Mental Health Month 2021 speech by Frances Crimmins

18 October 2021

Chief Executive Officer – Frances Crimmins

During Mental Health Month 2021, YWCA Canberra CEO Frances Crimmins was invited to present a virtual speech to employees of ActewAGL on the topic of Mental health awareness.

Good morning and welcome everyone. I’m Frances Crimmins, and I’m proud to be the Chief Executive Officer of YWCA Canberra.

I would like to begin by acknowledging the traditional owners and custodians of the land on which we gather today, the Ngunnawal and Ngambri people, and pay my respects to their Elders, past, present and future, as well as acknowledging any Aboriginal or Torres Strait Islander people who may be in the room with us today.

I also extend my respect to Aboriginal and Torres Strait Islander women who for thousands of years have preserved the culture and practices of their communities on country.

This land was never surrendered, and we acknowledge that it always was and will continue to always be Aboriginal land.

YWCA Canberra has had the privilege of working and serving the community on this land for over 90 years, and we are immensely grateful for this.

I would like to thank ActewAGL for inviting me here today to talk to you about mental health awareness during Mental Health Month.

Mental health is so often a taboo concept, when we need to be bringing it into the open. We live that ethos at YWCA Canberra in how we interact with and support both our staff and our many clients.

For those who don’t know, YWCA Canberra is a feminist not-for-profit organisation that has provided community services and represented women’s issues in Canberra since 1929.

While our services over the past 92 years have evolved and changed, the central focus of our work has always been to innovate to cater for the emerging needs of our community, particularly those who are most vulnerable.

Today, driven by our vision of “Girls and Women Thriving” we employ more than 300 people who deliver quality programs across 21 locations, in the areas of children’s services, community development, homelessness and affordable housing, domestic and family violence, youth services, personal and professional training, women’s leadership and advocacy.

Through these programs and services, we work with people of all ages and genders in the ACT and our wider region.

We see people at their heights of achievement, and those in the most vulnerable periods of their lives. And one thing we have found is that, regardless of a person’s age, socio-economic situation or perceived success, mental health issues can form and become debilitating.

And yet, unlike other forms of illness, society prohibits us from openly discussing mental health issues, and dissuades people from getting medical attention and treatment.

Before I dive in to exploring this in depth, I would like to provide a warning that I am going to be discussing some difficult topics. If you feel a need to drop out and take care of yourself at any time, please do so. That is definitely one advantage to virtual meetings.

Mental health awareness

I want to start with some statistics:

Almost half of the Australian population will experience a mental health disorder at some point in their lifetime.[i]
In any given year, one in five Australian adults will have a mental health condition.[ii]
The most common of these conditions is anxiety, which affects around 13 per cent of the population.[iii]

This is where I’d like to raise the impact of terminology of mental illness, which can hide the seriousness of these medical conditions. The names we use make it too easy to conflate being anxious with having anxiety, and being depressed with having depression.

When we talk about mental health conditions, these are not negative feelings caused solely by a temporary situation. Depressions isn’t just feeling sad. To quote the Federal Department of Health, “Mental and behavioural conditions result from a complex interplay of biological, social, psychological, environmental and economic factors, and can significantly affect how a person feels, thinks, behaves and interacts with other people.”[iv]

And yet too often, they are fobbed off as something that people should ‘just get over’, or that somehow going for a walk will overcome it.

We wouldn’t treat other illnesses the same. We wouldn’t tell someone with heart disease that they just need a weekend away and they’ll be fine. We wouldn’t recommend that a person with a sprained ankle just ‘looked on the bright side’. And it’s not appropriate to do so for people with mental health conditions. They deserve to be treated as we would treat people with any other medical issues.

In many ways, it can help to think of mental wellbeing as a spectrum rather than a “well or unwell” situation.

It’s a continuum where feeling good and functioning well is at one end and mental health conditions are at the other[v]. We can all experience places along the mental health continuum, with us moving up and down the scale because of things like our personal circumstances, health, workplace stresses and social pressures. The goal is just to keep us on the healthier side of the spectrum and prevent sliding into the zone where it becomes significantly impactful on our lives and we need medical assistance.

Causes of mental health issues

One of the biggest misunderstandings about mental health conditions is that they only happen to poor people or those who have experienced trauma in their life. That they don’t happen to “well-adjusted” people.

In reality, mental illness can happen to anyone, just like heart disease, diabetes or asthma.

And just like other disorders, sometimes they can run in the family.

Although our understanding of the causes of mental health issues is still developing, we know that some are linked to chemical imbalances in the brain which impair communication between nerve cells called neurotransmitters.

