When the 2021 census went out to all Australians on August 10 last year, it introduced a question asking about people’s diagnosed long-term health conditions.

Now, the first data from the census has been released and, maybe unsurprisingly, it tells us that mental health conditions are the most prevalent long-term health conditions affecting Australians today.

Over eight million people – about one-third of the population – reported having a long-term health condition. But mental health surpassed all other chronic illnesses in prevalence, with over 2.2 million people disclosing that they have a mental health condition.

That’s roughly 1 in 12 Australians.

These findings highlight a need to invest in not only physical healthcare, but to take urgent action in Australia’s mental health system to meet the increasing demand for services.

“When it comes to mental healthcare, we’re just at the beginning of ensuring that we have good, high-quality services available, and the staff for them,” says Dr Tamara Cavenett, president of the Australian Psychological Society (APS). “And I think that the data actually shows that we’re not managing Australian’s mental healthcare in the way that we should,”

Gendered perceptions

“When you work in the mental health field, it’s not surprising that it’s such a prevalent long-term health condition,” says Dr Madelyne Bisby, a postdoctoral research fellow at the eCentreClinic at Macquarie University, a specialist research clinic providing online mental health treatments.

In fact, according to insights from the first cohort of the National Study of Mental Health and Wellbeing (NSMHW) – also conducted by the Australian Bureau of Statistics – in 2020-21 there were 3.4 million Australians aged 16-85 years (17%) who saw a health professional for their mental health.

But delving a little deeper into the census data reveals that roughly 60% of Australians diagnosed with a mental health condition were women, highlighting long-standing gendered differences in how people perceive mental health – and how they ask for help.

“As a clinical psychologist, we often see more women than we do men,” explains Bisby.

“What they feel comfortable reporting can quite possibly reflect the stigma that still exists around saying that you have an issue around your mental health if you’re male,” adds Cavenett. “And we also know that the traditional services that we provide for men aren’t necessarily tailored to working with men.”

According to Cavenett these findings highlight the need for more research into how treatments and services can be tailored to make men feel more comfortable to seek out help.

The pandemic and mental health

The highest proportions of diagnosed mental health conditions were seen in people aged 20-34 years, supporting findings from the NSMHW that younger Australians (16-34 years) are more likely to experience high or very high levels of psychological distress than older Australians.

“We know that adolescence and young adulthood is the time when a lot of mental health disorders do emerge for the first time,” explains Bisby.

But Cavenett also thinks that the trend might reflect mental health issues created or exacerbated by the COVID-19 pandemic, in terms of a lack of employment opportunities and social interaction.

“What we know is that social contact is much more necessary the younger that you are. That doesn’t mean that it’s not important when you’re older, but that the need and the frequency is much higher in a younger age group,” says Cavenett.

“One of the key features of lockdown is that it takes away a lot of people’s coping resources, a lot of the things they do to stay mentally well – seeing friends in person, being able to go out and be social, and do the things that really bring meaning and value to your life,” adds Bisby.

These higher proportions of diagnosed mental health conditions may also reflect changing attitudes towards mental health in younger Australians – revealing a greater willingness to respond to and report mental health issues in the age group.

“They’re certainly comfortable accessing help and saying that they have a problem,” says Cavenett. “But it’s also causing a much greater demand on the system and the supply of psychologists to actually provide services. And that’s a real worry.”

Demand is increasing, but not the supply

The 2021 census is finally providing national data on long-term health conditions across the entire population, and this will be critical in informing delivery of healthcare services to all Australians.

“There’s a greater emphasis on chronic health conditions now as well, which is super important,” says Bisby.

But the data underlines a need for government to make a greater investment in supporting mental healthcare in particular, especially in the training of new psychologists to meet an increasing demand.

According to the APS, only 35% of the Government’s psychology workforce target listed in the National Mental Health Service Planning Framework is being met.

What does this mean in practice? According to Cavenett, in a pre-pandemic world only around one in 100 psychologists had closed their books to new patients. But now, that number is down to one in three.

“If you try and attempt to make an appointment with a psychologist, you’ve got a far less chance today of being able to get one in a reasonable and a timely fashion,” explains Cavenett.

It takes 6-8 years of training to become a psychologist in Australia, but Cavenett says students are dropping out after five or more years of study because training places are so scarce due to a lack of higher education funding.

“Until that’s addressed, we are essentially looking at increasing demand over time – and less and less psychologists able to meet that demand,” concludes Cavenett.

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