Recognising and responding to poor mental health

Introduction

The term ‘mental health’ refers to the state of being cognitively, emotionally and socially healthy (World Health Organization, 2017). Mental health conditions, such as anxiety and depression, can arise at any age or life stage. It is estimated that 45 per cent of Australians will experience a mental health condition in their lifetime (Australian Bureau of Statistics, 2008), with these conditions impacting on day-to-day functioning, relationships, and our physical health. The status of our mental health and wellbeing can change over time, and we must be able to recognise and respond to signs of mental ill-health or mental health conditions in ourselves and others.

The signs of mental ill-health may include: feeling consistently anxious or worried, feeling down and disengaging with normal activities, dramatic changes in mood, sleep problems, weight or appetite changes, becoming quiet or withdrawn, substance abuse, feeling guilty or worthless, and others (Health Direct Australia). However, these signs can sometimes be difficult to spot, whether in ourselves or in our family, friends and colleagues.

Accessing support for mental health conditions can be vital to their ongoing management. Treatment can be delivered in person, such as with a general practitioner or mental health professional, or increasingly, via online platforms such as mobile apps, and internet-based courses and counselling services.

The focus of Relationships Australia’s July 2018 online survey was to find out whether visitors to our website felt they could spot the signs of poor mental health in themselves and others, what kind of mental health support they preferred, and whether they could generally afford mental health support.

Previous research finds that…

  • One in five Australians aged 16-85 years old experience mental illness in any year (Black Dog Institute).
  • 4 million people experienced a common mental disorder in 2015 (Australian Institute of Health and Welfare).
  • 54% of Australians with a mental illness do not access any treatment (Mindframe).
  • Women are more likely than men to use services for mental health problems (Australian Bureau of Statistics, 2008).
  • The annual cost of mental illness in Australia has been estimated at $20 billion (Australian Bureau of Statistics, 2008).
  • The internet and other online-based support services have become increasingly popular in the last decade, especially for young people (Kauer, 2014).

Results

Approximately 1600 people responded to the Relationships Australia online survey in July 2018. Three quarters (73%) of respondents identified as female, with more female than male respondents in every age group (see Figure 1 below).  More than eighty-eight per cent of survey respondents were aged between 20-59 years, and more than fifty per cent of respondents comprised women aged between 30-49 years (inclusive).

As for previous surveys, the demographic profile of survey respondents remains consistent with our experience of the groups of people that would be accessing the Relationships Australia website.

A substantial majority of men and women reported that they are always or sometimes able to recognise when their own mental health is poor. Slightly more women (43%) than men (36%) reported that they could always recognise when their mental health is poor (Figure 2).

The majority of both men (87%) and women (93%) reported that they were always or sometimes able to recognise if others around them, such as family members or their partner, were suffering mental ill-health (Figure 3).

As shown in Figure 4, eighty-six per cent of women responded that they always or sometimes find mental health services useful. Fewer men (76%) responded that mental health services are always or sometimes useful. Ten per cent of male respondents reported that mental health support services are rarely useful.

As shown in Figure 5, two-thirds (66%) of women and fifty-five per cent of men reported that they would know where to go to access support for themselves or their partner’s mental health. One quarter of men (25%) reported that they do not know where to get mental health support, which was more than that reported by women (15%) (Figure 5).

More women (41%) than men (32%) reported that they can sometimes afford mental health support. Just under one third (32%) of women, and thirty per cent of men, responded that they can rarely or never afford mental health support if/when they need it (Figure 6).

Finally, respondents were asked whether they would prefer to use online mental health support platforms (such as the ‘headspace’ app), over other forms (such as seeing a counsellor or doctor in person) (Figure 7). Around one-third of both women (32%) and men (33%) reported that they do not prefer to use online mental health services over other, in-person forms of support. Just over half of female respondents (52%) and forty-five per cent of male respondents stated they would prefer to use more than one form of mental health support.

References

Australian Bureau of Statistics. (2008). National Survey of Mental Health and Wellbeing: Summary of Results, 2007. Cat. no. (4326.0). Canberra: ABS.

Australian Institute of Health and Welfare. (2018), Mental Health Services in Australia. Report. https://www.aihw.gov.au/reports/mental-health-services/mental-health-services-in-australia/report-contents/summary

Kauer, S. D., Mangan, C., & Sanci, L. (2014). Do Online Mental Health Services Improve Help-Seeking for Young People? A Systematic Review. Journal of Medical Internet Research, 16(3), e66. http://doi.org/10.2196/jmir.3103

World Health Organization. (2017). Mental Health Atlas. Online publication. http://apps.who.int/iris/bitstream/handle/10665/272735/9789241514019-eng.pdf?ua=1

Where to get help

Despite increased awareness of mental health issues in the community, suicide is the leading cause of death for young people aged 15-24 years in Australia.

According to Suicide Prevention Australia, suicidal thoughts and behaviour are connected to a range of social, personal and contextual risk factors, such as socio-economic disadvantage, bullying and social exclusion, sexual identity and childhood adversity. Young people may think about suicide because of difficult things that may have happened in their past, things currently going on in their lives that they may be having trouble coping with, how connected and supported they feel, and how they feel in terms of their self-worth and life outlook.  Mental health conditions such as depression or anxiety and stressful life events like exams or going through a relationship breakup can also contribute to suicidal thoughts in young people.

Below are some ideas and contact details for services that may help you if you, or someone you know, are thinking about or has attempted suicide.

If you are feeling unsafe right NOW, call the Police on 000.