Now, of course we know that people who have experienced trauma, especially in their formative years, have higher rates of mental health issues. We see that at YWCA Canberra in our community services quite often, with victim/survivors of domestic violence or people experiencing homelessness having a much higher rate of mental illness than the average.

And a recent study from the University of Southern Queensland put numbers to what we’d known for a long time, that young people growing up in low-income households are 25 per cent more likely to have mental health issues.

This is no doubt linked to the range of impacts of poverty on a person’s health, education and social development, not to mention the increased rates of bullying and the fact that being in poverty is often caused by traumatic experiences or intergenerational trauma.

But what causes this link between trauma and the prevalence of mental health conditions?

It’s stress. Chronic stress can result in significant changes to brain chemistry that can exacerbate or trigger underlying mental illness[vi].

Even relatively mild stress can impair the prefrontal cortex, which is the part of our brain that manages abstract thinking, planning, focusing, juggling multiple bits of information and even practising patience.[vii]

So of course a person who has been exposed to more stressful situations is at a higher risk.

But the point I want to make here is that anyone can experience mental health issues. It doesn’t matter how privileged or successful you are. Just as you can develop a serious illness at any point in your life, so you can develop mental health conditions.

And when treated appropriately and early, many people recover fully and have no further episodes of illness[viii]. That ‘early’ part is so important. Poor mental health can have long-term impacts on all aspects of your life and cause a snowballing effect if not addressed at the start. This is part of why raising awareness and reducing stigma and barriers to seeking assistance is so important[ix].

Impact of gender

Of course, I represent a feminist organisation so I want to say some things about women’s experience of mental health.

I do apologise that I am going to use binary gender languages and acknowledge that doesn’t reflect non-binary members of our society. Unfortunately, until statistical collection across Australia catches up to the realities of gender, I have to rely on a binary distinction.

Remember how I said earlier that one in five adults will have a mental health condition in any given year? Well, that statistic becomes a bit more interesting when you break it down by gender, with 22 percent of women and 18 percent of men (in the ABS binary collection structure of the time) experiencing mental health issues.[x]

This difference is even more pronounced when we look at women in the ACT, with nearly 50 per cent more suffering from anxiety than men.[xi]

Why is this? It’s complicated of course, but the pressure put on women in our society, combined with the persistent discrimination and marginalisation we experience, is bound to cause additional stress and, therefore, additional risk of developing a mental health issue.

I want to explore those causes a bit further.

Back in 2019, YWCA Canberra conducted a survey of over 1000 local women. The purpose of the research was to gain an understanding of women’s lives in the ACT: their roles in the workplace and the home, their hopes and fears.

We published the results in a publication called Our lives: Women in the ACT and have used it since to guide our advocacy work.

Hopefully you’ve heard of this and know that we’re running the survey again. For the women and non-binary people here, I encourage you to check out our website and do the survey, so you can have your voice heard.

Responses to our 2019 survey indicate that Canberra women are generally leading fulfilling and dynamic lives consisting of employment, recreation, family and volunteering. That’s not surprising, given our high income levels and the beautiful city we have the privilege to live in.

However, it was also clear from the survey that the demands of unpaid work are heavy and, for many women, the obligations that envelop their lives are impacting their mental wellbeing. More than half of the respondents said they are currently feeling ‘stressed’ or ‘burnt out’, with only 20 per cent feeling relaxed or energetic. Remember, this was before the COVID-19 pandemic, which I’ll talk more about soon.

The role of women in unpaid work, such as care for children and family members, household duties and community obligations, is one of the central factors affecting women’s economic progress.

While unpaid work contributes enormously to the wellbeing of individuals, families and communities, the stereotype of that being ‘women’s work’ persists. This impacts both women’s participation in the labour market and men’s equal contribution to the demands of the home. The unequal distribution of unpaid work can have immense impacts on women’s retirement stability, a fact most women are all too well aware of, and can lead to long-term high stress levels.

I’d like to show a quick video, which is a few years old now but demonstrates the impact of gender inequality in unpaid work: HILDA 2018: Are you doing your fair share at home? – YouTube

Moving on to another finding of our 2019 survey, when we asked about discrimination, more than half of all respondents said they had experienced instances of sexism in the last twelve months.

Other reports have found that one in five Canberra women experience sexual harassment in a twelve-month period.[xii] I’m sure that doesn’t surprise many women listening in: I don’t know a single woman who doesn’t have a story of sexual harassment.

Then, sadly, our survey found that domestic and interpersonal violence remains a feature in the lives of too many Canberra women. 24 per cent of 18 to 24 years olds said they had experienced emotional, physical, verbal or financial abuse in a domestic or interpersonal relationship in the previous twelve months.

