Why Australia’s Mental Health Crisis Can’t Be Solved Within Capitalism

Joseph Tafra

11/12/2021

Australia is facing a mental health crisis. Rates of depression and anxiety have been rising steadily, and the suicide rate has been climbing since 2006.

Almost 50% of Australians will experience mental illness in their lifetimes. At least six Australians kill themselves every day, and 30 more make an attempt. Suicide is the leading cause of death for Aussies aged 25-44, and the Indigenous suicide rate is twice that of the rest of the country.

This problem is widely acknowledged in Australia but what is being done to help?

According to ABC reporting, Australia’s "mental health crisis is back in the spotlight” in the Coalition’s 2021 budget. But the proposed spending is completely inadequate.

For one thing, the amount is quite low – $435 million over four years compared to more than 400 times that ($180 billion) for the military. More importantly, the money is not being spent effectively. Most will go to youth employment programs, which are important but have too narrow a focus considering 89% of people receiving unemployment payments are over 25. What’s left is mostly going to online counselling services, youth mental health organisation Headspace, and suicide prevention programs like Black Dog Institute and Everymind.

The social response to the mental health crisis is exemplified by R U OK? Day. This focuses mostly on one day a year to promote mental health awareness and education, check-in on friends and co-workers, and spread the word on social media. It’s not a bad idea but it puts the burden for mental health care on individual citizens.

Organisations like these are well-intentioned and do some good work, but they only deal with mental health symptoms while the causes of the crisis are left alone. The effectiveness of such initiatives is also unclear. Mental health experts have raised concerns about the usefulness of Headspace for those most in need, for example.

More broadly, suicide prevention is not a job for private initiatives but the public health sector. Yet according to the National Association of Practising Psychiatrists (NAPP), stingy healthcare budgets mean that:

• Only extremely ill patients are admitted to psychiatric inpatient care while others are turned away

• Patients are being discharged early

• Treatment is often inadequate

• Psychiatric inpatient units are continually full

• Follow-up care is often minimal or non-existent

The consequences are grim. NAPP points out that, of 140 Queensland Health patients who unexpectedly died during one year, 86 were mentally ill. Most of those killed themselves after being turned away by emergency departments or within a week of being discharged, apparently far too early.

This renders R U OK-inspired conversations with mates something of a bad joke if it turns out they are in crisis. Most people don’t have the training to provide acute mental health care, so the problem falls back on the underfunded public health system.

But even if these initiatives did all they promised – if a few sessions with Headspace or a chat with a colleague was sufficient for suicide prevention – we still wouldn’t have addressed why people are increasingly depressed, anxious, and suicidal.

Australia’s approach is hopelessly limited by individualism. Even when treatment is available, the goal is changing an individual’s inner life through therapies, medication, or both. This frames mental illness as a fault within individuals that needs correcting.

Individual therapy will naturally focus on one person and their problems, but there is compelling evidence that mental health trends emerge in response to social conditions.

Three major social causes of psychological distress are poverty, economic inequality, and a culture of competition. These are deeply interlinked effects of capitalism. It’s not surprising then that a capitalist country like Australia insists on “treating mental health as if it were a natural fact, like the weather,” to quote Mark Fisher.

According to a 2018 study from Frontiers in Psychiatry, poverty increases psychological distress – “financial hardship [is] strongly associated with depressions, suicide, drug dependence, and psychotic disorders” and rates of mental illness strongly track levels of unpaid debt.

The numbers are stark. Around 25% of Australia’s poorest people experience high to very high levels of psychological distress – for the wealthiest, that figure drops to 5%. To put those numbers in context, if we take 100 Australians experiencing psychological distress, on average 40 of them would be from the poorest fifth of the country; only eight would come from the richest.

Mental illness treats the rich more gently than the poor, too. According to the Frontiers study, “those with severe mental disorders and a better financial status tend to have fewer psychiatric symptoms and [better] quality of life.”

It’s not just poverty that increases rates of mental illness but poverty alongside great wealth. In a 2010 article in the British Journal of Psychiatry, Wilson and Pickett convincingly argued that greater economic inequality leads to worse mental health outcomes throughout society. Inequality affects the poor most acutely but we all suffer more as a result of it. Wilson and Pickett also point out that intense “social hierarchy and status competition” in unequal societies are what contribute to higher rates of mental illness.

To put it simply: being poor hurts, being poor while others are very rich hurts even more, and constantly competing for resources when there is plenty to go around compounds those hurts. Over time, that pain makes people sick.

The economic system that causes poverty and inequality is a human institution, built through human laws and maintained by human governments – it is open to social action and can be changed

Considering all this, Australia’s response to the mental health crisis is woefully inadequate. Services for those in crisis are chronically underfunded, government and private money is flowing into ineffective services that place the burden for mental illness on individuals, and the economic pressures driving the crisis are ignored.

It’s good to treat symptoms, but if the root causes are treatable, ignoring them is negligence. The economic system that causes poverty and inequality is a human institution, built through human laws and maintained by human governments – it is open to social action and can be changed.

Where is the government’s commitment to a jobs guarantee, to eliminating poverty, to housing the homeless, to reducing economic inequality? Refusing to tackle the underlying causes of psychological distress is an abandonment of Australians battling mental illness. Mental health is not merely personal; it’s a political issue and should be addressed as such.

Under socialism, the economy would focus on the needs of all, not the wants of a minority. Public housing, free healthcare, guaranteed jobs, genuine democratic power for all people – such measures would eliminate poverty, reduce and eventually dissolve economic inequality, and minimise unhealthy competition. In a socialist society, depression, anxiety, and other mental health issues wouldn’t magically disappear, but there would be a radical reduction in cases and severity.

A capitalist government like Australia’s will never legislate poverty and inequality away – after all, the wealth of a few necessitates poverty for many – so it is up to the mass of ordinary Australians to bring about this change.

Don’t settle for asking ‘R U OK?’ once a year. Start asking how we can end the corrupt system that is keeping us miserable.