R U OK? Day is one of the many mental health initiatives Australia can be proud of.
As a nation that tells it like it is, we’ve called out the silence and stigma that bogged mental health down in hushed tones for too long.
We’ve lifted the curtain between mental health professionals and the rest of us, by saying we should all at least ask.
That it’s everyone’s business.
Kudos aside, while breaking the silence is a good start, it’s not nearly enough, and here’s why.
The problem with R U OK? Day, (aside from the social awkwardness of having a water cooler conversation about your mental health) is that most people suffering from mental disorders are unaware.
A major study of over 4000 individuals, using a 93 item app-based questionnaire, plus objectively-sourced data from wearable technology – found that most people who scored in clinical ranges for a mental health disorder did not realise they had one.
73% of men - and 58% of women - who were in moderate through to extremely severe ranges of a mental health disorder, were unaware they were affected at the time of the survey.
In other words, Australians are in danger of appearing okay, until we’re not.
As a result, most people in need are not seeking help.
Only 17% of those in moderate to severe ranges engaged in any form of treatment.
The rise of mental health issues and the normality of not seeking treatment are, disturbingly, trends that this country has in common with others that lack Australia’s high level of mental health advocacy.
The disability level of moderate depression is classified on the World Health Organisation (WHO) Burden of Disease Scale, as similar to relapsing MS or deafness.
So, how can we not know we are not okay?
Unlike physical health issues, we’ve not had an objective measure of mental health before now.
Diagnosis has been, literally, what you are prepared to tell yourself or others. Imagine if the diagnosis of hepatitis or iron deficiency came down to a questionnaire, as opposed to a blood test?
How many of us would guess correctly the cause of tiredness?
So, let’s go back to the water cooler; when you ask someone, “Hey… are you okay?” - it’s a little like asking someone in the lift, “How are you?” We volley back, “Good, how are you?” with little thought.
Unlike a broken leg or eczema or many of the other conditions we routinely have to deal with, mental health often lacks a clear call to action.
Like the analogy of a frog in boiling water, its physiology adapts to the change in temperature so slowly that, by the time it’s perceived the danger, its immobilised from jumping out.
Unless we track our mental health when we are well, it’s hard to catch it when it crosses the line.
R U OK? Day has been useful in reducing the stigma attached to mental illness, as well as reminding us of our connections, and our friendships, which are strong protective factors in mental wellness.
Given that mental health will impact on more than half of us at some point in our lives, it’s time we paid attention to our mental health on a regular basis.
But, according to the data, many of us, have low emotional expression when stressed, and are less likely to seek social support when we need it most, opting to become self-critical and withdraw from others.
Australia is ready to move mental health from talk to action. It’s time to redefine how we improve the mental health of all Australians, reduce the costs borne by the economy – and, more importantly, make everyday life easier for the five million Australians who are suffering.
It's time for better insight, diagnosis, treatment and monitoring – not just upping counsellors, hospital beds and prescription rates.
Throwing more life rafts in is not the quick fix I think Australians deserve.
All mental health issues are cyclical, there is a slow onset and slow emergence from clinical ranges for most of us.
Given that mental health statistically will impact on more than half of us at some point in our lives, it’s time we paid attention to our mental health on a regular basis.
Not just annually. Not just on R U OK? Day.
Peta Slocombe is a psychologist and senior vice president, Corporate Health at Medibio.