Towards innovation and a partnership future for mental health nursing

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This year's announcement of psychiatrist Professor Patrick McGorry as Australian of the Year has brought mental health into the spotlight. In a public sense, the award represents a significant acknowledgement that mental health is a growing national concern. After all, 30% of the Australian population experience a mental health problem at any given time. With this in mind, it is important to realise that as few as onethird of them receive adequate treatment. Those treatment figures drop to 25% for young people and just 12% for young males in rural and remote areas.The World Health Organization (WHO) has recently launched an initiative on Depression in Public Health (2010). The WHO estimates that by 2020 mental illness will be the second leading cause of death and disability. The prevalence of mental illness in any period is higher for people who are disadvantaged, whether measured by educational qualification, equivalised household income or living in more disadvantaged areas. These social determinants of health do not cause mental illness; rather they exacerbate prevention and treatment efforts. Recognition of mental health problems is a key first step to accessing treatment but often people are not well informed about the signifiers of mental health issues or where to get treatment and support.A leading international researcher, clinician and advocate for the youth mental health reform agenda, Professor McGorry's work is pioneering a new frontier: early recognition of mental illness, and prevention and treatment of untoward consequences. His work with young individuals with emerging illness uses a proactive approach. Many psychiatric providers applaud this work as many have felt the sting and heart tug of working with a young person and their family during the first episode of mental illness. All hope that it is only one episode and that this talented, bright individual in front of you has a smoother path than that of other clients in the clinic waiting room or occupying adjacent rooms on the inpatient unit. Yet mental illness is disproportionately an illness of the young, with common onset in the teen years and symptoms emerging as early as school age.It is counterintuitive to think that prevention and intervention regarding mental illness, one of the oldest illnesses on the planet, would be seen as innovative. What is it that prevents a full spotlight on mental illness? While many factors play a role, arguably, stigma is the biggest distracter to the recognition of mental illness. In an era where little is private, mental illness is not talked about in social conversations. Public forums often present mental illness problems in an unflattering light, such as insensitive portrayal in movies and television, or stories in the news only when a horrendous crime occurs. Stigma places a mark of disgrace and for many shames not only the person diagnosed with mental illness, but also the family and significant others of the person. Stigma leads individuals not to speak of mental illness but to keep it hidden from public view. Most of all, stigma and the resulting silence contributes to fear, mistrust, and inadequate health coverage. It keeps people, many of whom already live on the fringes of society, from seeking professional help, which compounds discrimination. How many individuals would be recognised and seek help earlier without the barrier of stigma? Challenging the notion of stigma is akin to challenging the status quo; it has existed for so long in mental health care that is accepted as a reality.Such stark realities have not gone unnoticed. In recent times, mental health nurses around the globe have called for collaborative action between government and non-government organisations to improve early intervention and access to services for people with mental illness. Improved access and advocacy are linked to improved consumer voice and choice. Right now there are worldwide reforms underway to help ensure tailored assistance to people with mental illness and mental health problems living in the community. …