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ELIZABETH:

From Schwartz Media, I’m Elizabeth Kulas. This is 7am.

New work from the Productivity Commission shows the federal government spends twice as much on income support for people affected by their mental health as it does on their treatment. Rick Morton on the human realities of living in poverty while dealing with mental illness.

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ELIZABETH:

Rick, I want to talk about the figures that we’re starting to see now around mental health and poverty and how those things interact with government expectations around looking for work.

RICK:

Yeah. And we, you know, we are, I think for the first time ever now we've got the Productivity Commission, which is, you know, the government's economic advisory agency is investigating mental health. It's never done this before .

ELIZABETH:

Rick Morton is a senior reporter at The Saturday Paper.

RICK:

And it's kind of belled the cat, I think, on this issue, because for so long now, governments have, when they've been asked to fight mental health, they've just poured more money into the health system. Now, that is good. But in isolation, if you're not looking at the social issues attached to mental health, if you're not looking at trauma, a developmental trauma from children when they're young or the welfare system or housing or justice, then you are not fixing the system. In fact, you, you may actually be exacerbating it. And the Productivity Commission, has come out in black and white and said that parts of the income support system and parts of the employment services system are making mental help worse.

ELIZABETH:

And so what sort of figures are the Productivity Commission producing?

RICK:

Yeah, so I mean, there's some really interesting data from the Department of Employment, which is previously unpublished but has been provided to the commission, and they're saying that in February this year there were about 13 percent of the job active employment services caseload, people, had mental illness, but they made up only 7 percent of job placements between 2015 and this year. So already we're getting a signal that this system is not really built for people with mental illness. And we've got a problem that needs to be solved.

So if you break down the costs of mental health treatment, direct costs from both the federal government and the states and territories, the single largest expenditure of government money in any category on mental health is on income support for people with mental illness and their carers.

That reached almost ten billion dollars in the last financial year. Ten billion dollars. Now, to put that in context, the Commonwealth government spends just 4.6 billion dollars a year on Medicare rebates for people, the same people, with mental illnesses. So they spend half as much on the treatment side of things as they do on supporting people with illnesses. That to me is extremely telling. If you were looking at a program that wanted to prevent things rather than respond to them, you would reverse those numbers.

ELIZABETH:

So Rick, at the same time, as you're looking at this data, the Senate is holding its inquiry into Newstart, and hearing from some people who are affected both by mental illness and unemployment.

RICK:

Yeah so I think the testimony that really stood out to me was Renna. Renna’s a 43 year old single mum.

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Archival tape — Renna (senate enquiry submission):

‘So my name is Renna and I'd like all the senators to understand what it's like to be a mother raising an 11 year old girl, in particular, in this case, on Newstart.’

RICK:

Her partner died five years ago and three years ago when her daughter turned eight, she lost the single parent pension. That was kind of the start of her problems. She showed the committee, her income statement from Centrelink.

Archival tape — Renna (senate enquiry submission):

‘... my income statement from Centrelink and I sat down the other night to do some sums. So what I worked our was that for the fortnight, Charlie and I get $901.54…’

RICK:

By the time she deducts rent, groceries, and not just food for all lunches, but also toiletries …

Archival tape — Renna (senate enquiry submission):

’...school fees, excursions, books, uniforms and lunches. On top of all those things, the rego once every…’

RICK:

She’s got about $20.60. And it wasn't until she read all this out to the committee that she kind of took pause…

Archival tape — Renna (senate enquiry submission):

‘...so I put school lunches twice cause it seems like the bane of my everyday, if I can't afford a school lunch, then my daughter, I can't send her to school. So I sit there frightened that the Department of Child Protection will then knock on my door and say that they're taking my child because I can't afford to...I can’t afford to look after her [crying] I’m sorry.’

RICK:

And she actually said, she's like, she apologised. She said, I'm sorry. I don't normally kind of sit here and reflect on what my life is like.

Archival tape — Unidentified female:

‘Please. You don’t need to apologise to us.’

Archival tape — Renna (senate enquiry submission):

[crying] ‘I don't often sit down and do this. I run a very tight budget. But looking at this... I was in tears the other night.’

RICK:

When you get a moment like this where you can kind of see yourself outside of yourself, like Renna did, it broke her.

ELIZABETH:

And Rick on top of this she’s struggling to pay for medication.

RICK:

Correct. So she actually said that her prescriptions cost about one hundred dollars a month. And she said, you know, they're so expensive that sometimes she will skip taking her medication.

That's not an isolated story. I mean, I know so many people and other people who fronted this inquiry as well, who said that they would take one tablet one day, skip a day, because you will feel a little bit fuzzy headed and not operating at 100 percent, but it won't kill you. And that essentially makes a one month supply run for two.

ELIZABETH:

People are rationing medication.

RICK:

Yes, by rationing. I mean, we've got people in this country who are rationing their mental health medication and their therapy. We talk about the lack of choices people have. And that is such a false economy. But what other option did she have?

ELIZABETH:

And how does the government react to the pressure that its welfare programs put on people with mental illness?

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RICK:

The Productivity Commission didn't mince its words. I mean, it essentially says that 50 thousand people with mental illness need to be taken out of Job Active, which is the employment services system. The Productivity Commission said, that system actually aggravated existing mental health conditions and was too inflexible.

So I put questions to Michaelia Cash, she’s the employment minister for the federal government, and she said essentially that the government makes no apologies for moving people from welfare to work. I mean, it was a very long response, but that's essentially what it amounted to.

ELIZABETH:

We’ll be right back.

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ELIZABETH:

Rick, we're talking about the government's approach to mental health and one of the grimmest markers in this field is the suicide rate in Australia. Can you tell me what it says about the effectiveness of government policies, that figure?

