Australians With Mental Health Conditions Have A Really Hard Time Accessing Medical Care Compared With Everyone Else
This is a red flag for the Australian medical community.
Lila* is a 26-year-old university student who has been diagnosed with persistent depressive disorder and anxiety.
She has experienced consistent problems accessing psychological care due to affordability barriers and the amount of time that her appointments consume.
"I find the overwhelming amount of bureaucracy involved in mental healthcare to be counterintuitive to what someone with mental health issues needs."
Lila also says that her financial constraints mean that there is no communication between her general practitioner (GP) and psychiatrist.
"There's no connection between my GP and my psych aside from the original referral. I think that's kind of common to young people though, as I don't really have a 'family' GP, I just go where is open and bulk bills."
According to new research, Lila is just one of many Australians living with a mental health condition who are finding it difficult to access medical care, as compared to those who don't have a mental health condition.
In a survey of over 5,200 Australians, it was found that people with mental health conditions have additional challenges trying to negotiate the health system and experience barriers in accessing general care.
In 29 of the 39 factors explored in the study, including issues such as poor quality of medical care, poor communication between specialists and general practitioners, and issues with affordability, people with mental health conditions reported more challenges in receiving adequate healthcare.
Lisa Corscadden, senior researcher at the NSW Bureau of Health Information and lead author of the study, told BuzzFeed News that the research team was surprised at the "profound" differences in medical care access between people with mental health conditions and those without mental health conditions.
"Looking at things like after-hours access, a quarter of people with a mental health condition said it was very difficult to access care after-hours compared with 14% of people that didn't have a condition."
Corscadden says that it is difficult to use the data to figure out why people with mental health conditions are experiencing these barriers, due to the nature of the survey (participants weren't asked why they experienced these challenges, or what sort of healthcare they were attempting to access).
The paper concludes that medical systems are failing to provide equal access to overall care for people with mental health conditions, which is a stipulation outlined in the Equally Well Consensus Statement drafted by the National Mental Health Commission.
Associate professor Russell Roberts, co-chair of the national Equally Well implementation committee, told BuzzFeed News that he believes this a problem driven in part by a phenomenon called "diagnostic overshadowing", which means that the diagnosis of a mental illness overwhelms other medical interests.
"It's stigma at every stage of the process: it's harder to get access, it's harder to get screened, it's harder to get treated and it's harder to get hospitalised."
Roberts says that this overshadowing is in part responsible for a "20-year gap in terms of mortality between those with a mental illness versus those who don't have a mental illness."
More than a third (35%) of people in the study with a mental health condition also reported that hospital doctors "did not always show courtesy and respect", compared with 10% of people without a mental health condition.
Roberts believes this is down to discrimination and stigma.
"Some mental illnesses, they're treated really poorly by reception staff, sometimes because of the stigma and the fear about mental illness, and often anybody who goes somewhere and is treated poorly, they're less likely to go back again."
According to the Corscadden's study, 16% of people with mental health conditions report that their GP was not up-to-date following specialist care, compared with 9% of the general population.
Corscadden notes that the survey may not even capture the full scope of the problem.
"A limitation I think I should point out is that they don't necessarily capture people with a severe mental condition in these types of surveys."
Roberts believes that the first step to fixing the problem is to increase awareness of the statistics for caregivers who interact with people with mental health conditions.
"If somebody has a diagnosable mental health condition, there's an 80% chance they'll have a co-existing condition which, if not treated, will lead to their early death.
"Everybody, not just GPs, every primary care physician, every psychologist, and OT [occupational therapy] social worker should have this in the back of their mind. You don't have to be a GP to ask 'Have you had a complete physical assessment?'"
*Surname withheld at Lila's request