And the extremely high and rising costs of housing and inadequate supply of social and affordable housing are adding to this issue, with many women incapable of escaping domestic violence because they don’t have a home to go to, and others leaving to be homeless, staying in hotels, or living in inadequate or unsafe housing.

And then, in the workplace, there’s the gender pay gap, which grew during the pandemic. The national pay gap is 14.2 per cent for full-time employees, a difference of $261.50 each week.

The gender pay gap is a measure of the barriers women face in the workforce. This discrimination harms women’s careers, their financial stability and their long-term financial sustainability.

So, there are just a few of the complex reasons why women might experience additional pressures and vulnerabilities throughout their lives, which no doubt impact their risk of developing or exacerbating mental health issues.

Of course, I am not suggesting there aren’t gendered factors that impact men’s mental health. There absolutely are, and suicide sadly remains a leading cause of death in young and middle-age men in Australia.

To explore this link between gender and mental health, especially in a workplace context, I would like to show a short video: Gender, Work and Mental Health – YouTube

Impact of COVID-19

And of course, then we got COVID-19. A pandemic that put immense additional pressure on many people’s mental health as they coped with stress, social isolation, changes to working styles, reduced work or unemployment, and additional caring duties.

This led to psychological distress becoming common. Rates of requests for mental health support rose[xiii]. As anyone who has tried to see a psychologist in Canberra recently would know, it is almost impossible to find one taking new patients because of the high demand.

And the wider impacts of the pandemic have disproportionately impacted vulnerable people with complex support needs, those on low incomes or in insecure employment. For example, during the first wave last year, we saw a 170 per cent increase in referrals to YWCA Canberra’s housing and homelessness services, as well as a steep spike in demand for our domestic and family violence service. Our food hub and community centre in Lanyon saw a significant increase in Canberrans requiring emergency food and help paying their bills.

And this trend has sadly recurred during the latest lockdown.

These additional stresses have resulted in a significant increase in users of our community services reporting poor to very poor mental health during the lockdown.

Our youth engagement services have noticed a spike in anxiety, depression, self-harming and suicidal ideation in the young people they work with, especially in low-income homes, as well as difficulty getting specialist help.

Sadly, people who are already in vulnerable groups have no positive end in sight, with the recent announcement that the Commonwealth will be scaling back disaster payments. These are payments for people who have been significantly impacted by lost or reduced employment during the Canberra lockdown, and are just trying to survive. We are expecting another surge in demand for community services and mental health support when this happens.

And with the waiting list to get into ACT Government social housing even as a priority case being nearly a full year[xiv], we expect to see yet more homelessness, and yet more mental health issues.

Those of us lucky enough to still have jobs and a home are also experiencing the impacts in the form of ‘pandemic fatigue’. If you can recall back to January, which seems like a decade ago, many of us optimistically looked forward to 2021 as having to be better than 2020. Then 2021 happened. And we’re all just tired. Tired of being scared. Tired of not being able to live and develop in the way we imagined. Tired of not being able to see our friends and family.

And this long-term strain can cause the same changes in brain chemistry that we see in people who have experienced trauma.

Social barriers to change

I know that exploration of the current reality of mental health in the ACT and Australia was a bit depressing, which is somewhat ironic, but it’s important to understand what is happening. And it’s even more important to understand why there has been so little progress on mental health awareness.

One of the biggest issues we have in being open about mental health issues in Australia is the perception that it makes people ‘weak’. And our society abhors any form of weakness (which, as the head of a feminist organisation, I could talk about at length but I will keep myself to topic).

This misperception goes on to suggest that talking about any form of weakness, or showing vulnerability, is to be avoided. But I believe it should be embraced.

I’d like to use an example from our professional training. We offer the She Leads Diploma in Leadership and Management, which includes panel sessions with women and non-binary leaders.

When we ask students what they found most rewarding in the panel sessions, one of the most common answers is that these leaders showed vulnerability. That they spoke of their problems, their issues and concerns, in an open format, even though they were speaking to strangers.

This display of vulnerability is a way for us to all connect, as human beings, because we are all vulnerable in some way, whether we like to admit it or not. It’s part of being human. Pretending our vulnerabilities don’t exist, making discussion of them taboo, doesn’t make them go away. It entrenches them, by preventing us from seeking sources of growth.

The same is far too true of mental health.

I want you to think back to the statistics I started with. One in five people you know will experience a mental health issue in the next twelve months.

Let’s compare that with cardiovascular diseases, which around one in 17 Australians suffer from. Yet which one do we hear about more on the news? Which one are we more comfortable reading about? Which one would we talk about a bbq?

