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| Australians are yelling in grief and frustration – but will Scott Morrison act? | Australians are yelling in grief and frustration – but will Scott Morrison act? |
| (about 4 hours later) | |
| The facts on suicide in Australia, the Productivity Commission informs us, are stark. Every year, 3,000 people end their own lives, more than eight people every day. It is the leading cause of death for young adults, and suicide rates in Indigenous communities are more than double the rest of the community. This picture has been static for a decade. | The facts on suicide in Australia, the Productivity Commission informs us, are stark. Every year, 3,000 people end their own lives, more than eight people every day. It is the leading cause of death for young adults, and suicide rates in Indigenous communities are more than double the rest of the community. This picture has been static for a decade. |
| Some people with mental illness are plagued with suicidal ideations, and for some that ends in tragedy, but as Scott Morrison’s suicide prevention adviser, Christine Morgan, told me earlier this year, a substantial proportion of people who take their lives in Australia never present to clinicians with depression or another illness. | Some people with mental illness are plagued with suicidal ideations, and for some that ends in tragedy, but as Scott Morrison’s suicide prevention adviser, Christine Morgan, told me earlier this year, a substantial proportion of people who take their lives in Australia never present to clinicians with depression or another illness. |
| So the paths leading to the ultimate end point are different, but here’s something we know: up to 25% of people who attempt to take their own lives will try again, and the risk of relapse is significantly higher during the first three months following discharge from hospital after an attempt. | So the paths leading to the ultimate end point are different, but here’s something we know: up to 25% of people who attempt to take their own lives will try again, and the risk of relapse is significantly higher during the first three months following discharge from hospital after an attempt. |
| How do you start a conversation about mental health with someone who is depressed? | How do you start a conversation about mental health with someone who is depressed? |
| The Productivity Commission flagged this particular data point this week in a draft report into the management of mental health in Australia. It noted that half the people discharged from hospital after a suicide attempt do not attend follow-up treatment, and it’s not really clear in the system who is responsible for trying to ensure that they do. | The Productivity Commission flagged this particular data point this week in a draft report into the management of mental health in Australia. It noted that half the people discharged from hospital after a suicide attempt do not attend follow-up treatment, and it’s not really clear in the system who is responsible for trying to ensure that they do. |
| The commission cites a recent study suggesting that adequate aftercare could reduce the prevalence of suicide attempts that reach hospital emergency departments by about 20% and all suicide deaths by 1%. Perhaps this sounds a bit marginal in the dry world of percentages, but if we pull this out of the data points and locate it in the world of humans – our partners and children and parents and relatives and friends – this translates to saving 34 lives each year, and preventing about 6,000 attempted suicides. | The commission cites a recent study suggesting that adequate aftercare could reduce the prevalence of suicide attempts that reach hospital emergency departments by about 20% and all suicide deaths by 1%. Perhaps this sounds a bit marginal in the dry world of percentages, but if we pull this out of the data points and locate it in the world of humans – our partners and children and parents and relatives and friends – this translates to saving 34 lives each year, and preventing about 6,000 attempted suicides. |
| Sometimes, the scale of problems in complex social policy areas like mental health feel paralysing. When it comes to making things better, it feels hard to know where to start. But this example is such a simple thing: tweaking a system so it provides adequate aftercare for people demonstrably at risk. | Sometimes, the scale of problems in complex social policy areas like mental health feel paralysing. When it comes to making things better, it feels hard to know where to start. But this example is such a simple thing: tweaking a system so it provides adequate aftercare for people demonstrably at risk. |
| Some people battling suicidal thoughts have family support, so they will be driven to their follow up appointments, and coaxed and nagged and loved into wellness, but some of our most vulnerable people have absolutely no support at all. | Some people battling suicidal thoughts have family support, so they will be driven to their follow up appointments, and coaxed and nagged and loved into wellness, but some of our most vulnerable people have absolutely no support at all. |
| People don’t deserve superior care just because they are lucky enough to have people who cherish them. In a decent society, we owe our fellow humans the respect of care because we are all connected. The measure of how one person is treated in their most trying, desperate, hours, is the measure of all of us. | People don’t deserve superior care just because they are lucky enough to have people who cherish them. In a decent society, we owe our fellow humans the respect of care because we are all connected. The measure of how one person is treated in their most trying, desperate, hours, is the measure of all of us. |
