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COLUMN
Being the Commissioner is a humbling experience. Listening to the stories of people who are brave enough to share is also a privilege.
Over the last two years, the Commission carried out a series of community consultations across the State to listen to the community and learn about their experiences, challenges and hopes. We held more than 60 consultations, service visits and an online survey where more than 3,000 people gave us their views and feedback. This was a diverse group with many having a lived experience of mental health issues, as well as families, service providers, mental health professionals, community workers and community members.
One of the most significant concerns to surface from our consultations, was that people with lived experience of mental health issues said that they wanted health workers to understand their mental health issues better.
Having a holistic understanding of a person’s cultural context and environment, as well as their physical and mental health is essential for getting the right support and offering opportunities to improve wellbeing. Improving mental health literacy across the workforce is key to optimising these opportunities. Whereas most health literacy projects are about educating the public to help them understand their own health needs, the Mental Health Commission of NSW is undertaking the Health Literacy Initiative that aims to support the important relationship between a health worker and their client, to achieve the best holistic health outcomes for the person. This focus upon supporting the health literacy of the workforce and creating enabling environments is unique and has been recognised by the World Health Organization.
Health literacy is about people’s ability to access, understand, appraise, remember and use health information and health care services. It means understanding the context in which people access information and providing clear communication about how, when and where people can access help so they can make more informed choices about both their health needs.
Health literacy helps a clinician or health worker to tune in to what is happening for someone. It helps the patient tune in and understand their options, too. Achieving that comes back to providing holistic care.
The resources developed through the Commonwealth-funded Health Literacy Initiative will add to the toolkit that health and social support workers use in their work. It’s not about creating a new performance standard, but about creating a new set of guides and resources that health and social service workers can draw upon. This health literacy toolkit then becomes more useful as each worker can draw upon it, given their own experience and professional setting, whether in a local health district, primary health network or community-managed service.
Studies vary in their findings but in general it’s been shown that people with mental health issues have reduced life expectancy by 20 years in males and 15 years in females[1].
We know that many health workers practice a whole-of-person approach, but when we also know that people with severe mental illness continue to have a reduced life expectancy, we need to increase our efforts to support workers to get the best overall health outcomes for their clients. If you have a mental health issue and go to a health worker, they should be able to see you as a whole person, and say: ‘OK, we have discussed your mental health during this past fortnight, but I’ve also noticed that lump on your forearm. Have you seen someone about that?’ And equally important, if you are seeking advice about feelings of tightness in your chest, then questions about your mood and feelings also need to be explored further.
People often tell us that they have poor experiences with a service in which they are misjudged or are seen through the prism of stigma. As such, some people are hesitant to reach out, even though they may be experiencing physical or mental distress.
What that means is they delay seeking help.
We hope that by improving health and mental health literacy across the health and social care workforce and having a common language, that we can break down stigma, strengthen trust, provide care earlier and improve life outcomes.
The Commission’s Health Literacy Initiative has been invited to join the World Health Organizations’ global network of health literacy projects.
Resources developed throughout the three-year Initiative will be freely available on the Mental Health Commission of NSW website.
[1] Wahlbeck et al. 2011, “Outcomes of Nordic mental health systems: life expectancy of patients with mental disorders”, The British Journal of Psychiatry (United Kingdom: Royal College of Psychiatrists, 2011), 199, 453–458, cited in AIHW, “Physical health of people with mental illness”, Australia’s health 2020 (July 2020)