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RUBY:

From Schwartz Media, I’m Ruby Jones, this is 7am.

A landmark report has quantified the economic and social cost of Australia’s mental health crisis.

It’s also pointed to poverty and unemployment as key factors behind why so many people are struggling with mental health.

Today, senior reporter for The Saturday Paper, Rick Morton, how the government’s social policies are causing harm to our most vulnerable communities.

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RUBY:

Rick, let's start by talking about this report into mental health in Australia that has just been released. It's one of the most exhaustive reports that's ever been commissioned into this. So what did we find out?

RICK:

The Productivity Commission's Mental Health Report was ordered by Scott Morrison when he was treasurer, and it aimed to find out what mental health actually cost the nation in terms of lost productivity due to mental illness and a whole bunch of other factors.

Archival Tape -- Scott Morrison:

“This is first and foremost a health issue...”

RICK:

And the report was released by Morrison last Monday at a press conference in Melbourne.

Archival Tape -- Scott Morrison:

“But health issues have very significant and serious economic consequences as well. And if there's ever been a year to understand that, it's Covid-19 pandemic of 2020.”

RICK:

By its own conservative estimate, the Productivity Commission places the cost of mental illness to the Australian economy each year between $200 billion and $220 billion.

Archival Tape -- Scott Morrison:

“That's more than a tenth of the size of Australia's entire economic production in 2019. It's around $550 to $600 million each and every day.”

RICK:

Now, for context, that's just shy of the projected $227 billion dollar spent on the entire social services portfolio this financial year.

Archival Tape -- Scott Morrison:

“It's also the social, emotional cost of suffering, exclusion and in worst cases, premature death.”

RICK:

But the stuff that I found most interesting and most telling and places where we can make a huge difference, according to the Productivity Commission, is in social exclusion and poverty.

RUBY:

Can you tell me more about that? What did the report find in terms of how people who are experiencing poverty are particularly disadvantaged?

RICK:

So a key finding of the Productivity Commission report was that people who are unemployed are more likely to have mental health struggles.

Archival Tape -- Scott Morrison:

“People receiving unemployment benefits are three times as likely to have depression or anxiety as wage earners are.”

RICK:

And as the Prime Minister said himself, that's not only because they have less money, but also less social support and less sense of control and autonomy over their lives.

Archival Tape -- Scott Morrison:

“Now, this is not only a result of financial hardship, but is often associated with limited social support, loneliness and a decreased sense of personal control and achievement.”

RICK:

And that's the profound statistic. And it's probably one that the coalition would, you know, be unwilling to delve into in any particular detail because their social services policies, their Social Security policies are actually a huge part of this problem. And, you know, the most recent example and the worst in certainly in my memory is robo-debt.

And you couldn't have scripted this any better. While the Prime Minister was talking about this Productivity Commission mental health report, lawyers representing the class action against robo-debt announced that a settlement had been reached with the Commonwealth. And it was the largest such payout involving the largest number of people against government in Australian history.

RUBY:

Let's talk about robo-debt, because this was a government scheme which had huge impacts on some of the most vulnerable people in our community, the kind of people that this report was identifying as being most at risk, right?

RICK:

Absolutely. You know, the robo-debt fiasco stands as a clear example of how the government's own, quote unquote, tough love approach to disadvantage can quickly metastasise. It was an industrial scale operation designed to raise more than $4 billion of Centrelink debt that, for the most part, never existed. It was really, as James Cruz, a young man who had one of these debts, told me, it was really a collective traumatic experience.

Archival Tape -- James Cruz:

“Obviously, I was just shocked. Like, I like I had no idea. I hadn't heard that this was happening.This is the first I'd heard of it.”

RICK:

He received a robo-debt notice in early 2016. He was one of the first, essentially, and it was for sixteen thousand dollars.

Archival Tape -- James Cruz:

“And, you know, I just said, like, I don't have this money. Like, I don't know where this has come from. Like where are you getting these details?”

RICK:

He'd never heard of having the debt before until he got this phone call from Dun and Bradstreet, which is a favoured private debt collector used by Centrelink and Services Australia.

