0:00
Good afternoon everyone.
0:02
Welcome.
0:03
Thanks for joining us.
0:04
I'd like to begin first with an acknowledgement of Country.
0:10
In the spirit of reconciliation on behalf of SANE Australia and my Co panelists, we would like to acknowledge the Traditional Custodians of country throughout Australia and their connections to land, sea and community.
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We pay our respects to Elders past and present and extend that respect to all Aboriginal and Torres Strait Islander peoples today.
0:28
I am joining you from Wangal and Bedigal lands where I live and work.
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At SANE we recognise that lived experience lives here.
0:39
We respect and champion the individual and collective expertise of people with the lived experience of mental health issues, trauma, and experiences of suicide, as well as the experience of their families and communities and those who are impacted or bereaved by suicide.
0:56
We recognise those vital contributions at all levels and value the courage of those who share these perspectives for the purpose of learning and growing together to help us achieve better outcomes for all.
1:08
Thank you so much for being here.
1:09
Welcome to this webinar where we'll be unpacking the findings of the 2026 National Stigma and Discrimination Report Card.
1:17
This session is being recorded and it will be available to watch later online.
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A little bit of housekeeping.
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We will have some time for questions at the end.
1:26
You are welcome to submit questions throughout the session using the Q&A button at the bottom of your screen, and we'll leave some time for questions for the panel at the end.
1:36
If you want to ask a question of a particular panelist, please let us know when you submit your question.
1:42
It's great to see so many people joining us online.
1:45
I think we saw over 300 registered for this session to come together and talk about such an important issue.
1:52
Stigma and discrimination remain one of the biggest barriers to mental health recovery and participation in Australia.
1:59
I'm incredibly proud of the work that went into this landmark report card from my team here at SANE Australia, from those we worked with at the National Mental Health Commission, from our partners at the University of Melbourne, Prof. Nikki Reavley and her colleagues, Amy Morgan, who's with us today, and really critically, all the people with lived experience who shaped the design.
2:21
This work was a really big initiative and commitment that we started and it represents a major step board in how Australia understands and tackles the stigma and discrimination faced by people living with mental health issues and their families and people who support them.
2:39
SANE has been a leader on stigma for 40 years.
2:42
We've been calling it out, advocating for change and working alongside people whose lives are shaped by it every day.
2:49
For me, this work is both professional and personal.
2:53
I know first-hand how stigma can affect the way people see you, shape the opportunities that are available to you, influence how much of yourself you are able to share where and with whom, and even shape the way you come to see yourself.
3:08
Reflecting on the findings in this report that you're about to hear about, I can recall my own experience aged only 12 when my first of.
3:15
And you know, a number of psychiatrists told my mum that because of my mental health challenges presenting at the time, she should lower her expectations because it was unlikely that I would go on to have a job or get married.
3:27
And she warned me, quite fearful, that I should never tell anyone about that or let mental illness get on my official record anywhere lest it ruin my future potential.
3:37
Whoops–a –daisy.
3:39
Unfortunately, stigma, shame, fear and discrimination are still stopping people from seeking help and while many things have gotten better over the years, it still excludes them in many ways from connection, community and participation.
3:52
This issue must be something that everyone in Australia, all communities, schools, employers, the media, services, governments, healthcare services and decision makers should see, should recognise, understand, measure regularly and take serious action to address.
4:10
So in partnership with Professor Nikki Reavley and her team at the University of Melbourne, we developed an updated and new and rigorous methodology, beginning with a representative national survey.
4:22
That methodology, in the lived experience LED design that went into it, is a significant step forward in how we think about and measure stigma and discrimination.
4:31
It means that we can talk about the findings in this report with confidence that they broadly represent attitudes to mental illness and can tell us how stigma and discrimination are really experienced across Australia.
4:44
We did something else really important in the design.
4:47
We aligned the survey with comparable past national studies conducted also by the same University of Melbourne team, including a national study of stigmatising attitudes in 2011 and the 2014 National Survey of Discrimination of Positive Treatment.
5:04
So what this means, and importantly for the first time, is we can now describe not only what people are thinking and what they're experiencing today, but also how those experiences have changed over the past decade.
5:18
This is a world-first, and the results are quite sobering.
5:22
Overall, the findings reinforce what many people already know from their lived experience.
5:28
Stigma remains one of the most significant barriers to recovery and participation.
5:34
70% of respondents report discrimination in at least one part of their life, and 68% of people with mental health challenges reported that living with stigma and discrimination was worse than the symptoms of mental illness itself.
5:49
While some stigmatising attitudes have declined over time, others have not. And whilst social understanding of mental health challenges has improved thanks to the excellent work of the mental health sector in generating awareness, this improved understanding hasn't necessarily translated everywhere into greater inclusion, so there is more work to be done.
6:11
Importantly, what these data in this report is designed to show is where the impacts are still felt the most, and these are finding meaningful employment, finding a partner, making friends, finding a safe and secure home and being treated equally by our health system.
6:29
So where to from here?
6:30
The results show us clearly that awareness alone is not enough.
6:34
We must prioritise action into the systems around us that are still reinforcing the largest burden of discrimination and inequity.
6:42
This means investment into programs for employers and employees to improve workplace accessibility and inclusion.
6:49
We need better systems of support for inclusive support for families and communities, supporting whole families together.
