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Study paints bleak picture for men’s mental health


Matt Woodley


29/05/2019 3:20:31 PM

Beyond Blue research has revealed suicidal behaviour among Australian men could be up to three times greater than some estimates.

Depressed man
There were more than 30,000 ambulance attendances for men who had thoughts of suicide or had attempted suicide between July 2015 and June 2016.

The study, which focused on ambulance call outs to men presenting with acute mental health issues, self-harm or suicidal behaviour, found there were 30,197 ambulance attendances for men who had thoughts of suicide or had attempted suicide between July 2015 and June 2016.
 
In addition, the three-year research program discovered ambulances made an average of 82 attendances each day to men who had either tried to take their lives or were having serious thoughts about doing so.
 
Previous data based on presentation to hospital emergency departments only identified approximately 10,000 male cases annually, leading Beyond Blue Chair Julia Gillard to describe current knowledge about male suicide as ‘just the tip of the iceberg’.
 
Dr Caroline Johnson, GP and Senior Lecturer in General Practice at the University of Melbourne, told newsGP that while men are generally less likely to access primary care services than women and children, there is much GPs can and already do to help men think about their mental health.
 
‘There are cultural factors here, such as the issue of so-called “toxic masculinity” where men fear being defined as weak or not coping,’ she said. ‘Society needs to keep sending the message that getting help for mental distress is a sign of strength, not weakness.
 
‘Simple things that GPs can do to open up a conversation about mental health include asking how work and family life are going, while ensuring appropriate use of silence and active listening to create a space for the patient to talk.
 
‘Regularly updating the medical record regarding employment status, hobbies, family history, alcohol and substance use can create opportunities for more conversations about social and emotional wellbeing.’
 
National suicide figures show that an average of six men take their lives in Australia each day. Dr Johnson said everyone has a tipping point as to when they will seek help.
 
‘In some cases it unfortunately happens quite late in the illness experience, often when alcohol or conflict is involved, and the emergency services will then be drawn in to assist,’ she said.
 
‘Paying attention to possible tipping points and encouraging people to talk about their mental health before a crisis arrives is a role that GPs do fulfil, by gently plugging away at building rapport with patients over time. Encouraging continuity of care helps that process.’

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The findings led researchers to determine that Australia’s healthcare system is in need of urgent reform to prevent a ‘revolving door’ of acute presentations to hospital emergency departments.

According to paramedic clinical records from New South Wales, Victoria, Queensland, the Australian Capital Territory, the Northern Territory and Tasmania, there were 112,637 ambulance attendances for men experiencing acute mental health issues between July 2015 and June 2016. Of those:

  • 15% were for those experiencing suicidal thoughts
  • 8% were for suicide attempts
  • 42% had already presented to the ambulance service at least once
  • 20% were for more than one mental health issue
  • 10% were for anxiety, 9% depression, 8% psychosis
  • 78% were transported to hospital
  • 60% of attendances occurred after-hours.
In addition to collating information on ambulance attendances, Beyond Blue researchers conducted an online survey of 1230 paramedics, and interviewed 73 paramedics from city and country areas, and 30 men who had used ambulance services for mental health and suicide-related issues.
 
The research revealed limited capabilities among paramedics to deal with acute mental health issues, with only 14% receiving comprehensive training for mental health presentations, while two out of three felt under-prepared to talk to patients about their needs.
 
The findings led researchers to determine that Australia’s healthcare system is in need of urgent reform to prevent a ‘revolving door’ of acute presentations to hospital emergency departments.
 
‘We need better options for men who are in suicidal crisis,’ Monash University Professor Dan Lubman, who led the research project, said.
 
‘If they don’t have life-threatening injuries, they shouldn’t be at emergency departments. Yet paramedics feel they have too few alternatives.
 
‘Our paramedics need more support and people with acute mental health issues or who feel suicidal need better models of care.’
 
Dr Johnson agrees that better pathways are needed for people seeking mental health treatment, but said the idea of a ‘no wrong door’ approach means all points of entry to the system need to be equipped with the knowledge and skills to help people in crisis, regardless of the nature of the problem.
 
‘Sometimes an acute presentation in crisis can be the tipping point a person needs to get the right kind of help: so finding better solutions for dealing with patients in crisis is as much a part of the solution as improving support in the community,’ she said.
 
‘Whatever way someone ends up seeking help for the first time, it has to be safe enough and compassionate enough that they will get the message that it is really, really good to be seeking help. 
 
‘This is achieved by offering stigma-free acute services and following through with timely, affordable sub-acute support, reinforcing that the only real shame about having a mental health crisis is not being able to turn that into an opportunity to make life better.’



Beyond Blue men’s health mental health suicide


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