If you would like to talk to someone you can contact one or more of the services below.   You don’t have to provide your name or personal details:

  • Kid’s Helpline: information is available at www.kidshelpline.com.au or by calling 1800 55 1800.
  • Lifeline: information is available at www.lifeline.org.au or by calling 13 11 14.
  • SANE Australia: information is available at www.sane.org or by calling 1800 18 7263.
  • Suicide Call Back Service: information is available at www.suicidecallbackservice.org.au or by calling 1300 659 467.
  • Youth Beyond Blue: information is available at www.youthbeyondblue.com or by calling 1300 22 4636.
  • Black Dog Institute: information is available at www.blackdoginstitute.org.au or  by calling 02 9382 4530.
  • Mensline Australia: information is available at www.mensline.org.au or by calling 1300 78 99 78.
  • National Sexual Assault, Domestic and Family Violence Counselling Service: information is available at www.1800respect.org.au or by calling 1800 737 732, 24-hours a day, seven days a week.
    • Translating and Interpreting Service:  13 14 50.
    • National Relay Service: 133 677.

The effects of partnering on friendships

Introduction

Most individuals can identify issues or problems they would only discuss with a small group of people that are very close to them.  A person’s closest ties are often referred to as a core discussion group or network, usually comprising a small, intimate and significant number of friends and family.

As core discussion groups are thought to involve strong social ties, you might expect that the composition of a person’s group will be largely stable over time.  However, core discussion groups have been found to change over a person’s life course, with relationships strongly affected by the contexts in which people interact with others (Doreian & Conti, 2012).

Recent research has shown that these networks may be less a ‘core’ and more a highly contextual support network in which members are added and dropped as people shift from environment to environment.  Small (2015) argues that the core discussion network is not always a representation of our strongest ties; it is a combination of people we are close to, people we are not close to but who are knowledgeable about the matters we regularly find important, and people we are not close to but who are available because of our routine activities.

Of interest to Relationships Australia is how core social networks contribute to wellbeing, particularly for families experiencing a significant life event such as separation.  While the social networks of married couples are not well studied, it is not surprising that previous research has shown the social networks of men and women change after divorce (Milardo, 1987).  While changes in social networks are not necessarily positive or negative, we have previous discussed how a reduction in the number of important relationships may lead to a reduction in personal wellbeing.

The focus of Relationships Australia’s May 2018 online survey was to examine how partnering and separation affect the close friendships of visitors to our website, with the aim of better understanding how the wellbeing of people experiencing relationship breakdown might be negatively impacted by changes in their core discussion groups.

Previous research finds that…

  • Life transitions such as starting school or university, entering the workforce, marriage, divorce, parenthood and retirement are associated with changes in core discussion groups
  • Core discussion groups tend to be smaller in later years
  • Core networks are affected by institutional contexts; for example, how a day care centre structures opportunities for interaction, through drop-off and pick-up hours, field trips and meetings affects how parents form social networks

Results

More than 1400 people responded to the Relationships Australia online survey in May 2018.  Four‑fifths (78%) of respondents identified as female, with more female than male respondents in every age group (see figure 1 below).  More than 85 per cent of survey respondents were aged between 20-59 years, and more than half (56%) comprised women aged between 30-49 years (inclusive).

As for previous surveys, the demographic profile of survey respondents remains consistent with our experience of the groups of people that would be accessing the Relationships Australia website.

Fifty per cent of survey respondents reported that they were married, 12 per cent were single and living alone and 10 per cent reported that they were single but living with other people.  Almost all survey respondents were/had been in a long-term relationship.

More men (15%) than women (8%) reported that they had no close friends outside of their long-term relationship.  Around one‑third of men and women reported they had 1-2 close friends outside their relationship and a further one-third reported that they had 3-4 close friends outside of their relationship.  Women (30%) were more likely than men (19%) to report they had 5 or more close friends outside of their relationship when they were in a long-term relationship (figure 2).

When examining the number of close friends by gender, on average, men and women’s estimates of the number of close friends outside their long-term relationship were consistent with men and women’s estimates of their partner’s friendships outside their long-term relationship (figure 2).

Survey respondents were asked whether they had more or fewer close friendships when in a long‑term relationship (figure 3).  Irrespective of their current relationship status, a significantly larger proportion of survey respondents reported they had fewer, rather than more, close friends when involved in a long-term relationship.  Separated or divorced individuals were the most likely to report they had fewer friends when involved in a long-term relationship, while single people living alone were the most likely to report they had more close friends when involved in a long-term relationship.

Survey respondents who were currently separated or divorced were most likely to report they spent too little time with close friends, while single, married and de facto respondents were more likely to report they spent about the right amount of time with close friends.  Very few respondents reported they spent too much time with close friends (table 1).

Table 1. Desirability of time with friends by current relationship status

Current relationship statusToo little timeEnough timeOther
Single and living alone47457
Single and living with other people54433
Separated/divorced and living alone59346
Separated/divorced and living with people other than (ex) partner60345
Married/de facto and living with my partner49465

There were significant differences in the reports of men and women when they were asked who they turned to for support when they had problems (figure 4).  While a significant proportion of men and women reported they turned to their partner (45%), women were more likely to turn to immediate family (18%) or friends (26%) than men (16% & 17%).

References

Doreian, P., Conti, N., 2012. Social context, spatial structure and social network structure. Socia. Netw. 34 (January (1)), 32–46

Kalmijn, M., 2012. Longitudinal analyses of the effects of age, marriage, and parenthood on social contacts and support. Adv. Life Course Res. 17, 177–190.

Milardo, R.M., 1987. Changes in social networks of women and men following divorce a review. J. Fam. Issues 8 (March (1)), 78–96.

Small, M. L. (2015). How stable is the core discussion network? Social Networks40, 90-102.