6:58
We must review our health, housing and welfare systems and reduce the baked in structural stigma that limits access by those living with mental health challenges and particularly so for those experiencing intersectional disadvantage, discrimination and racism.
7:15
Stigma and its impacts are still a day-to-day reality for me and for many people and families that SANE supports everyday through our digital services around the country.
7:24
It is still at the school gate, in the workplace and at the pub.
7:29
We must be consistent and persistent in our approach and this means strong leadership and accountability.
7:34
So I'm delighted to be working with the National Mental Health Commission and that they have committed to ongoing support of the National Stigma and Discrimination Report Card.
7:42
This first report card will be followed up by a second in 2028.
7:47
Together we can create a future where everyone is treated with dignity, understanding and respect, and where no one is held back in the future.
7:56
I'm now very pleased to introduce our first speaker from the panel, Mr. David McGrath.
8:01
With extensive experience as a Board Director for the Black Dog Institute, a senior executive in New South Wales Health and formerly chairing the National Mental Health Standing Committee, David now leads the National Mental Health Commission's work to monitor, evaluate and improve Australia's mental health and suicide prevention system.
8:17
He is a highly experienced public policy expert and he's been an advisor to the World Health Organisation for over a decade.
8:24
Thanks Rachel and welcome everybody. I'm really grateful for everybody's participation in this conversation today about the National Mental Health Commission's 2026 Stigma and Discrimination Report Card delivered in partnership with SANE and very grateful to Rachel for her leadership on these issues. I'd too like to acknowledge the traditional owners of the lands that we're meeting on today for me that's the Gadigal people of the Eora Nation and to pay my respects to elders past present and emerging and also acknowledge all those people with the lived experience and mental health challenges and suicidality and the significant contribution they make to better policies, programs, and outcomes in this country.
9:05
The Stigma and Discrimination Report Card is a unique and important piece of work because it brings together perspectives from people with the lived experience, with national data and insights that allow us to draw a picture of those experiences that people are having with regards to stigma and discrimination.
9:22
It's clear on where progress is being made, where progress isn't being made, and on the sorts of areas where we need to tackle change.
9:29
As Rachel indicated, while awareness has improved a lot in recent years around mental health challenges, and the community is now far more aware, aware and more willing to have conversations about mental health challenges, that hasn't necessarily translated into behaviour change or attitudinal change.
9:46
And they're the things that we really need to tackle collectively across the community.
9:51
Rachel indicated a number of the domains where stigma is still a serious problem in employment spheres, in access to housing, intimate relationships, and most challengingly, in the healthcare system itself, where you'd hope that people felt the safest to come forward and talk about their experiences in order to get any support or assistance that they may be seeking.
10:13
It's not simply about data.
10:16
Now this tool does provide us with data, but it does also take people's specific experiences and translates those into a template for change, a template for action on behalf of governments and on behalf of communities.
10:31
And it's not just governments that need to take action, it's across the entire community where actions required.
10:37
We all need to contribute to achieving the change that's required.
10:39
Government can show leadership, but it’s requires and it's incumbent upon all of us to drive that change across the community.
10:49
The role of the Commission is to monitor and report on issues that the community is experiencing with regards to mental health challenges.
10:57
And as I said earlier, I'm very grateful to Rachel for her leadership on this particular issue, to assist us in giving governments across the country clear advice on where things aren't going the way that they ought to and where people aren't having the sorts of experiences that we'd like them to have.
11:14
And to provide us with a framework for suggesting change and driving change across those areas of government where it's needed.
11:24
So the message from us is important.
11:27
We need to move from awareness to action.
11:30
That action needs to happen immediately and we need to see in the future iterations of this report card.
11:37
And it's important that I highlight that we intend to have follow up data collections, again in partnership with SANE and the University of Melbourne, so we can see over time if change is occurring and if we are getting better outcomes for people.
11:51
And as such this particular report card is important in achieving that.
11:56
It's essential that we work together to improve people's experiences of stigma and discrimination because it's important that people with mental health challenges have all the same opportunities that the rest of the community has to participate fully in community life and participate fully, you know, in such a way that their lives meet their hopes and expectations for the future.
12:19
So thank you again for joining us for this conversation today.
12:22
I really appreciate you making the time to join us.
12:26
I'd like to reiterate my thanks to Rachel and the University of Melbourne for the work that's been done and I hope that this leads to lasting change in the community into the future.
12:37
Thanks, Rachel.
12:42
Thanks.
12:43
Thanks so much, David.
12:46
I'm really, really pleased to introduce our next speaker.
12:50
Associate Professor Amy Morgan is principal research fellow at the School of Population and Global Health, University of Melbourne.
12:57
She's published over 150 scientific papers on improving mental health literacy, reducing stigma and preventing mental ill health.
13:04
Today she's going to be presenting the findings from the work she did with Professor Nikki Reavley to help develop and do the detailed analysis in the Stigma and Discrimination Report card and take us through the data and what it's telling us.
13:19
Thanks so much, Amy.
13:21
Thank you so much, Rachel.
13:22
Before I start, can everyone hear me OK and see my slides?
13:26
OK?
13:26
Yep, beautiful.
13:28
So thanks for having me.
13:30
I'm I'm here to present, as Rachel said, on, on the data underpinning the report card and to give a bit of a overview on on what stigma is and why it's important to add to what's already been said.
