Funds should have a very honest conversation with their insurer if that’s the case. Michael Rooney: Most funds have it in the cover that members personally apply for, rather than a group contract arrangement. Most group arrangements now have got rid of the suicide clause for automatic cover. Damian Hill: It’s in retail policies for the same reason, as opposed to group policies. Via group policies now, most Australians are getting at least some cover. I’m not saying that’s enough, but for that amount they’re usually getting it without the suicide exclusions. Lisa Munsie: When that’s highlighted at senior level it doesn’t make sense and it’s highly unfair, that’s when the change actually occurs.

Damian Hill: Lots of the changes to insurance coverage have come through the superannuation funds getting this cover available. That it’s not just on suicide exclusion. It’s the hours worked etc, and that is another area that’s come down as insurance has been provided to more and more Australians via their superannuation funds. If you have such a big group, you’re getting all of Australia rather than some selected against, which is usually the part that makes insurers run an absolute mile. Pat McGorry: The idea of early intervention is a recent thing in psychiatry, so there are definitions of early syndromes. The one we developed in Melbourne is now called the Psychosis Risk Syndrome, and it’s going to be in version 5 of the DSM (Diagnostic and Statistical Manual of Mental Disorders). It’s controversial for a number of reasons. It defines a group of people who have a current need for care because they have depression and anxiety and other symptoms, but they don’t have warning signs – like TIAs (transient ischemic attacks) or chest pain – which indicates they’re at risk for something more serious, mainly psychotic illness or schizophrenia. It predicts, between 20 to 40 per cent, if a person has a chance of becoming psychotic within the next 12 months, which is a relative risk of about 400 times the general population. If you had a blood test that did that it, then everyone would be happy. But, because it’s a definition of a clinical picture, it’s become controversial especially because it might mean that, in the US, people get medicated.

In Australia, they’d probably get counselling or those sorts of supports first before that would be considered. Or things like fish oil, which we’ve been researching. It’s a very important conceptual breakthrough in psychiatry. But some people have raised the issue, what does that mean for insurers? Would you be excluded from getting insurance if you had this risk syndrome and then recovered? Mark Woodward: The attraction of group insurance is it provides breadth of cover, blanket cover and removes the specific nature of somebody’s experience like that. What we’ll see and something we’re looking at actively at the moment is taking this notion a bit further back, and I wonder if there might be a segué to what you’ve just been describing. It’s this description of well-being. If we can better understand our general condition, our general health. Eat well. Exercise well. Engage well in society. All these are precursors to the topic we’re discussing now. There are ways that that can be managed much more efficiently and much more effectively.

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