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mental health

Oct 30, 2013


As I write this, I can hear Jeremy Oxley pounding out “I’m alone with you tonight” (in my mind, anyway).  His voice and the songs of the Sunnyboys were part of my growing up.

Oxley’s struggles with schizophrenia and his rediscovery of the joys of music are profiled in a moving documentary, The Sunnyboy, which screens on ABC1 this Sunday (November 3) at 9.30pm.

I recommend making a date with it. You don’t need to have been a fan to find this an engrossing film. For those readers whose lives have been touched one way or another by mental illness, it will likely raise some familiar themes.

Many thanks to the film’s director Kaye Harrison (pictured below, right, with Oxley) for writing below about some of the complexities and ethical issues involved in making such an intimate portrait of Oxley and his relationships. Continue reading “Don’t miss The Sunnyboy…coming soon to a screen near you”

cardiovascular disease

May 23, 2013


The poor physical health of people with mental illness has been known about for decades – one of the first studies in this area was published as far back as 1934 (see reference 1 at the bottom of this article).

A National Summit on Mental Health and Physical Health will be held in Sydney tomorrow with the aim of identifying actions that could be taken in the “immediate, short and long term” to address these longstanding health concerns.

In the article below, public health writer and publisher Dr Mark Ragg urges summit participants to come up with a ‘Closing the Gap’ style campaign to reduce the 20-25 year difference in life expectancy suffered by people with serious mental illness.


Will there be money on the table to address this critical issue?

Mark Ragg writes:

Tomorrow in Sydney a whole bunch of people in important positions get together with the opportunity to make a real difference for one of the most disadvantaged groups of people in this flat brown land.

They’re gathering at Parliament House for the national summit of health and mental health ministers who will discuss the physical health of people with mental illness, and expectations are high.

For it won’t just be the ministers present, who have to reconcile stakeholders’ wishes, ideology and budgetary reality. They’ll be surrounded by consumers, mental health commissioners, advocates and others who all want to see something solid happen. Spectacular isn’t necessary. Real is enough.

And this is why.

People with a serious mental illness die young, probably 25 years earlier on average than they should. And they don’t die necessarily of suicide, as significant a problem as that is. They die of all those run-of-the-mill conditions that get everybody else – heart attacks, diabetes, kidney failure, lung cancer. All things that are preventable to some extent, but not yet in that group of marginalised people.

The lifespan of people with serious mental illness is similar to that of an average person in the times of Parkes and Barton. On any given day, a person with serious mental illness is roughly twice as likely to die as a person without serious mental illness, even after adjusting for socioeconomic status.

Why? Continue reading “Previewing a national summit: what will it take to improve the health of people with mental illness?”


Dec 2, 2012


Thousands of words have been written and said about mental health in the wake of the first national report card on mental health and suicide prevention (including quite a few at Croakey).

But it’s the NSW Ombudsman’s recent report, Denial of rights: the need to improve accommodation and support for people with psychiatric disability, that provides perhaps the starkest reminder of the gulf between the experiences of some patients, who remain stuck in institutions, and the enlightened rhetoric of policy.

The report found that many people living in mental health facilities do not clinically need to be there. It notes that mental health legislation and United Nations principles require the care and treatment of people with mental illness to be provided in the least restrictive environment possible.

It says: “The conservative estimate is that around one-third of people currently living in mental health facilities in NSW could be discharged to the community, if appropriate accommodation and supports were available.” Continue reading “Why some patients remain stuck in institutional care – for decades”

environmental health

Jul 3, 2012


After 17 years at the helm of SANE Australia, Barbara Hocking OAM is about to retire (her last day on the job is July 13).

SANE Australia is a national organisation helping people affected by mental illness (consumers, their family and other carers), through education, applied research and campaigning for improved services and attitudes.

In the online Q and A session below, Barbara Hocking reflects upon some of the successes and disappointments that she’s seen over that period.

Her priorities for mental health into the future include:

• Decent, comprehensive, coordinated community-based care rather than the ongoing crisis-oriented system.