13:46
So firstly, what do we mean by stigma?
13:49
The word actually comes from ancient Greece where criminals and slaves were branded with hot irons, making a a a mark or a stigma from the Greek word for tattoo.
14:03
And it wasn't until the late 16th or early 17th centuries that the negative use of the term appeared.
14:08
But today the World Health Organisation defines stigma, as you can see here.
14:14
It's a mark of shame, disgrace or disapproval.
14:18
Disapproval which results in rejection, discrimination and exclusion.
14:23
And although different conditions can be stigmatised, throughout history, people with mental health problems have been treated differently, excluded and even brutalised.
14:35
So we know the impact from stigma and discrimination is real and has many negative effects, as you can see here.
14:44
And it's because people with mental health problems can be treated poorly by others, or they can anticipate being treated poorly because of the stigma and so consequently can withdraw from relationships or from seeking life opportunities.
14:59
And as we've heard it, stigma and discrimination is a major concern by from people with mental health problems.
15:07
And that's why it's such a priority area to to improve and focus on.
15:15
So just briefly, how does stigma have this impact?
15:19
So there's an American sociologist called Bruce Link who has a theory called modified labelling theory.
15:26
And this shows how the public comes to treat someone differently once they have been labeled with a mental illness.
15:35
So the theory holds that from childhood we all absorb cultural stereotypes about mentally ill people.
15:42
So when someone is labeled, others don't see them as an individual anymore, they see them through that stereotype.
15:48
So they're dangerous, incompetent, weak, unpredictable and so on.
15:54
And these stereotypes lead to negative emotions like fear and then the behavioural consequence, which is discrimination.
16:00
So as an example, I'm not going to allow dangerous people like that move into my neighborhood.
16:10
There's different forms of stigma that that we know.
16:13
There's what members of the public believe about others with mental illness.
16:17
So that's public stigma.
16:19
And that can be attitudes that I've just talked about, beliefs about dangerousness and unpredictability and incompetence.
16:27
There's also a desire for social control.
16:30
And so this often expresses in a desire to force people into treatment or to lock them away.
16:40
There's desire for social distance, which which isn't related to COVID, it's around unwillingness to interact with someone socially who has a mental health problem.
16:51
So they're from the the public stigma side.
16:53
And then there's also people with mental health problems then internalise that public stigma.
16:59
So that's called self stigma and that's can have really devastating consequences because it can stop people seeking opportunities because of that, those negative beliefs.
17:11
Finally, we have stigma by association, which is the stigma towards people who care for those with their mental health problems.
17:19
So the stigma by association there.
17:26
So after that brief introduction to stigma and its impact, the the rest of my presentation were really give an overview of some of the key findings from the National Survey of Stigma and Discrimination, which informed the report card.
17:42
So the main thing to take away from this slide is that the survey was a comprehensive assessment of stigma and discrimination in the Australian population.
17:52
We had lots of questions around what members of the public thought about people with different conditions.
17:59
We had lots of questions around what people with lived experience, so people who had experienced a mental health condition recently, how they've been treated both negatively and positively, and also experiences of their carers.
18:14
And we, we did have input from a lived experience advisory committee into the survey to make sure it was capturing, you know, the questions that were really important.
18:24
And as Rachel mentioned, we designed it such that we could compare the results with those from previous surveys to look at change over time.
18:37
So a bit more information about that.
18:39
So two previous surveys, one in 2011 focused on on stigma in the general public, one in 2014 focused on how people with mental health problems have been treated by others, so their experiences of discrimination.
18:55
And then the 2024 survey combined both into one.
18:59
And so these were large surveys, more than 5000 people in each nationally representative and really rigorous.
19:07
So it means that we can be confident that the results do truly represent the Australian community.
19:17
So first up, these are some results on stigmatising attitudes.
19:24
So we had brief vignettes describing a person with a mental health condition and we had six conditions we included with vignettes.
19:36
So as you can see here, depression, bipolar disorder, an early example of schizophrenia, an example of someone who had long term or untreated schizophrenia, borderline personality disorder and attention deficit hyperactivity disorder.
19:54
And so importantly, these vignettes describe someone with symptoms and where those were having an impact on their life, but they hadn't sought treatment.
20:01
So just bear that in mind.
20:03
So the main thing from this slide to take away is that stigma varies by mental health condition.
20:10
So it's stronger towards people with long term schizophrenia.
20:14
You can see the green line here is always at the top, not as strong for people with depression.
20:22
That's the dark blue line down here.
20:24
And it also different beliefs have more or less endorsement in the population.
20:30
So there's quite high endorsement that people are unpredictable, much less so now that it's a personal weakness in terms of desire for social distance.
20:42
So this is where we ask respondents in relation to the vignette of the person, how willing would they be to interact with them so to move next door, spend an evening socialising, make friends with them, work closely on a job or marry into family.
20:57
And again, you can see it's long term schizophrenia and and also borderline personality disorder to some extent that are more severely stigmatized with depression, the least stigmatised of, of the six conditions that we included.
21:17
We also examined, so not everyone is, is holds these stigmatising views.
21:20
We, we wanted to see other particular characteristics that make you more likely to be stigmatising.
21:27
So we looked at that and found that you tend you tended to have less stigma if you spoke English only at home.