RICK:

Mmm. Yeah, so I think the most important thing that it says is that we are really going nowhere. So the suicide rate is about 12 people every for every 10,0000. We haven't moved in two decades.

I mean, that sounds like, okay, well, at least we're not getting worse, right. But that's against the backdrop of two decades of massive increases in antidepressant use, multibillion dollar increases in government spending on suicide awareness, then about five different mental health strategies in that two decades. And we have gone completely nowhere. And that is a problem because we've now got Scott Morrison, who wants to get the suicide rate to zero—

Archival tape — Scott Morrison:

‘2017 more than 3000 Australians died by their own hands, they took their own lives.’

RICK:

—which is a very ambitious plan and a very bold plan and one that I think that you will fail if it is divorced from social reform. And I think that's what this Productivity Commission is saying.

Archival tape — Scott Morrison:

‘….working right across government whether its on mental health issues or other programs to ensure that we are working together to work towards zero on suicide. This is a big job, it’s a curse on our country, but I’m sure working together we can break it.’

RICK:

So now they're working on getting kind of a children's mental health plan together, which is going to be ready by June next year. And there was some criticism at the time because it doesn't have any goals in it. It doesn't have any particular targets.

And beyond that, they've got another suicide awareness campaign. And you know that the industry is very skeptical of suicide awareness campaigns now because we've had so many of them. And they don't really work. We've done a lot of the heavy lifting over the last two decades of increasing awareness and reducing stigma when it comes to mental ill health. But we haven't changed the suicide rate.

ELIZABETH:

So Rick what about access to services in this area, because it's obviously exceedingly complex.

RICK:

That one that one's the key, obviously. We don't have any services between mild mental illness and moderate to severe. There is nothing. I spoke to Roger Gurr, he's a psychiatrist and the director of Headspace Youth Early Psychosis programs. And he was saying that in all of western Sydney, when he has to think about referring young people who've got trauma in their background. When he gets kids who clearly need intensive, trauma-informed support, he said there is one person in all of western Sydney, one person for 1.6 million people, who are capable of providing that support, who are publicly funded. So, you know, it's affordable. That is a crazy statistic to me, because that alone shows you the access where we really needed, it ain't there. And we have really dropped the ball.

ELIZABETH:

Rick, as you sat listening to someone like Renna giving evidence. What went through your head?

RICK:

To be perfectly honest, I cried because I was raised by a single mum. And I remember my mum doing her sums in her notepad every night when, you know, when we were in school. And those sums were all of the money that she had in her bank account, which was not much. And then all of the bills that she had to pay and the groceries and how much they came to, so she could do what amounted to the arithmetic of our existence.

And you know, she had to do it every night and every day, because when you're poor, if you miss 10 cents in the equation and your 10 cent short for a bus ticket and then you get a fine because you don't have a ticket or you can't afford to take advantage of grocery sales and things like that that you need to plan in advance for, then you enter a financial spiral. And I guess I saw in Renna, the just the kind of, the crushing continuity of that arithmetic, like she does that every week.

When she ended that testimony, she kind of just trailed off like there wasn't. And she just kind of lost a bit of umph in her voice.

Archival tape — Renna (senate enquiry submission):

‘Considering my daughter is 11 and about to go into high school and I've got four years of university before I get any sort of qualification. I just wonder how the hell can I get through? There's no end in sight so.’

RICK:

You know, and what poverty does and the Productivity Commission mentions this as well. I mean, there are 70,0000 people in entrenched poverty, that's the worst of the worst right, in any given year. The cognitive tax that people pay to be poor. There's a decision every other hour about, you know, should I forego my tablet today to make this last, or can I actually make up the money somewhere else if I don't get the car serviced?

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And that tax on your cognitive ability reduces your defenses when mental illness comes. We talk about resilience and things like that, when you get struck down by mental illness and it does happen to everyone, regardless of how much money you have or where you were born. But for people whose defenses are already low, then what hope do we expect them to have, particularly when we've got no support services for them? That's what struck me about Renna's testimony, because she's still out there scraping through and she's at the intersection of all of these things.

Archival tape — Renna (senate enquiry submission):

‘...and can I just say, the one thing I did want to say was about my girl. You know, I'm trying to encourage her to, she's she's pre-teen, I'm trying to encourage her to think about what she eats, good nutritional behaviors and looking after herself. But it's really hard when things like a pair of underwear is a luxury item, you know, and she's watching me not eat.’

RICK:

And, you know, if the government wants to know what it needs to do to reform mental health and the social system to help people, they need to start with Renna.

ELIZABETH:

Rick, thank you.

RICK:

Thank you so much.

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ELIZABETH:

Elsewhere in the news:

Over three thousand firefighters are battling more than 70 bushfires across NSW and Queensland. Federal Defence Minister Linda Reynolds told the Senate that reservists may be called up to help the Australian Defence Force respond. The Rural Fire Service’s deputy commissioner Rob Rogers said the situation was unprecedented and worse than he could have imagined. Emergency warnings are also in place in Western Australia, where bushfires threaten homes in Perth’s north east.

And in an interview on Tuesday, Former deputy prime minister Barnaby Joyce has suggested that two people who died in the NSW bushfires "most likely" voted for the Greens. He criticised the party for arguing that climate change policies and unprecedented fires were linked. Speaking of Greens MP Adam Bandt, he said, quote “what I wish Bandt would do is not try to extend this argument to political purposes ... to make these spurious links, that a policy change would have stopped the fires is so insulting and just completely beyond the pale.”

This is 7am. I’m Elizabeth Kulas. See you Thursday.

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