One of the biggest charitable donors to youth mental health services is taking its money out of treatment and putting it into prevention, warning that illness is skyrocketing but Australia is not doing enough to stop problems developing in the first place.
The sector estimates just 1 per cent of the Australian mental healthcare budget is spent on prevention, and the rest goes on treatment.
“The current funding of mental healthcare is not working,” said Caroline Gurney, the chief executive of philanthropic fund manager Future Generation Global, which is switching its investment from established mental health charities to smaller ones focused on prevention.
She said prevention had been effective in physical diseases such as skin cancer and heart disease. “We need to start tackling the root causes behind the alarming increase in youth mental health conditions, distress and suicidal ideation.”
However, others in the mental health sector argue prevention is an emerging field and not enough is known about what works, particularly across populations.
The latest National Survey of Mental Health and Wellbeing in 2020 found almost 40 per cent of 24-year-olds had experienced a 12-month mental health disorder, up from a quarter in 2016.
Future Generation Global – which has contributed $65 million to social causes over seven years – will move away from major mental health charities and invest in smaller operations that focus on addressing risk factors and promoting preventative measures.
They include programs on parenting, sleep quality, and reducing bullying. “Investment in domestic violence prevention is mental health protective factor,” said the company’s social impact officer Emily Fuller. “Social isolation is a huge factor.”
The new beneficiaries include ReachOut, a service for young people and parents who are having a tough time, anti-bullying organisation Project Rockit, meditation and mindfulness app Smiling Mind, and Prevention United, which offers practical strategies for better wellbeing.
Fuller said the organisations represented the “prevention spectrum,” and Future Generation Global had developed a way to measure impact so that it would be able to demonstrate the value of the investment to governments.
“There’s not the body of evidence because there hasn’t been the investment,” said Fuller. “That’s exactly why you need private investment to forge this new frontier.”
Stephen Carbone, from Prevention United, said research had shown evidence-based programs could reduce the likelihood someone would develop a mental health problem, particularly depression but also anxiety and childhood behavioural disorders.
Only the Western Australian government has committed to increasing its prevention spend to 5 per cent of the mental healthcare budget.
“No one is suggesting you shut down treatment services,” Carbone said. “But you need to adjust your spending so that you have not got all your eggs in one basket.”
However, The University of Sydney’s Brain and Mind Centre’s co-director of policy, Ian Hickie, said while more investment was needed in both treatment and prevention, there was debate over the effectiveness of prevention in mental health, particularly on a large scale.
There was no mass-population silver bullet, like vaccination and anti-smoking campaigns in physical health, so more research was needed.
Indicator prevention – targeting young people who already had symptoms, similar to early intervention – was more effective than so-called universal prevention, which would look for solutions that could be rolled out across big numbers of people, he said.
“The desire to have preventative, universal programs outweighs the evidence of what would work,” he said. “Indicator prevention and early intervention do derive a benefit, but they’re not something you’d do to everybody.”
BackTrack founder Bernie Shakeshaft welcomed the funding, saying it would allow his organisation to support young people in the bush in a holistic way. They have faced significant trauma, and needed everything from legal help and a roof over their head to adults they can trust.
“Your kids are kicked out of school, out of home, out of the footy team, out of everything,” he said.
“We do whatever it takes, for as long as it takes.” They need practical help, but they also need “hope, I reckon. If you were to ask the kids ‘what is BackTrack’, they’d come up with words like belonging, and family.”
Many of Australia’s leading fund managers waive their performance and management fees when they manage Future Generation’s investments, allowing the organisation to contribute tens of millions to social causes.
If you or someone you know needs support, call Lifeline on 13 11 14 or Beyond Blue on 1300 22 4636.
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