Although approximately 80% of the population enjoy 'good' mental health free of mental disorders, it has been estimated that mental disorders caused 13% of the total disease burden in 1996. Although mental illness is not a major direct cause of death, it is associated with a proportion of deaths due to suicide and some other conditions, and is an important cause of chronic disability. For males, substance use disorders (from alcohol or other drugs) accounted for 33% of the mental health burden, while for females affective disorders such as depression accounted for 39% of the mental health burden (AIHW 2000a).
Policy initiatives
After completion of the initial National Mental Health Strategy (1992 to 1998), the Second National Mental Health Plan was endorsed in July 1998 as the framework for ongoing activity. The Plan is operating over a five-year period from 1998-99 to 2002-03, and is a joint initiative of the Commonwealth Government and the state and territory governments. The National Depression Initiative (being carried forward by an independent public company called 'beyondblue') will build on priorities identified in the National Action Plan for Depression. The aims of 'beyondblue' are to increase community awareness of depressive illness, to foster greater understanding of the illness, and to support research into prevention, treatment and management approaches (Commonwealth Department of Health and Aged Care 2001a).
In the 1999-2000 Federal Budget, $48m over five years from July 1999 was committed for a National Suicide Prevention Strategy to build on the former National Youth Suicide Prevention Strategy. While the Strategy will continue to focus on youth suicide, it will be expanded to include other high risk groups such as the elderly, people with mental illnesses, or substance use problems, prisoners, and people living in rural communities, and in Aboriginal and Torres Strait Islander communities. In the 2001-02 Federal Budget, $120.4m over four years from July 2001 was committed to the Better Outcomes In Mental Health Care initiative which aims to increase the involvement of general practitioners in the provision of primary mental health care (Commonwealth Department of Health and Aged Care 2001b).
Psychological distress
In the 2001 NHS, information on mental health was collected from adult respondents, using the Kessler 10 Scale (K10), a 10-item scale of current psychological distress. The K10 asks about negative emotional states in the four weeks prior to interview. The results from the K10 are grouped into four categories: low (indicating little or no psychological distress), moderate, high, and very high levels of psychological distress. Based on research from other population studies, a very high level of psychological distress, as shown by the K10, may indicate a need for professional help.
In 2001, 3.6% of the adult population reported a very high level of psychological distress. Women were more likely than men to report high (10.9% of women and 7.2% of men) and very high (4.4% of women and 2.7% of men) levels of distress. The greatest sex difference was between young women and men aged 18-24 years, with 5.4% of women having very high levels of psychological distress compared to 2.7% of men in this age group (graph 9.20). A higher proportion of both males and females aged 45-54 years reported very high levels of psychological distress compared with any other age group.
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