21:34
So not didn't have a second language that you spoke at home.
21:38
You were younger in age.
21:42
You you had a mental health problem yourself at some point, or you knew someone with a mental health problem in the past 12 months, or you were a female or other gender compared to the male.
21:53
And interestingly, we found that education level was inconsistent.
21:57
So it it, it reduced stigmatising attitudes, but seemed to be associated with more desire for social distance.
22:08
So now we we can look at, OK, what's changed over time.
22:11
So we could compare 2 vignettes, the depression vignette and the early schizophrenia vignette and say, have these attitudes improved or, or worsened over time up from 2011 to 2024?
22:26
So here's the endorsement of in our sample, those who agreed or strongly agreed with each stigmatising attitude.
22:36
And you can see, so the dark blue is from 2011 and the Gray is 2024.
22:41
So you can see there's been a decrease actually across most of these stigmatising attitudes and, and some big decreases.
22:49
So a big decrease in beliefs about unpredictability and dangerousness.
22:53
And they, they're the kind of ones that were more, more endorsed in the past.
23:01
So that's that's a good result.
23:04
Similarly for early schizophrenia, there's been improvements in these attitudes.
23:10
Again, unpredictability has decreased.
23:12
So you can see it's still highly endorsed.
23:14
So more than 50% of our sample agreed.
23:17
That's the person in the vignette who had early schizophrenia was unpredictable.
23:24
And the other thing to note is that some attitudes are not really endorsed and not agreed with in the populations around.
23:33
That's a personal a sign of personal weakness or not a real medical illness.
23:38
People don't tend to believe that anymore, which is good.
23:43
However, the picture is a bit different when we look at desire for social distance.
23:48
So this is for depression.
23:51
The change over time.
23:53
So the grey bars is 2024.
23:56
So you can see actually it's, there actually hasn't been a reduction.
24:01
It's, it's either stable or there's a slight increase.
24:04
And the picture is even worse for early schizophrenia.
24:08
You can see there's been a clear increase in desire for social distance across each of these kinds of interactions.
24:16
So the the unwillingness to make friends with the person with early schizophrenia has more than doubled, since 2011.
24:29
So this is a little bit counterintuitive, counterintuitive to us, and we're still trying to think through why these findings have diverged.
24:40
But certainly when we look at experiences of discrimination, they do align with the the worsening desire for social distance.
24:50
So we've seen here, this is from the 2014.
24:55
So that's the grey bar versus 2024 is the purple bar.
25:00
People with mental health problems were asked how they whether they've been treated unfairly because of their mental health problem by people in a range of different situations.
25:10
So their family, friends, health professional, workplace and so on.
25:15
And you can see here that this has increased over time, the people reporting discrimination and it's most common from family and friends.
25:29
So more than 40% of respondents said that they'd experienced discrimination by friends or family.
25:34
So there's some good news with some attitudes improving.
25:37
But we can see that people are saying they're being discriminated, more people are being discriminated, which is not obviously the direction, the pattern we wanna see.
25:49
On the other hand, there is some other good news in terms of positive treatment.
25:53
So this is when we say treatment, it's like support from people around you.
25:57
Not, not not treatment of the mental health problem by a professional.
26:01
So we asked whether people had been treated more positively because of their mental health condition.
26:06
And in a lot of situations this had gone up.
26:10
So in friends, family, health professionals and in the workplace, more people were saying they've been treated more positively.
26:19
So that might be, you know, being more supportive and understanding or in the workplace having a reasonable adjustment, for example.
26:29
We also wanted to look at where is discrimination doing the most harm?
26:35
As we all know, this is a big complex problem.
26:39
So we need to sort of prioritise where to direct attention.
26:43
And This is why we looked at what we called the burden of discrimination.
26:47
So this is just from 2024's data.
26:51
We asked respondents, OK, if they were discriminated, how frequently did they experience that and how much what, what sort of impact did that have on them?
27:01
And that could be from very positive to very negative impact.
27:06
And then we combine those two together.
27:08
So the more frequent and the more negative impact, the higher the burden.
27:13
And what you can see is that the burden, and this is in the population as a whole.
27:18
It doesn't necessarily mean for one individual, but the burden in the population is in finding a job, keeping a job, in dating or in most intimate relationships and in housing and welfare.
27:32
And even though family and friends had the highest probability of, of people who had experienced discrimination, it it it didn't, doesn't seem to hold the highest burden because it's things like finding a job that really impacts your life if discrimination affects you there.
27:53
So this is really, we think important information from the survey 'cause it can guide where to, yeah, where to direct if it's to reduce stigma and discrimination.
28:05
I think, yeah, I think that's it.
28:06
There's more, much more information.
28:08
If you're interested in our publications, which you can see here, they should be freely available to access.
28:14
We do have more coming in the works as well, in particular one on disclosure and its impact and self stigma and its impact.
28:23
So watch, watch out for those and thank you very much.
28:28
I'll stop sharing now.
28:31
Thanks so much, Amy.
28:33
It's fantastic to have you take us through the data and actually how we measure stigma and what informs the information that's in the Commission's report card.
28:44
I'm really pleased to introduce our next panellist.
28:47
We're about to hear from one of SANE’s longest serving peer ambassadors.
28:52
Very pleased to introduce to you Doctor Dov Degen.
