We’re also trying to get that income stream going, because social security is completely insufficient. It barely provides accommodation or food, but in respect to care, it’s totally insufficient. The challenge for the insurance industry is to get people rehabilitated, and saving for a retirement benefit. But during the time they’re disabled, there might be periods in and out of disablement, and they can continue to earn an income.

Pat McGorry: We’ve done follow-up work on 700 young people we’ve treated (through Orygen in Melbourne) over eight years, and definitely what Damian was saying is right. Young people (with mental illnesses) go in and out of the workforce, and they have periods of ill health. It’s quite unpredictable.

A lot of young people become ill before they finish vocational training, so they may not get into the workforce. One of our goals is helping them return to school or education. Or, if they’ve started working, get them back to work very fast. There’s some good new programs showing that that’s possible.

This pessimism about the treatment of serious mental illness is quite misplaced. It’s an artefact of the very poor delivery systems in place to treat people.

John Mendoza: Our assessment of risk actuarially is based on past practice and past records. With mental health if we had evidence-based practice being done and quality care being available, then we’d see better results. If you have depression or bipolar or schizophrenia as Pat’s saying, with evidence-based intervention and appropriate supports, your prospects of return to work etc are good.

Mark’s point about data is really important. You have rich data within your individual organisations and as an industry. I used some recently in talking to government about the five insurers who looked at their suicide data cost and it was representing 9 per cent to 11 per cent of their total death payouts: compare that to the 1.4 per cent of the total deaths in the Australian population that suicide represents. Suicides are occurring in the highly productive years.

Dawn O’Neil: Stigma is a massive issue and it’s a major reason why there’s not been the awareness. The other issue is that when mental institutions were deinstitutionalised, the small amount of community-based organisations providing services were absolutely overwhelmed. We were one of those. Our call rates went through the roof and they were from people with serious mental illness whom we didn’t have any real capacity to cope with.