R U OK now?

I am so lucky to have people who care enough to realise when I’m tracking badly and do what they can to help. Many, many people deal with mental illness in isolation. Many don’t have someone to ask if they’re okay, or to notice when they’re not.

The fact that I am white, educated and middle-class has not made me immune from having a mental illness but it has kept me alive. Mental illness treatment discriminates on the basis of age, race, gender, sexuality, socioeconomic status, politics, ability. The problem is not whether someone asks “R U OK?” but a complete and utter lack of infrastructure.

Something you could do today is write to or call your local member to ask why they SO LOVE to cut mental health funding. Over the years, both major parties, at State and Federal level, have defunded vital programs, supported bogus platforms/people, withdrawn whopping great swathes of cash from at-risk people to the tune of hundreds of millions of dollars. In December, the Covid-related boost to Mental Health Care Plan subsidies will be removed.

We have a fundamental problem. In 2016, when I first wrote this post, it was reported that one-in-ten young Indigenous men rate their happiness as zero out of 10. These men — specifically those living in the northern part of this country — have the highest suicide rate of any group ANYWHERE in the world. They are not serviced by mental health professionals. They are at the mercy of communities that don’t care or understand.

Beyond that, a lack of good mental health funding (and a lack of governments who give a shit about it) means we’re also not making much progress in the ol’ research area. Lifestyle statistics for chronic mental illnesses just haven’t changed very much in the past fifty years. Thirty per cent of people with bipolar disorder die by suicide. Something like ninety per cent of people who make an attempt on their life will make another attempt within 12 months. This has been true for decades.

The only thing we’re good at is awareness. 80–85% of young Australian people know what “anxiety” and “depression” are. The issue, at a broad social level, isn’t that we’re not asking the question. It is easier (socially) to be open about mental health issues than it has EVER been. More people are saying “I’m not okay” than in any other time in modern history.

What this means is that, when we ask “Are you ok?” and the askee says “No”, it’s not necessarily a lack of education that makes the next step hard. I’ve seen a lot of conversation today around ‘knowing what to say next’ but that’s not the point. The thing to say next is: “Did you know your GP can provide a bulk-billed plan for you?” or “Do you know you can call Lifeline 24 hours a day on 13 11 14?” but the issue is that THOSE services are underfunded and undersupported. I once called Lifeline and the woman on the other end told me to “wear pink”.

You can get a referral from your GP and if you’re in a metro area you might wait six months to see a psychiatrist for $450. You can spend every dollar you have to see a psychiatrist but there’s a good chance they won’t have medicine that will help you because no one’s funded the research to invent it yet. If you’re rural, sorry, you’ll have to travel into the city (which is really easy when you’re too depressed to get out of bed or are disoriented or psychotic) and no, there’s no service to help you get there. If you’re over 80, you have proportionately the highest risk of suicide and the least available services to make sure you don’t.

You can see a psychologist every day of your damn life but you will have to beg, borrow and steal to do it and at the end of the process, there’s still no guarantee you will even be receiving the right treatment because it is CHRONICALLY MISMANAGED and DESPERATELY UNDERFUNDED. If you go into your local emergency room and tell them you want to die, right now, right in the waiting room, they will call a person who will try to talk you out of it on the phone because there are NO BEDS and even when there are beds, they are for people who are a danger to others or who are criminally dangerous and not for people like you who just need someone to point them in the right direction.

So the problem is not R U OK? Day, and the problem is not asking the question in the first place. It’s understanding there is no “next step” for a lot of people. The steps are easily exhausted. The steps are not readily available. The steps are DISAPPEARING.

Mark Butler, Minister for Health and Aged Care, would probably LOVE to hear from you: 02 6277 7220 minister.butler@health.gov.au