• A social inclusion campaign to reduce the loneliness and isolation experienced by many people living with mental illness.

• Research, including to provide evidence of effectiveness of current activities.


Learning from a voice of experience

Q: When you started the job in 1995, what did you picture as the main challenges and issues that you and SANE Australia needed to address?

The main challenges as seen from SANE Australia’s perspective were reducing stigma, advocating for good treatment for the person with mental illness and support for families.


Q. Has your understanding of those changed over time? If so, how?

Photo by Morganna Magee

These are still critical issues but we also have a greater understanding now of the importance of a complete treatment package which incorporates psychological and medication treatments, decent accommodation, employment and community support programs to reduce isolation and to promote social inclusion.

I often say to clinicians that having someone symptom free in the back room of a boarding house with nothing to do and no friends is not a great success story.

There is also better understanding and recognition now that providing good mental health care is an important suicide prevention strategy.

Continue reading “Over the past 17 years, what has changed for people with mental illness?”

evidence-based issues

Dec 1, 2011


Welcome to a new feature at Croakey.

The Primary Health Care Research and Information Service (better known as PHC RIS) is to provide a regular article profiling an item from its weekly bulletin.

The first article ties in neatly with the current Croakey series on mental health reform, looking at shared care models for adults with severe and persistent disorders.


Shared care in mental illness 

Olga Anikeeva, Research Associate at PHC RIS, writes:

A rapid review conducted by Kelly et al (2011)  sought to address the lack of best practice guidelines for the development and implementation of shared care models for mental health consumers.

In order to improve detection, treatment and outcomes for mental disorders, service models that integrate mental health care with primary health care are necessary.

However, models of shared care are currently poorly defined and can include transfer of care from provider to provider, involvement of one or more services in patient care, or formal cross-service arrangements.

Thus, the aim of the review was to determine whether shared care arrangements result in improved clinical outcomes and to identify the critical components of an effective shared care model. The focus of the review was primarily on adults with severe and persistent mental disorders.

The authors found that models of shared care that incorporate primary health services and specialist mental health care can lead to improvements in clinical outcomes, particularly among individuals with depression and anxiety disorders. They also found some evidence for reduced relapse rates among individuals with psychoses and related disorders. Continue reading “More effort needed to strengthen shared care arrangements for people with serious mental illness”

mental health

Nov 3, 2011


How to save more than half a million dollars (and feel much better).

That could be the subtitle for a new book telling the stories of people who have quit smoking while living with a mental illness.

Maxie Ashton, Project Manager of the Tobacco and Mental Illness Project in South Australia, explains below why smoking among people with mental health problems is a social justice issue.

(I particularly liked the story about the ex-smoker who successfully advised their psychiatrist on how to quit smoking).


Telling some stories that matter

Maxie Ashton writes:

Now I can smell the orange blossom! is a record of real life stories of 21 people who have managed to quit tobacco while living with a mental illness. The stories bust the long held myth that people with mental illness who smoke can’t or don’t want to quit.

The book is produced by the South Australia Tobacco in Mental Illness Project.

All the storytellers live with a mental illness which has had a big impact on their lives. They had been heavy smokers for many years and had been experiencing the serious health effects of smoking. They were all heavily addicted to nicotine which they said was overwhelming, and in the beginning, they didn’t believe they would ever be free of tobacco.

However, step by step they worked toward their goal and these stories are a powerful record of their journey in tackling one of the most challenging addictions.















Continue reading “Quit smoking, save money, feel better, and write a special book”

adverse events

Aug 29, 2011


Thanks to Reema Rattan, for providing this update of the latest health and medical reading at The Conversation.

The stories below cover medical mishaps, men’s health, breast cancer screening, alcohol labelling, media reporting of suicide, hospital care of patients with mental health problems, puberty, the NT Intervention, bariatric surgery and type 2 diabetes, and the hazards of sedentary behaviour.