| I’m going to be very honest: it is hard to read that simple, lucid observation from the Productivity Commission and not weep, or feel wildly angry. It breaks me, as a human, that people are dying in despair every day in this country, in part, because of a failure to tweak the health system in a very modest and manageable way. | I’m going to be very honest: it is hard to read that simple, lucid observation from the Productivity Commission and not weep, or feel wildly angry. It breaks me, as a human, that people are dying in despair every day in this country, in part, because of a failure to tweak the health system in a very modest and manageable way. |
| It wasn’t just the Productivity Commission bowling up a report this week triggering either deep sadness or cold fury about injustice, or neglect, or a failure of proper care and attention. The interim report of the royal commission into aged care reads like a gut punch. | It wasn’t just the Productivity Commission bowling up a report this week triggering either deep sadness or cold fury about injustice, or neglect, or a failure of proper care and attention. The interim report of the royal commission into aged care reads like a gut punch. |
| Part of the reason voters are frustrated with politics is because they inhabit the gap between what politics should be and what it actually delivers. | Part of the reason voters are frustrated with politics is because they inhabit the gap between what politics should be and what it actually delivers. |
| The commissioners found the system that tends to our parents and grandparents, with some “admirable exceptions”, is floundering, fragmented, unsupported, underfunded, poorly managed, often unsafe and seemingly uncaring. | The commissioners found the system that tends to our parents and grandparents, with some “admirable exceptions”, is floundering, fragmented, unsupported, underfunded, poorly managed, often unsafe and seemingly uncaring. |
| Their words, not mine. | Their words, not mine. |
| People (16,000 of them in 2017-18) are dying in Australia while waiting for home care packages, or moving into residential care, “often with great trepidation”, because they lack viable alternatives. The commissioners noted the fear about going into residential care is magnified if people are alone, because they know no one will visit them. | People (16,000 of them in 2017-18) are dying in Australia while waiting for home care packages, or moving into residential care, “often with great trepidation”, because they lack viable alternatives. The commissioners noted the fear about going into residential care is magnified if people are alone, because they know no one will visit them. |
| Once in care people “become infantilised, lose autonomy, and are prevented from making decisions or doing physical things that were routine when they lived at home, on the grounds that they could hurt themselves”. Families and friends managing these transitions feel intense guilt, loss and fear: “guilt at not being able to guarantee care at home any longer; loss of the person who, even if living [with] dementia or otherwise cognitively impaired, is still a unique personality; and fear of how this loved older person or young person living with disability will be treated when there is no one there to look out for them”. | Once in care people “become infantilised, lose autonomy, and are prevented from making decisions or doing physical things that were routine when they lived at home, on the grounds that they could hurt themselves”. Families and friends managing these transitions feel intense guilt, loss and fear: “guilt at not being able to guarantee care at home any longer; loss of the person who, even if living [with] dementia or otherwise cognitively impaired, is still a unique personality; and fear of how this loved older person or young person living with disability will be treated when there is no one there to look out for them”. |
| And this is before we hit the actual instances of terrible unkindness and neglect, like people having maggots in their open wounds – cases the commission references – or frail elderly people entering care in relatively good spirits and mentally alert “only to die a few months later after suffering from falls, serious pressure injuries and significant pain and distress”. | And this is before we hit the actual instances of terrible unkindness and neglect, like people having maggots in their open wounds – cases the commission references – or frail elderly people entering care in relatively good spirits and mentally alert “only to die a few months later after suffering from falls, serious pressure injuries and significant pain and distress”. |
| I’m sorry to labour these terrible things, but there is a point to the explication, and it’s this: none of us should be looking away. These are distressing realities that need to be confronted. | I’m sorry to labour these terrible things, but there is a point to the explication, and it’s this: none of us should be looking away. These are distressing realities that need to be confronted. |
| Of course none of this – the cool appraisal by economists of deficiencies in the mental health system, or the bracing recount of what a lot of aged care is really like in Australia – will be a surprise to the many, many people who are looking after their loved ones every day of the week. | Of course none of this – the cool appraisal by economists of deficiencies in the mental health system, or the bracing recount of what a lot of aged care is really like in Australia – will be a surprise to the many, many people who are looking after their loved ones every day of the week. |
| Australian parents taking their distressed kids to the psychologist, or rushing to get to grandma or grandpa in the nursing home after work, or withdrawing from work because they can’t juggle their obligations to loved ones who rely on them, already know about systemic deficiency. | Australian parents taking their distressed kids to the psychologist, or rushing to get to grandma or grandpa in the nursing home after work, or withdrawing from work because they can’t juggle their obligations to loved ones who rely on them, already know about systemic deficiency. |