As I said earlier, mental health conditions are a medical issue and deserve to be treated as such rather than stigmatised.

One of the biggest obstacles for people recovering from mental illness is the attitudes of people around them. Too often, people recovering from an illness that they have been receiving medical treatment for face isolation and discrimination for that illness. The same people who would send flowers to someone who has been diagnosed with cancer shun those who have been diagnosed with schizophrenia. This needs to change, to ensure quality of life for people with mental illness and support their recovery.[xv]

This is linked to another misconception, that people with mental health issues need to just pull themselves together. Everyone else can cope with the current situation, so why can’t you?

But you wouldn’t expect a person with a sprained ankle to run a race like someone who is uninjured, so why do we expect people with mental health issues to be able to deal with life issues like everyone else? Just as a person with a sprained ankle needs medical supports and time to recover, so too do people with mental health issues.

And again like other conditions, such as heart disease or diabetes, there are things we can do to make ourselves less likely to develop a mental health condition. Using the terminology earlier to mental health being a spectrum, these are things that keep us on the healthier side and present us from moving further into the unhealthy end.

Self-care

Which is where I’d like to move onto some more practical topics. Even if you have never suffered from mental health issues, there are ways we can all look after our mental health, especially in these challenging times.

First of all, I’d like to encourage everyone to give yourself permission to take it slow right now.

Working in the advocacy space, I have seen so many passionate, incredible people burn out even at the best of times because they pushed themselves too far. And with so many of us feeling scared, isolated and overworked during the pandemic, especially those with added caring responsibilities, the risk of burn out is so much higher.

Of course, I don’t mean that we should stop fighting for what’s right and pushing for personal and professional development. But we need to do so mindfully.

You might have heard of the saying that ‘you can’t pour from an empty cup’. Just like an oxygen mask on a plane, it’s important to look after yourself before others.

And after over 18 months of stress, isolation and uncertainty, self-care is not a luxury: it is a necessity.

Self care has become a bit of a buzz-term over the last few years, and is often equated with a bubble bath and a glass of wine. Although those can be great things in moderation, for long-term benefits we need to do more.

Self-care comes in two categories: active and passive[xvi]. We’re generally more familiar with the passive forms, like meditation, listening to music, taking a walk (within COVID-19 restrictions) or a quiet cup of tea.

Active self-care requires a bit more effort and is not always comfortable. It includes things like going to a psychologist, investing in your personal development and setting healthy boundaries on your time and mental and emotional labour.

I know that that sounds like work when you’re stressed and just want to relax. But these things will help you reduce stressful factors in your life and often have much better long-term positive impacts than passive self-care.

Once you’ve taken care of yourself, then you can make yourself available to others if you have the capacity to do so.

For those of you fortunate enough to not have experienced a mental health condition in the past, I encourage you to learn more about it. To read about people’s lived experiences. To know how to ask the right questions, how to listen, and how to validate what other people are experiencing. The R U OK? website[xvii] has some great tips on this, including ones tailored to different situations, and the Mental Health Month website has a section on how to be a good ally[xviii].

Having allies and safe spaces is incredibly important when dealing with mental health issues. The relief of knowing you can take down your barriers, stop pretending and just be yourself, fully and truthfully, can bring a moment of peace to a person whose day is otherwise filled with mental turmoil.

I would particularly encourage those of you in management positions to actively demonstrate that you are an ally. And by demonstrate, I don’t mean telling people that you are safe to talk to. I mean encouraging people to take care of themselves first. Discussing the impact of stress and what you are doing to mitigate it in the workplace. Being authentic and sharing your own vulnerability where appropriate. And avoiding any stigmatising language or behaviours.

And of course, for those of you who have experienced or are experiencing mental health issues, I encourage you to seek help. There are thankfully many organisations around now with free services. And I know you’ve got an employee assistance program as well.

References

[i] Department of Health | Prevalence of mental disorders in the Australian population

[ii] Mental health, 2017-18 financial year | Australian Bureau of Statistics (abs.gov.au)

[iii] ibid

[iv] Department of Health | The fourth national mental health plan

[v] What is mental health – Beyond Blue

[vi] Types of mental health issues and illnesses – Better Health Channel

[vii] How coronavirus stress may scramble our brains | Science News

[viii] Department of Health | Myths, misunderstandings and facts about mental illness

[ix] New national strategy to tackle stigma and discrimination of people with mental illness – National Mental Health Commission

[x] Mental health, 2017-18 financial year | Australian Bureau of Statistics (abs.gov.au)

[xi] Mental health, 2017-18 financial year | Australian Bureau of Statistics (abs.gov.au)