28:55
Dov is a dual trained nephrologist and general medicine physician who currently holds clinical appointments within both the public and private system.
29:03
Dov is a passionate mental health advocate for SANE and also for Beyond Blue and has a sensitivity to psychosocial issues, enabling him to deliver holistic care to his patients.
29:14
He was recently awarded an OAM in the King's Birthday Honors for service to medicine and mental health support.
29:20
Thanks for joining us, Dov.
29:21
Thanks for having me and thanks for the kind introduction.
29:25
So I've been with SANE since 2015.
29:27
It's been an absolute pleasure to be part of the organisation.
29:31
I remember prior to joining, I had this conception of an idea of becoming an advocate, but I had no idea what that would look like or the journey that would lead me here.
29:40
And the first campaign I ever did for mental health and openly disclosing my story was through a Lived campaign, through SANE, which was beautifully filmed.
29:49
It ends up being shared by thousands of people viewed it, you know, across Australia.
29:54
I got countless messages from doctors and nurses about their lived experience, and I guess it really gave me the fire that this is a conversation and dialogue that people are willing to have.
30:06
We just needed the appropriate catalyst to come forward.
30:08
And unfortunately, in the medical profession, mental illness is heavily stigmatised, as you'll hear from my experience.
30:16
And as a result, a lot of people don't come forward and are unable to access adequate supports, which is very sad.
30:24
I've used various platforms to share my messages, social media campaigns, radio broadcast interviews and thankfully with the OAM.
30:32
Now I've been able to launch the messages at an even greater audience and I'm hoping to appeal to as many people as possible.
30:40
And the idealist in me would like to reach a national level if possible.
30:44
Unfortunately, up until now, despite my best efforts and openly disclosing my story of a doctor with a lived experience of bipolar disorder, I have been unable to have the desired impact on the medical world.
30:56
And during every step of my medical journey, whether it's as a student or a training registrar or a consultant physician, I have faced all of the stigmas that you've outlined beautifully in your report.
31:07
I think that there's a lot of value in raising awareness for mental health in the community.
31:12
There are days that we know of like RUOK Day?
31:14
We have something called Crazy Socks for Docs Day at work where we wear beautiful coloured socks.
31:20
But unfortunately, in my experience, it does nothing to advance the conversation in a meaningful way.
31:25
And what we actually need is system reform.
31:28
We need higher level, multifaceted discussions to tackle how deeply embedded this complex issue is.
31:34
Wearing crazy socks, for example, won't overcome work burnout.
31:38
It won't overcome unpaid overtime and a whole raft of things which would be a whole other talk altogether as to the problems faced by doctors.
31:47
So we really need greater planning, we need greater funding.
31:51
And mental health needs to be seen on par with physical illness.
31:54
It needs to be legitimised with physical illness because unfortunately, in my experience, people or employees who are unwell due to mental health reasons do not receive the same level of support and understanding as those with physical illnesses.
32:09
I have never seen a colleague call in sick for work due to anxiety or depression.
32:14
They'll feel much safer to say they have a migraine.
32:17
And both of these things are arguably organic illnesses.
32:20
They both affect the mind.
32:22
And yet, for whatever reason, mental health hasn't been legitimised in the same way as physical illness.
32:27
And the only way that I can reconcile it is because the brain's invisible.
32:31
We can't easily map map its progress and its journey to recovery.
32:35
And so it's less well understood and accepted.
32:39
In terms of how bipolar has affected my career, I've lived with the diagnosis for over 20 years, I've had the soul destroying lows of depression, I've had the soaring heights of mania and fortunately for me, my relapses have been few and far between and yet they've been heavily impactful when they've occurred.
32:58
When I'm well, I'm high functioning, I'm a medical specialist, I'm dual trained, I'm a researcher, I'm an educator, I'm very capable and motivated, and living with a mental illness has not meant that I can't achieve my goals nor live a successful life.
33:13
So while I acknowledge my illness and I manage it, it is not who I am, and the label of having bipolar disorder doesn't define me any more than one of my patients who has high blood pressure or diabetes.
33:26
But unfortunately, particularly my manic episodes have been heavily, heavily stigmatised by the medical community and wider society, and I have had huge ramifications which have been even worse than the illness itself.
33:39
I've lost jobs, I've had restrictions put on me by AHPRA, which is our National Regulation Board.
33:45
I've suffered immense personal and professional shame and unfortunately, depression as well.
33:50
Beyond your typical biological factors, I've also inadvertently damaged relationships with colleagues and friends, and sadly, even to this day, I've been unable to repair some of them.
34:02
I was first hospitalised in a psychiatric ward during second year medical school.
34:07
I had just four weeks left of my training for the year, and I was forced to repeat the entire year just to do those four weeks.
34:14
And despite being surrounded by somewhat 200 medical students, medical lecturers, colleagues and peers, even if they were worried about me, not one single person was able to raise the alarm or successfully get me help.
34:28
And that was one of the primary reasons I decided to become a mental health advocate, because I thought to myself, if a medical student going through a medical mental health crisis can't access appropriate help and resources, then what?
34:41
What on earth like assistance does the general public have, particularly if they're not aware of what's out there and what's available for them?