| They know from lived experience that governments, when they are not cutting, throw money at problems, either to try and fix things, or to shut up various stakeholders who will flame them if they don’t get funding, and things on the ground don’t seem to improve, or improvements seem slow. | They know from lived experience that governments, when they are not cutting, throw money at problems, either to try and fix things, or to shut up various stakeholders who will flame them if they don’t get funding, and things on the ground don’t seem to improve, or improvements seem slow. |
| Part of the reason voters are frustrated with politics is because they inhabit the gap between what politics should be and what it actually delivers. I hate saying this because it makes me sound cynical, which I’m not, even after a couple of decades watching circus antics at close range. Politics, despite all appearances to the contrary, can be heroic, and empathetic and self-aware – but not nearly often enough. | Part of the reason voters are frustrated with politics is because they inhabit the gap between what politics should be and what it actually delivers. I hate saying this because it makes me sound cynical, which I’m not, even after a couple of decades watching circus antics at close range. Politics, despite all appearances to the contrary, can be heroic, and empathetic and self-aware – but not nearly often enough. |
| It’s clear that we need to do much better on mental health and aged care. It’s clear that the Coalition, which is now entering its third term in office, has not done enough to fix problems that are hiding in plain sight. Thursday’s first run government response to the aged care royal commission, which involved a startled looking Richard Colebeck (the aged care minister) standing in the Blue Room in parliament with nothing to say, was less than encouraging. | It’s clear that we need to do much better on mental health and aged care. It’s clear that the Coalition, which is now entering its third term in office, has not done enough to fix problems that are hiding in plain sight. Thursday’s first run government response to the aged care royal commission, which involved a startled looking Richard Colebeck (the aged care minister) standing in the Blue Room in parliament with nothing to say, was less than encouraging. |
| But rather than just stating the obvious, I want this weekend to make a personal plea to Scott Morrison. The prime minister has made mental health and aged care personal priorities, so we will all be watching what he does in both of these areas. | But rather than just stating the obvious, I want this weekend to make a personal plea to Scott Morrison. The prime minister has made mental health and aged care personal priorities, so we will all be watching what he does in both of these areas. |
| PM promises more funding after aged care system found to be 'harmful' and underfunded | PM promises more funding after aged care system found to be 'harmful' and underfunded |
| While both of these areas will doubtless require more resourcing, that’s not the beginning and end of the issue. Stopping people from taking their own lives, or improving the mental health of Australians, or ensuring an elderly person doesn’t suffer terrible, inexcusable indignity and neglect in their final years of life will take a government prepared to do the arduous, considered, detailed policy work to deliver those objectives. | While both of these areas will doubtless require more resourcing, that’s not the beginning and end of the issue. Stopping people from taking their own lives, or improving the mental health of Australians, or ensuring an elderly person doesn’t suffer terrible, inexcusable indignity and neglect in their final years of life will take a government prepared to do the arduous, considered, detailed policy work to deliver those objectives. |
| That means doing something more substantial than applying bandaids to deficient systems. It means going back to first principles, even if that means taking on noisy interest groups within these systems who might just have to lose out. It will require, dare I say it, some expertise, some deliberation, some concentration, considered reflection and some courage. | That means doing something more substantial than applying bandaids to deficient systems. It means going back to first principles, even if that means taking on noisy interest groups within these systems who might just have to lose out. It will require, dare I say it, some expertise, some deliberation, some concentration, considered reflection and some courage. |
| It will require genuine reform – a practice that feels out of fashion in Canberra. | It will require genuine reform – a practice that feels out of fashion in Canberra. |
| So rather than crying in grief, or yelling in frustration, this weekend, on the behalf of readers and voters, I’m asking Scott Morrison – journalist to prime minister, but more importantly, human to human. | So rather than crying in grief, or yelling in frustration, this weekend, on the behalf of readers and voters, I’m asking Scott Morrison – journalist to prime minister, but more importantly, human to human. |
| Are you that prime minister? Are you the prime minister to do the work, and get this done? | Are you that prime minister? Are you the prime minister to do the work, and get this done? |
| • In Australia, the crisis support service Lifeline is 13 11 14. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In the UK, Samaritans can be contacted on 116 123. Other international suicide helplines can be found at befrienders.org | |
| Australian politics | Australian politics |
| Katharine Murphy on politics | Katharine Murphy on politics |
| Mental health | Mental health |
| Suicide rates | Suicide rates |
| Scott Morrison | Scott Morrison |
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