Archival Tape -- James Cruz:

“It was like the most shocking, anxiety inducing phone call that I’ve ever had.”

RICK:

So and, you know, he was saying that as he began to fight this and dispute this, even though he was still in a payment plan, he started watching all these other people come forward with debts and he saw them suffer.

Archival Tape -- James Cruz:

“At this point, I've been hearing stories of people who were in much worse circumstances than I was. And, you know, now we know, like we know that people, you know, ended their lives over this.”

RICK:

And he was saying to me that, you know, people ended their lives over this. We saw that there was testimony from families who lost loved ones. And he said that there were people who were thrown into absolute financial chaos.

You know, he battled that for four years.

And the only reason they wiped his debt was because, in May this year, they were about to lose a legal case and they realised that they were stuffed and they announced that they were repaying $720 million. And James Cruz was one of them.

Archival Tape -- James Cruz:

“Yeah, it was just…yeah I felt like I was never going to escape. It was extremely stressful.”

RICK:

But while robo-debt is one of the most explicit examples of government policy that's caused harm, the commission's report draws a portrait of a system that entrenches stress and mental injury across government. And just as robo-debt with the decision, so are these other social policy settings.

And I guess what I mean by that is that they have a whole suite of what are meant to be tough love policies aimed at getting people into work and finding jobs.

But what these policies end up doing is actually haranguing, harassing and bullying really vulnerable people, people who are down on their luck, people who have already had mental health problems and trying to fit them into a system that squeezes out a certain type of person. And it does so at great cost.

RUBY:

We'll be back after this.

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RUBY:

Rick, the Productivity Commission's report, it really paints this picture of a system that entrenches stress and mental injury. So what are these other components of the social services system that are causing harm? Can you go into some detail?

RICK:

Well, one of the key features of the entire social services system is this concept of mutual obligation. And this is the idea that recipients of welfare have a right to support only where they meet a series of strict conditions ostensibly designed to encourage them into work, study or other training. So the idea being that, you know, the government is obliged to pay you welfare and a safety net and you're obliged to work for it, essentially. In practise, these obligations are often anything but supportive.

And according to this report, mutual obligations in particular, these requirements can aggravate mental illness and increase distress. You know, and there is also a question mark, according to the commission, over whether these mutual obligation requirements can cause mental illness in the first place. So you could get a perfectly healthy person down on their luck, come into this system and actually develop a clinical representation of mental illness because of the system. And there's just not enough evidence to know, you know, how widespread that is. But the commission notes that it is definitely possible

RUBY:

Right. So basically, the report is saying that amongst people who already experience mental illness, having to deal with mutual obligations can make that mental illness worse. But it’s also saying that there is a possibility that these arrangements might actually cause mental health issues in people that previously don't have them?

RICK:

Absolutely. So speaking to Kristin O'Connell, the spokesperson for the Australian Unemployed Workers Union, and she was saying that this report finally recognises what they have been saying for years, and that's mutual obligations hurt people.

Archival Tape -- Kristin O'Connell

“People who are in the system for a length of time are developing mental ill health and having diagnosed conditions that are clearly related to the exposure to job agencies and to these pointless, repetitive, punitive mutual obligations.”

RICK:

She said, we need to stop mucking around with this inherently flawed job active employment services system that systematically breaks people and creates mental health issues.

Archival Tape -- Kristin O'Connell

“This really just shows that we have a suite of policy failures when you take them together, the brutally low payments and the government's absolute refusal to accept responsibility for things like robo-debt and the many other punitive programmes that they put in place to punish people just for being poor.”

RICK:

They're strong words, but that's essentially what the Productivity Commission have also found.

Archival Tape -- Kristin O'Connell:

“It's proof that the government is absolutely happy for people in the welfare system to be brutalised, to be denied justice and for no one to have responsibility for that.”

RUBY:

So if these systems are causing harm, is there a way to fix that?

