Black Dog Institute and Everymind, under The Prevention Hub, recently submitted a response to the Australian Government Department of Health’s National Preventive Health Strategy. This strategy aims to provide an overarching, long-term approach to prevention in Australia. While not disease specific, the Strategy focuses on system wide, evidence-based approaches to reducing poor health.

The submission represents our shared view about the importance and benefits of explicitly ensuring that the prevention of mental illness is incorporated into the Preventive Health Strategy. There is a need for a co-ordinated, whole-of-government approach to prevention but the prevention of mental illness must be prioritised within the long-term strategy to maximise benefits and outcomes for individuals and communities. 

In any one year, over two million Australians will experience anxiety and a further one million will be affected by depression. Given the interconnectivity of physical health, mental health and wellbeing there is a strong case for embedding the prevention of mental illness into all components of the Strategy.  It is our recommendation that the Strategy should recognise the equal importance of mental and physical health, with mental health included as a standalone strategic goal.

While the Strategy details investment targets for preventive health initiatives, it is our recommendation that funding for the prevention of mental ill-health should be specified within the Strategy and be proportional to its contribution the burden of disease. The social and economic costs of mental ill-health are estimated to be in the order of $200 billion, with mental ill-health known to contribute to 12% of the overall burden of disease in Australia. Despite this, mental health funding currently represents only 7.6% of total government expenditure and only 0.076% of total health expenditure is focused on the prevention of mental illness. There is strong evidence to suggest that investment in preventive initiatives can significantly reduce the incidence of mental ill-health  and the Strategy should seek to set specific funding targets in order to achieve this.

Our submission stressed the central importance of research and evaluation within the Strategy. We believe that all preventative programs should be evaluated over time and the results of programs should be published and disseminated. This approach would ensure that only preventative initiatives with the highest level of evidence are pursued. In addition, there is a need for quality population and regional studies to understand the incidence and prevalence of mental illnesses and the associated risk factors to enable data-informed priority setting and measurement of outcomes over time. 

The impacts of COVID-19 on mental health and wellbeing has been profound and will likely be long-lasting. Community surveys, for example, have shown a sharp rise in the level of psychological distress being experienced and the incidence of depression and anxiety in the community, with many people experiencing mental health issues for the first time.  These experiences have highlighted the importance of having a preventive strategy that is adaptive to the impacts of disasters, pandemics and similar events on the health and mental health of the population.

While our submission supports the Government’s strategic focus on preventing illness and promoting wellbeing, the response reflects our belief that the prevention of mental ill-health must be of central focus within the Strategy. Mental ill-health is common, distressing and potentially disabling, yet it is not inevitable. With appropriate investment and policy supporting the prevention of mental ill-health we can significantly reduce the social and financial impacts. 

Black Dog Institute and Everymind believe that Australia’s Preventive Health Strategy must be supported by appropriate policy, implementation, investment and evaluation in order to ensure that its vision and goals are realised. As a leading Australian collaboration focusing on prevention of depression and anxiety and the translation of knowledge to policy and practice, we look forward to continuing to work with the government on their preventive health approach.

Productivity Commission. (2020). Mental Health Inquiry Final Report. Australian Government, Canberra.

AIHW (Australian Institute of Health and Welfare) (2019). Australian Burden of Disease Study: impact and causes of illness and death in Australia 2015. Australian Burden of Disease Study series no. 19. Cat. no. BOD 22. Canberra: AIHW.

Mendelson, T., & Eaton, W. W. (2018). Recent advances in the prevention of mental disorders. Social Psychiatry and Psychiatric Epidemiology, 53(4), 325-339.

Fisher, J. R., Tran, T. D., Hammarberg, K., Sastry, J., Nguyen, H., Rowe, H., Popplestone, S., Stocker, R., Stubber, C., & Kirkman, M. (2020). Mental health of people in Australia in the first month of COVID-19 restrictions: a national survey. The Medical journal of Australia, 213(10), 458–464.