in terms of recovery.  This is about you and me.  To pick up Norman's point, there is, I think, an undo focus on the severe mental illness, the 2% or 3% in many instances - and my stats are probably wrong - whereas in effect it's actually having a broader recognition and responsiveness to broader issues and people's needs in relation to the workplace.

It is also very much about looking at what can be done in a workplace, to echo Pat's point about what can you do as colleagues, what can you do as supervisors, what can an organisation do, and arguably, what can be done on a broader community level?  Some statistics are really worth, I think, reflecting on.

Australia actually doesn't do particularly well in this space.  If you look at Switzerland, for instance, I think over 60%, 66% or something of people with severe mental illness are actually in employment.  In Australia, we bat below 50%, and we pride ourselves on being a country that's, you know, fair and open and those sort of issues.

If I look at it on other fronts, the productivity data is really quite convincing in terms of - - I mean, Pat's touched on it, Norman's touched on it.  We are missing such incredible opportunities.  The stats are pretty stark in relation to the amount of, what is it, sick leave that's currently being taken that's tied with mental illness, the amount of sick leave that's actually been tied in relation to work place stress.  Some of the statistics that are less known are the fact that if you are suffering mental ill health, you appear more frequently in voluntary and involuntary redundancies, that sort of data.  The missed opportunities in terms of talented people, the productivity figures speak for themselves.  The data in terms of workplace costs speak for themselves.  What is less known is the extent to which work is actually part of a recovery process. And, I think Dee's experience very much highlights that as well.

It's interesting, in terms of my own experience - and I touch on the intersection between physical health and mental health - I wear with a lot of pride that I am a cancer survivor, but I can only once remember someone coming up to me and saying I'm a mental health survivor.  And the statistics as such should argue that that is something, if we had far more open disclosure, would be more readily actually brought forward.  Most situations are like the one that Dee described, where there's actually been, you know, clear either anecdotal or harder evidence to show that disclosure has come at a price.  So that is a challenge we collectively face, not an individual, not, you know, a managerial system.  That is something that we as individuals have some ability to actually impact upon.

I think the second issue is when I became ill - and my stats were one in nine - there was a flexibility and a recognition and an ability of the HR systems to deal with it.  That is less frequent.  That is a less prepared and a less comfortable path organisationally, if somebody actually does put their hand up or actually does identify in terms of having issues in relation to mental ill health.

It's interesting, when Allan and I speak at foras  of this type, I think I probably spend three times longer in the foyer, as does he, with people coming up at the end and saying how do I know if I've got a problem in my organisation?  It's happened to me personally or, you know, my daughter or my son has experienced these issues, but what should I actually be doing organisationally to deal with it?  And, that's actually really encouraging - a bit depressing on some fronts - but really encouraging in terms of the fact that there is that interest.  And, that is because people like Pat, John Brogden, Dee, a whole range of other people in Australia - and this is to our credit - have had the courage to actually come forward and say yep, it's either something that's happened to me, I've done something about it.  I need your help to actually improve it on a more service basis.  So, you know, a conference like this today puts a long range of those issues on the table.

Just to pick up some of the issues that you asked in questions, I very much echo the concept of having systems in the organisation in terms of early detection.  That comes through in data.  Pat knows that data far better than I do.  You are operationally far more familiar with this.  But it was interesting recently meeting with the Canadian Commission, who have done some excellent work in this regard.  They struck the same issues, an interest in terms of employers, but not necessarily having an idea about what works, hence the national report card, trying to get together a good understanding of what particular interventions work in the workplace.

The second thing is most people actually want to see the evidence as well, too.  It was interesting talking with my Canadian colleague.  She talked about a number of companies that were being really innovative, and actually booking access to what is a psychiatric or psychological services, that could be accessed quite quickly in the workplace.  So, I think that was a question from my colleague here from what is it, the tax office.  People are trialling different models.  And, I think that's something we are really keen to encourage in the report card as well.  What is interesting is that this company was very much also looking at the bottom line impacts, and they could see a discernible reduction in terms of people's leave as a result of illness.

So, what we are doing at the moment - and one of the things that's really encouraging - is a group of the coalition of the interested have got together, and that includes Paul from Comcare.  It includes the BCA.  It includes the Small Business Association, because I very much echo the comment that was made by a colleague on this side of the room.  It's often harder in small businesses.  Interestingly enough, I found that in many instances they were a lot keener in terms of the recruitment of people experiencing mental ill-health, but on the other hand, you know, as Peter Smaller said to me quite a few times, Rob, there's got to be then the support given when something goes wrong.  What do we do?  We're on our own.  You know, we're a hairdresser, we're a mechanic.  What actually is available in that sort of situation.  Beyond Blue, Work Safe Australia, a whole group of us have got together, and actually looked at how we can use the tools that those organisations - and they are very creditable organisations - the work that Comcare has got, the data that Work Safe Australia already has, to pull together some really solid and useful tools for you as practitioners to actually look at whether they work in your own work places.

I mean, the interesting thing has been that there has been no appetite.  There is no shortage of appetite in terms of people actually looking for solutions on this.  We need more work that is actually done in Australia, and we need to ensure that people such as yourself but also people such as Dee, a carer, a family, a supporter, and those with lived experience understand what opportunities are available for them.

The very clear message we picked up from the Canadians is this is about getting a good sense of what works, about actually having systems in a work places, but it's also about individuals.

One of the most disturbing bits of data I've seen in the last 12 months was a survey done by the Human Rights Commission - Graeme Innis who is probably known to many of you or you would have seen him on the media - where he surveyed supervisors, none of whom actually believed that they would be dealing with mental ill-health in terms of their workforce.  Now, that's a worry.  That's certainly an indicator in terms of the fact that there's a lot more to do.  I'm also of the view look at what you can do individually.

Talking with Paul as I was coming in, there's so much that can be done in relation to what you as a colleague in a workplace can actually do as well, too.  I echo very much Norman and Patrick's comment this morning about language.  Sometimes language is unintentionally hurtful, but can be actually incredibly damaging.  So, some of those issues are quite pivotal.

I want to wrap up, because I want to have the opportunity for you to ask me questions and to answer those.  The National Mental Health Commission, in essence its aim could not have been put better than it was by Dee.  In effect, to provide a whole of government, whole of service system, whole of life look at mental health services, whether that's in the correctional setting, whether that's in the housing setting, whether that's in the health section, or whether that's actually in the work place.  To realise that there are real economic issues here, that there are real productivity issues, and there are real opportunities in terms of making those intersecting boxes intersect more effectively.

The Commission will, at the end of the year, produce its first report card, which, in essence, will just report on state of play.  But, a very clear message from the report card will be the importance of the workplace in relation to recovery, in relation to making the best use of the talent that Australia has, but also looking at some avenues where we hope to work with Comcare, how we hope to work with employers, and how we hope to actually pull together lived experience of individuals, but also solid data to actually back the work that you're actually doing.

I'm going to stop at this point and actually open up for questions, but to very much echo and to, I think, applaud the organisers of this conference.  To have all of you together in this room, you're the people that can actually fundamentally drive some of the changes in a work place setting, so I really do welcome your questions.  Thank you very much.  [Acclamation]

Page last updated: 18 Jan 2018