RICK:

Well, if you talk to experts in this field, like Professor Ian Hickie, who's the co-director of the University of Sydney's Brain and Mind Centre and a former national mental health commissioner. He was saying to me that any government policy that might have an impact on mental health should come with an assessment the way that infrastructure projects must meet environmental approvals.

Archival Tape -- Professor Ian Hickie:

“I'm of the general view that for many social welfare and health policies, we should have a mental health impact statement, just like we have an environmental impact statement for many other developments in the physical world.”

RICK:

He said all of these issues should be looked at.

Archival Tape -- Professor Ian Hickie:

“Housing support, rental support, childcare support. They are the other critical aspects that if you're really serious about mental health and growing mental health and overcoming disadvantages would be very high priorities.”

RICK:

These things cost money. But as a report has identified, the cost of not taking mental health into consideration is also considerable. And it seems like a no brainer, I guess, to invest in this kind of stuff that can avoid those costs, particularly when they quantify it as they are here in this report.

RUBY:

And so, Rick, we've just seen the government settle the robo-debt class action. Do you think that that will signal a change in the government's approach to delivering social services? Do you think that there will be a rethink, given especially how unsuccessful that programme ultimately was and the harm that it caused?

RICK:

No. I mean, if you look at the robo debt thing, I mean, they thought they had it easy, right? They thought they were going to get $4.2 billion or whatever it was over eight years, I think. Easy as. It ended up costing them about $2 billion. They never made a saving. It costs money. And they almost got dragged through the courts where they would have been found to have acted unlawfully based on the advice that they had at the time. They only stopped that programme when it looked like they had no other avenue to go down. And I just don't think they've learnt a lesson.

I do think that this Productivity Commission report, if people talk about it and, you know, if people see it for what it is, which is a test, it's a test of this government and any that follows it to make policy based on evidence and not ideology. And I don't care what your ideology is, but whatever the policy is, if it's going to cause harm, then, you know, no one in their right mind should be doing it.

And yet we have these kind of arguable policies that are on paper. They say that, you know, we don't want anyone to be addicted to drugs and alcohol. Of course not. And they say that if anyone who wants to work or anyone who can work should be able to work and make. Absolutely. Those are all statements that are easy to agree with. But how do you go about doing that can actually cause great harm, particularly when you don't understand what disadvantage feels like and the decision making that goes on in the brains of people who have nothing. You know, scarcity creates a different kind of thinker then plenty does. And, you know, people who have huge donors, political donors and who come from middle class or rich families don't understand that. And that's when you have to give way to ideology and you have to actually listen to reports like this.

And, you know, genuinely, my personal view is that they just do not understand why anyone would be poor, because to them it doesn't make sense. And, you know, I don't blame them for not understanding, I blame them for not trying to empathise. But, you know, if you don't come from that world, it looks like madness to be poor. It looks painful. And it is, it's a horrible existence. And so they think, you know, obviously, if you're not trying to get out of it, then you must want to be there. And so they can't reconcile that in their heads.

And I'm talking particularly about conservative ideologues, but also there's this kind of technocratic fervour that has taken over a lot of federal governments since, you know, the 1990s, essentially, where we kind of itemised people and put them down to bits and then just become, you know, almost like chess pieces on a spreadsheet. You know, they don't think that it's because of policy. They think it's because they choose to be there, which is just bonkers, to be quite honest, it just doesn't make any sense at all. But that's where we are, I guess.

RUBY:

Rick, thank you so much for talking to me today.

RICK:

Thanks, Ruby. Thanks for having me.

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RUBY:

Also in the news today…

The Queensland state government has announced it will allow residents from Greater Sydney to enter the state from December 1, in an easing of coronavirus restrictions.

The Premier, Annastacia Palaszczuk, said she will announce changes to the Victorian border today.

And in the US, President Donald Trump says he has authorised the agency responsible for the presidential transition process, to begin "initial protocols" that would recognise Joe Biden as the winner of the 2020 election.

But he has said he will continue his legal challenges to the election result.

I’m Ruby Jones, this is 7am, see ya tomorrow.

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