34:51
Back in 2023, I suffered an unexpected set back of mental health in the wake of COVID, having worked for two years without annual leave, suffering professional burnout, all sorts of factors beyond my control, and as as usual, no systemic help from the hospital network.
35:10
The episode cost me severely.
35:12
I lost my public position in the hospital where I'd worked for several years.
35:16
My private practice I lost.
35:18
I lost five years worth of patients.
35:21
I basically didn't have a job after having built a very successful career for myself, and not dissimilar to my experience in medical school, which was about 15 years earlier, I had peers who were worried about me.
35:33
And yet again, there wasn't an adequate system in place to help me.
35:38
Despite being a mental health advocate and well known to the hospital, and I was eventually hospitalised again. The stigma followed me everywhere.
35:46
And I'm not angry at anyone.
35:49
I don't blame them.
35:50
I think it's lack of familiarity that builds stigma.
35:53
I think it's the ignorance around it that breeds the fear, which is what leads to people's discomfort.
35:58
And that's ultimately what leads people to stay away.
36:01
And that's why one of the things I always advocate in my talks to people is to always be there for people who are suffering because they're much more likely to come through the other side with your support.
36:12
And just to give you a bit of added context, I studied mental health for 9 weeks during medical school.
36:17
That has not changed.
36:19
So it's no wonder that doctors are ill equipped at dealing with it because they're not aware of some of the lower prevalent conditions and how to manage them appropriately.
36:27
When I recovered from that episode in 2023 dealt with immense shame and professional embarrassment for the things I said and did while I was manic.
36:36
I was not supported at all.
36:38
No one contacted me to check on me.
36:40
I didn't receive cards and flowers like I would have had I suffered from cancer or a comparable physical illness.
36:47
And just to top it off, I was reported to AHPRA despite never harming a patient.
36:52
And by the time AHPRA decided to impose conditions on my medical registration, I had already made a full recovery.
36:59
Those registrations left me almost unable to work as a doctor for eight months, despite my psychiatrist putting in writing, and she'd known me for 10 years, that I was medically well.
37:09
The hospital did not recognise that and did not allow me to work.
37:13
In order to get employment, I stacked shelves in a pharmacy for $30.00 an hour.
37:17
I'm not too humble to admit to doing this sort of work, but it was a complete waste of my time and a complete waste of my skill sets.
37:25
And I actually thought to myself, after 16 years of being a doctor, should I quit?
37:29
Should I resign?
37:30
And tenacity and perseverance did not allow me to do this because I know the sort of doctor I am.
37:36
I know how empathic and compassionate I am.
37:38
I know how much I can give to the medical organisation.
37:41
And I stuck it through.
37:42
I went through bureaucratic hell.
37:44
I dealt with the most incompetent of staff you can ever imagine.
37:48
1800 numbers that got you nowhere.
37:50
Press 1 now, Press 2 now.
37:52
I couldn't talk to anyone.
37:53
I couldn't speak to anyone sensible.
37:55
And I had to jump through hurdles and loopholes that I would never put anyone through in my wildest imagination.
38:01
So I was punished for having a relapse.
38:03
I was not supported, and I was unable to get back to work.
38:08
There is a happy ending though.
38:09
I persevered.
38:11
I got back there.
38:12
I got a better career case mix than I had before.
38:16
I made major changes to my life.
38:18
I reduced exposure to toxic workplaces.
38:22
I chose to do things that I love.
38:24
I continue to do the mental health advocacy work.
38:27
And unbeknownst to me, I was awarded an OAM, which never in my wildest dreams would I ever imagined because I didn't do any of this advocacy work for accolade or recognition.
38:37
But I'm so happy I got it.
38:38
Not for the letters.
38:39
I don't really care about letters next to my name, but people are starting to listen to me.
38:43
The CEO of my hospital, the very hospital I was stigmatised at, has now put out a video about my journey, my experience.
38:51
The organisation wants me to talk to their AGM.
38:54
They want me to outline exactly what happened to me, how the system can improve.
38:59
And I do firmly believe that people are starting to listen.
39:02
But it's taken a very long time.
39:04
And as we all know, unfortunately, culture change is painstakingly slow.
39:09
But I'm a patient person and I'm willing to stick it out and I'm really grateful to connect with everyone in the audience who's listening to me.
39:16
Now.
39:16
I know I can't see your faces, but all the like minded souls and the hard work that's done by this organisation to tackle stigma because I now have a fire in my belly because of how personal this is.
39:28
But I also know the power of individuals coming together and if my story alone can start shifting stubborn, you know, dinosaur like attitudes in my hospital networks, then I can only imagine if we all start speaking up openly, disclosing in the workplace and coming together the shift that we can make in society.
39:47
Thanks for your time.
39:50
Thanks so much, Dov and thank you for sharing your experience with us.
39:55
It's always so powerful to hear you speak.
39:57
We've reached the Q&A portion, which is usually when people remember that they wanted to submit a question, so get them coming through.
40:05
I'm going to begin with the first one that I'm going to invite each of our panelists to speak to.
40:12
So first of all, having now had a chance to listen to Dov’s experience and walk through the data.
40:20
What is the one action that governments or services or employers or communities could take to have a significant impact on stigma and discrimination either at a national or at a local level?
40:31
I'm going to start with you, Dov.
40:34
If you maybe wanted to give us something that's top of mind for you, and then I'll go to David and to Amy.