A health prescription: doctors, own up to medical mishaps immediately
By Thomas Faunce, ARC Future Fellow at Australian National University

An expansion of the fiduciary duties of doctors towards patients could provide better protection to those suffering from medical mishaps. Such an expansion would require doctors to promptly disclose adverse events.

A New South Wales District Court is currently hearing a case about a surgical pack allegedly left inside Helen Caroline Anne O’Hagan’s abdomen for more than 15 years.

It’s claimed surgeon Dr Samuel Sakker negligently failed to remove it during a partial colectomy he performed in August 1992 at the Poplars Private Hospital in Epping, Sydney.

Mrs O’Hagan subsequently experienced cramping, fevers and loss of bowel control but assumed they were related to her chronic abdominal and pelvic problems.

Read more –


Tread carefully: revised guidelines for better reporting of suicide deaths
By Jaelea Skehan, Conjoint Teaching Fellow in the School of Medicine and Public Health at the University of Newcastle

The Australian Press Council (APC) has released guidelines for reporting about suicides for the print media today. They are binding for around 98% of Australian newspapers and magazines.

The guidelines articulate some of the differences between reporting on the broader issue of suicide and the reporting of individual deaths. Continue reading “A stack of reading: the latest health and medical news from The Conversation”


Nov 13, 2009


Reads of the week

I know, I know - we're all too busy, no time to read etc - but here are a few articles from recent times that are worth the effort, if you haven't spotted them already. They cover every

I know, I know – we’re all too busy, no time to read etc – but here are a few articles from recent times that are worth the effort, if you haven’t spotted them already. They cover everything from the health impacts of inequality to mental health, alcohol policy, and the ties that bind pharma and medicine.

Continue reading “Reads of the week”

consumer health information

Nov 11, 2009


health and medical research

Jun 2, 2009


Simon Chapman, professor of public health at the University of Sydney, has provided a robust critique of Jennifer Doggett’s recent critique of increased tobacco taxes:

Erstwhile Croakey correspondent Jennifer Doggett has written a piece for ABC-Online challenging the wisdom of  increasing tobacco tax, arguing that it would be regressive and harm the poor (it will “mean they cut back on other essentials, such as food, heating and housing costs.)

I suppose the corollary of this argument is that all caring people should support the lowering of tobacco tax to make it easier for those who smoke most (the poor) to keep on smoking and thus widen even further the smoking caused disease gap between rich and poor. What a perverse way of “helping” the poor while feeling good about social justice.

The poor, along with the young, are the most responsive to tobacco price rises. The heavy smoking Kerry Packer wouldn’t have cared less if he paid $13 a pack or $30, but budget conscious people do.

The responsiveness takes the form of quitting (the poor are quitting at broadly the same rate as the more well off, but from a much higher “ever smoking” prevalence) but also from reducing the amount smoked each day. Between 1980 and  2004, average daily consumption in Australia reduced from 20 (males) and 18 (females) cigarettes a  day to 14 – a 30% decline.

Along the way Jennifer trots out the myth that will not die that “seventy to 80 per cent of people with serious mental illnesses smoke and for people with schizophrenia the smoking rate is 90 per cent”.

A recent metanalysis of all studies of smoking & schizophrenia showed the average smoking prevalence was 62% (range 14-80%) with none topping 90%. (see Chapman S, Ragg M, McGeechan K. Citation bias in the reporting of the prevalence of smoking in people with schizophrenia. Aust NZ J Psychiatry 2009;43:277-82.)

While those with mental illness are under-studied, some evidence suggests that their cessation rates mirror those of the wider community. Yes, they smoke more, but their rate of decline (from a higher starting point) is not dissimilar to everyone else’s.

The only thing one needs to know about why tobacco tax is a the most effective way of bringing smoking down is to look at the tobacco industry’s reaction. Each year, you can set your watch by the predictability of their lobbying.

As Philip Morris put it with such candour as far back as 1983 in an internal memo “the most certain way to reduce consumption is through price”.