Mental health burden on the rise: AIHW

Mental health conditions and substance abuse now cause the second heaviest burden of disease, according to a new analysis released by the Australian Institute of Health and Welfare (AIHW).
 
The organisation’s latest Australian Burden of Disease Study, released today, suggests the disease group has leapfrogged musculoskeletal conditions and now lies second only to cancer for its overall impact on the population.
 
The AIHW analysis assesses the overall burden of a disease by calculating years of healthy life lost due to ill health alongside years of life lost due to premature death. 
 
According to the report authors, cancers caused 17% of the overall burden while mental health and substance use disorders caused 15%.
 
While the majority of cancer’s impact is caused by early death, much of the burden from mental health conditions and substance abuse is non-fatal, with the greatest impact found among younger generations.
 
Specifically, anxiety disorders, depressive disorders and bipolar disorder combine to cause 54% of the overall burden in the category, the AIHW reports.
 
For Dr Cathy Andronis, Chair of RACGP Specific Interests Psychological Medicine, the figures reflect a trend that has been clear to many working within general practice.
 
‘It doesn’t surprise me at all really, they are alarming figures,’ she told newsGP.
 
‘We in general practice have been seeing this gradually building up over many years, and COVID probably made it more obvious to everyone.’
 
The analysis used new data from the National Survey of Mental Health and Wellbeing (NSMHW), which suggested the category is the leading disease group causing non-fatal burden.
 
Musculoskeletal conditions, cardiovascular diseases and neurological conditions were also among the five leading categories that caused the greatest burden.
 
Of specific conditions, the burden caused due to anxiety disorders has risen by 33% between 2003 and 2023, the AIHW notes – again a shift that does not surprise Dr Andronis.
 
‘I think we’ve made the world physically safer in the outside environment; however, we’ve replaced that with less safety internally and mentally so it may appear that we’re better but in reality, psychologically we’re actually worse,’ she said.
 
‘One of the things we’ve tried to advocate strongly for is more time in general practice, to not have to rush through things to be able to get to the bottom of what’s going on.
 
‘Underneath a lot of symptoms, you’ll find mental health distress.
 
‘What is really disappointing to see is the suicide figures going up, particularly for males, who are less likely to make contact with GPs, [and] are less likely to have more in-depth conversations or longer consultations.’
 
Other notable shifts in the past two decades include decreases in the impact of coronary heart disease, stroke, lung, bowel and breast cancer and rheumatoid arthritis. Stroke in particular was the third ranked specific disease in 2003, and is now ranked at number 12.
 
However, there has been a substantial increase for dementia, with its rank now second of the total burden in 2023.
 
Last year’s study found that COVID-19 contributed 2.7% of the total disease burden in Australia – a trend driven by premature deaths that disproportionately took place among males, and in older Australians aged from 75–84.
 
This year, that had decreased significantly, with COVID‑19 ranking 30th among the specific diseases, making up 0.9% of the total burden and 1.5% of overall fatal burden.
 
However, the study’s authors say the estimates may change as more data become available for the latter part of the year.
 
The study also indicates that Australians are living longer but spending more time in poor health.
 
It suggests that the overall proportion of people’s lives spent in ill health has remained around the same.
 
The AIHW brackets mental health and substance abuse together but says it may separate them in future reports.
 
Meanwhile, Dr Andronis said that even though the findings are concerning for mental health advocates, it highlights the need for investment in general practice – particularly when GPs are reporting mental health as the most common presentation.
 
‘There’s a reliance on governments to take the lead when in reality the lead has to be taken by the individuals themselves,’ she said.
 
‘The person who can most help them to do that, apart from their family and their friends, is usually their GP, someone who is readily available and accessible and can help people face up to what it is that they need to change in their life.’
 
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