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What we talk about when we talk about mental health

  • 19 October 2021
Millions of Australians are slowly emerging from another lockdown and it’s again reported our mental health has suffered. The Victorian Government recently announced 93,000 hours for mental health clinicians to work across the state, and the delivery of 20 pop-up community mental health sites. This fast-track of services precedes a coming ground-up redevelopment of the state’s mental health system, all in response to what we hear often is a mental health crisis.

Or is it a crisis in our well-being? Or does this crisis mean millions of us now have a mental illness? According to Professor Jayashri Kulkarni, Head of the Department of Psychiatry at the Central Clinical School, Monash University, the terms ‘mental health’, ‘well-being’ and ‘mental illness’ are often blurred in public discourse.

‘Unfortunately, we are interchanging those terms. And I say unfortunately because it’s easy for governments to then invest in the well-being spectrum,’ Kulkarni says. ‘That blurring is convenient  because “mental health” and “wellbeing” can be the low-hanging fruit. It can lead to public health programs to help the general community, and that isn’t going to work well for people with severe mental illness.’

Nick Haslam, Professor of Psychology at Melbourne University, has spent the last five years researching what he calls ‘concept creep’ regarding experiences connected to terms such as ‘bullying’, ‘trauma’, and ‘mental health’. While Haslam doesn’t offer concrete definitions for mental health, well-being, and mental illness, he believes they should still be differentiated.

‘People are talking about mental health to refer to things we might previously have not talked about in terms of mental health,’ he says. ‘The distinction may be worth keeping between experiences and behaviour that are significantly abnormal and dysfunctional — and involve some sort of impairent — versus ordinary experiences of anxiety and sadness.’

Psychiatry has since the middle of last century expanded the range of conditions judged as ‘mental disorders’. But, Haslam says, the criteria for deciding when some disorders are present has become significantly less stringent. ‘The same disorder now refers to a wider range of people than it previously did,’ he says, adding that there is ‘concept creep downwards to include minor cases.’

'You can see the widespread loss of well-being and you also see a majority can get through with their coping skills and social support. On the other hand, there’s been an up to 30 per cent increase in need for care in the population compared to what normally occurs.'

Haslam says having a mental