Parliament House Victoria

Royal Commission
into Mental Health
On the Line submission


The Victorian government has begun the process of a Royal Commission into mental health, beginning with a call for submissions to help shape the Terms of Reference.

On the Line, along with many other organisations that operate in this field, has submitted a response that outlines just some of the areas that we consider to be priorities in this review.

The challenge before us is significant and urgent. One in five Australians have experienced a mental health condition in the past 12 months, and almost half of us will experience a mental health issue during our lifetime. Mental health issues are estimated to cost the Australian economy up to $60 billion annually in health care, lost productivity, and many other direct and indirect costs.

You can read the full Victorian Royal Commission into Mental Health – On the Line submission here, but some of the areas we highlighted as critically important included:


Adapting and expanding our approach

Adapting our current approach to include more preventative measures and look beyond the ‘medical model’ to help people feel better.

There are clear correlations between the comparative lack of action on early, causative factors, and the increasing prevalence of issues such as substance abuse, anxiety, depression, loneliness and suicide. Common mental health issues can result from the build-up of many smaller challenges in a person’s life. When these concerns are not adequately addressed, they can become more problematic and manifest as more serious health concerns.

Therefore, we need to look beyond the current reactive and biologically based model that treats the outcomes or symptoms of mental illness, and also look at the underlying causes.  It’s important that we approach mental health with tailored Primary (community-wide education and skills building), Secondary (early intervention) and Tertiary (treatment) strategies.


Addressing Stigma

Working to address the stigma surrounding mental health issues and encourage help-seeking behaviours.

Sixty-five percent of people with a diagnosable mental illness do not access treatment, which is believed to be related to ongoing perceived stigma, plus intrinsic beliefs about gender roles, rural stoicism and cultural attitudes concerning shame.

It therefore essential to normalise the concept of mental and social health and wellbeing, and associated help-seeking behaviours. This will require a deep cultural change in how mental health is communicated and addressed.


Improving access

Improving access to mental health practitioners, support, and self-management opportunities for all people regardless of their geographic location; or their socioeconomic, mental or physical health, gender or any other minority status.

Difficulty navigating a potentially complicated and costly mental health system negatively impacts help-seeking behaviours. Lack of services, or services that are overburdened, particularly in rural, regional and remote areas, aggravates the development of mental health issues.

Adapting our approach includes the development of more tailored options that better suit people’s strengths and preferences, making services available out of hours and in different locations, reducing costs and implementing better end to end care.


Addressing loneliness and valuing strong personal relationships

Understanding the role of loneliness in mental health issues and suicide, and the importance of strong relationships in prevention, support and treatment interventions.

Loneliness is increasingly being classified as a disease: one that affects people of all ages and walks of life. Loneliness now kills more people annually than people than obesity and has a marked impact on mental health.

Loneliness and a lack of strong, supportive relationships informs the development of many mental health issues including depression, anxiety, substance abuse, and even suicidal ideation.

It is well-documented that having a strong circle of supporting peers is one of the most beneficial ways to maintain good mental health. Support networks help prevent distress from escalating into more serious or even destructive issues, while also providing the individual with an emotional safety net.

Elevating the importance of close personal relationships in public health messaging is one of the most effective changes we could make to our system.


Suicide Prevention

Suicide prevention initiatives with a more holistic focus of social health and wellbeing. 

In Victoria alone, more than 600 people took their lives during in 2017. Nationally, the suicide rate increased by 9 per cent, becoming the 13th leading cause of death (up from 15th position in 2016).  It is widely believed that for each death by suicide, there are at least 20 more attempts. In addition, each suicide has been shown to have a devastating direct or indirect ripple effect on potentially hundreds of family, friends, colleagues and others.

These startling figures show that the mental health system needs to adapt if it is to deal with this health crisis effectively.

Many current suicide prevention services operating at local, state and national level are recognised to be effective means of providing support. However, current approaches to suicide prevention focus heavily on the outcomes and symptoms of suicidal behaviour. As a result, contact with an individual engaged in help-seeking behaviour often occurs only once they are experiencing significant psychological distress.

Recent research suggests that suicide arises in part from a deficit in coping skills, and therefore requires a paradigm shift in suicide prevention that focuses on social health and wellbeing, rather than a medical model of mental health and risk management.


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