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.

So our effectiveness to provide a voice was overcome by the absolutely overwhelming demand. It’s only recently that we’ve been able to do it again. It was my own little team in my very unsophisticated office that realised the suicide figures. We have the Department of Health administering billions of dollars, and none of them have ever said, suicide is the leading cause of death. Colin Tate: Chris, is mental health the poor cousin within the (NSW) Health Department? Chris Shipway: Amongst the mental health and drug and alcohol brethren, the drug and alcohol workers will say if only we had things as good as mental health. Usually, if you want to find the drug and alcohol service, if it’s hospital-based, and down the back of the hospital near the incinerator in what looks like a tool shed. How do you connect all of those other services that should be providing support and advice to people who are contemplating suicide?

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