40:41
I guess there's two parts to the answer.
40:44
So part A is obviously raising awareness and recognition because, as I briefly outlined, I think a big part of stigma is people's ignorance.
40:53
There's a reason why we're seeing depression being more accepted than, say, schizophrenia, because there's a lot of national campaigning and recognition for depression, but not for the lower prevalence disorders.
41:04
And I see the same thing in the medical system.
41:07
So I think the first thing that needs to change is the awareness, the recognition, the discussions of lived experience, the fact that mental health doesn't discriminate, the power of the individual story, all of those things.
41:18
And then Part B is the tackling, what do we do with that information?
41:21
How do we breach the gap of ignorance?
41:23
How do we educate people?
41:25
How do we depict mental health health in the media in a way that's actually comparable?
41:29
I don't see bipolar disorder being depicted particularly in the way that I've experienced it when I watch people on TV portraying it.
41:37
So I think the public needs greater awareness, understanding and education.
41:41
And then it will have a downflow effect into how employers treat their staff, how people treat each other because they won't be is afraid of things that they don't understand.
41:51
David, I'll turn to you.
41:52
What actions are top of mind?
41:55
Yeah, thanks, Rachel.
41:56
My answers not as sort of concrete as Dov’s, perhaps not quite as exciting, but you'd appreciate given the role of the Commission, I'm very interested in data and how government holds itself accountable.
42:10
And so I think one of the benefits of this report is we create a baseline to be able to say to government, this is where we're starting from.
42:17
I'd like a longitudinal data set where the government makes a commitment to driving down the experiences that this report demonstrates and that we monitor that over time such that we can demonstrate that we are driving down those experiences for people in the community with mental health challenges.
42:35
So I think the number one thing we could do is say, publish the data, make a commitment to drive it down.
42:41
Look, absolutely agree with that.
42:43
It is so much data that can tell us a powerful story, but also data that we're missing, particularly as Dovsaid on more complex conditions and high impact psychosis and complex conditions are some of the ones we still don't have current data for.
42:58
Amy, top of mind for you, what's one action in one setting or nationally that could make a difference?
43:05
I suppose as a, as a researcher, I always come back to you delivering, you know, evidence based things, things that we know are going to work to reduce stigma.
43:14
And there was a piece of research I did a few years ago mapping what stigma initiatives existed across Australia and what and what had evidence of effectiveness.
43:25
And it was clear from that that there were some things that were really effective, but they weren't widely implemented.
43:31
They were just in little pockets around the place.
43:33
So things like placements with nursing students in in a camp with recovered people, people in recovery, pharmacy student training, things like this.
43:45
So I think greater implementation of what we know works scaling up, that's a sort of low hanging fruit thing we could do to start.
43:56
Excellent.
43:57
I'm going to turn to another question that's come through on the Q&A.
44:01
Someone's asked a quite a detailed question essentially about psychiatric definitions and whether some diagnostic labels are actually causing or increasing stigma.
44:12
And then conversely, are there ways of measuring stigma and impacts that don't rely on these?
44:17
So Amy, I might direct that one to you.
44:20
Yeah, this is a tricky one.
44:23
We, it's very complex.
44:26
I would say when we measured the stigmatising attitudes, we don't attach a label to the vignettes for that reason.
44:34
We we just describe a person's symptoms and and how they're behaving.
44:42
And so not everyone, I guess, will maybe identify that it's schizophrenia, but it's the behaviors themselves that people are finding they want to stay away from.
44:54
So but yeah, it's, I think removing labels is not going to solve everything.
45:00
It might, might be helpful for some people.
45:02
But yeah, it's a, it's a complex.
45:06
It's a complex, it's a complex thing, basically.
45:10
Yeah.
45:11
And I was supposed to jump in, there's a question that's come through as well about why suicide related stigma wasn't included in the report.
45:19
So I might just briefly speak to that and then I might hand to you as well, David.
45:23
But as I mentioned in my opening remarks, the work is ongoing.
45:28
We will be producing some spotlight reports and then a second National Stigma and Discrimination report card in 2028.
45:34
And so one of the things we can do is evolve the design and the methodology to include further things to be measured.
45:41
So suicide's one that's suicide related.
45:44
Stigma and discrimination is one that has already been suggested, and we will be welcoming ideas and contributions.
45:50
Stigma@sane.org is where people can send any comments or feedback through, but that's certainly one that we want to consider for future reports.
45:59
But perhaps, David, what are your thoughts on what other things could be included or specifically what do we know about suicide related stigma?
46:10
I just, I just might just go back to the previous question and just sort of around the labelling and just to say, I think, you know, Amy's correct.
46:17
It's it's very complicated.
46:19
I think that in the first instance, you'd want to take the advice of people with a lived experience about whether that that particular labelling has a stigmatising effect on their lives or not.
46:29
And I think that's probably your first port of call.
46:31
So to answer both questions at once, you could say that's clearly a, a data area you could look at.
46:36
And in terms of the, the labelling of the health system as a whole, and given there's a 25% of people who were involved in this data set indicated that they had a stigmatising experience inside the healthcare system, it's probably a question that warrants additional interrogation.
46:52
You got to, you got to remember that the those labels for the purpose of a particular profession's decision making around their next set of process responses.
47:03
And I don't think they they ought to have any additional meaning in the community other than that.
47:09
But unfortunately, popular cultures appropriated them in an unfortunate way, in a way that's not helpful.
47:15
And I think perhaps we could look at popular culture as a second area of measurement that might have benefits in the in the next set of data collections and indicators that we look at.
47:29
So I don't have a clear answer to that first question, but I do think that there are opportunities for us to start pursuing questions as a result of the query that that individuals made.
47:43
I'm, I'm loath to talk too much about suicide prevention given the role of the National Suicide Prevention Office as in a separate entity inside the Commission.
47:52
So I try to leave suicide prevention for Alex Haines to talk about as a matter of respect, but just to say that there are many other things that we could look at as part of this set of data.
48:05
I hope it's an ongoing data collection and I hope this is the first of many conversations of this type.
48:12
Thanks. Amy, I might direct the next question to you.
48:17
There's a question that's come through about young people.
48:20
Were there many insights around participants aged in a lower bracket 18 to 35?
48:27
And can you elaborate a little bit more on the breakdown from an age perspective?
48:33
OK.
48:34
So in terms of age, it's it's weighted, the data are weighted to the Australian population.
48:39
So it's, that means that the proportion of young people in the population is the same as in the survey.
48:46
So I don't have exact numbers, but basically it's, you know, it's representative in that way in terms of, I think I presented that younger people tend to hold less stigma towards people with mental health conditions.
49:04
So both less endorsement of those negative attitudes and less, less desire for social distance in terms of discrim, their experiences of discrimination.
49:16
To be honest, I actually can't recall if that was associated with age or not.
49:21
I'd have to go back to the paper, which was my colleague, Professor Nikki Reavley led that paper.
49:29
So, so I mean, age is definitely stigma definitely varies by age and you could perhaps, you know, perhaps it's all the efforts that have been done recently around sort of awareness and you know, mental health literacy type things that have perhaps resulted in that lowest stigma.
49:54
But we don't, we can't say for sure with this data.
49:58
Dov, the next question I'm going to take, I'm going to direct to you.
50:02
Someone's asked about structures within the workplace like WHS and new codes around psychosocial safety or you know, the role of HR departments as well.
50:14
Can you talk to us a little bit about, you know, in a, in a workplace where these things look better, how you might hope that someone who has a better experience than you might be treated like?
50:26
What would good look like for a workplace that is comfortable and able to spot you when you need support and engage in that kind of process in a way that feels validating and supportive and not discriminatory?
50:42
It's a really good question.
50:43
So a few years ago I was elected to be part of the Victorian Department Premier of Cabinet to design a framework to create mentally healthy, safe environment.
50:53
And it's a really great document, but it's not rocket science.
50:56
And what struck me when I look at that report is that we do none of those things in the hospital system.
51:02
So I know your question was geared in a more positive slant, but I guess that showed me the deficit in terms of what I see in my day-to-day employment versus what an idealistic framework would look like.
51:13
What I'd like to see is that open disclosure is comfortable.
51:17
I don't know any doctors that would say I have schizophrenia when they apply for a medical position, for example, let alone tell their colleagues.
51:24
So I'd like to see an environment where people can say that and it's not met with any discrimination, punitive measure, job restriction, anything like that.
51:33
And, you know, hypothetically, if someone does need a bit of extra assistance, like I've had medical students quietly confide in me after my talk saying, you know, I've got schizophrenia.
51:42
I'm worried about doing night shifts because the effects of sleep deprivation on my mental health.
51:47
So they should be able to tell their employer, hey, I've got schizophrenia.
51:50
I might struggle with the on calls and then get some sort of modification to their work timesheet so that they don't have to do those on calls.
51:58
But in practice, they're not doing that.
52:00
They're just doing the dangerous shifts because they're too afraid to come forward because of the very real discrimination stigma that has not only happened to me but happened to others.
52:09
So I think you need to see an environment where people feel open and comfortable.
52:13
There needs to be a flowing communication with your employer so that there's no issue.
52:18
There's full understanding of what you're going through.
52:21
And if there does need to be some conditional changes, then you do the same as if you've got a diabetic person who might have a low blood sugar on a shift, you make appropriate accountabilities and conditions for that individual so that they're able to work safely.
52:36
And if I'm going to be really, you know, idealistic, then have check-ins with that person.
52:41
No one's checked in with me in the three years since I went back to work.
52:45
Not one person.
52:46
I mean, I was the face of all the problems in the hospital.
52:49
Now I'm the poster boy for the OAM.
52:51
But maybe come and actually talk to me about what my experience has been like.
52:56
Invite me to come and talk to HR, OH&S, Human Resources so that I can help improve the policies and the infrastructure.
53:04
The problem is you need senior leadership with an appetite for change and who have the kind of tolerance and enlightened perspective to understand what mental health is and what it looks like.
53:17
And it's high prevalence not only amongst doctors but amongst wider society.
53:21
And you know, leadership stems from the top down.
53:24
So unless you have people in positions of power like our blessed politicians to actually care about mental health, you're not going to see palpable change on the floor because all of the people that I work with know what the issue is.
53:37
They all or roll their eyes around RUOK day.
53:39
But what we actually need to see is these sorts of discussions like we're having today at a very high level with with parties who are actually interested in treating their colleagues not just as co-workers, but as people.
53:52
And then when you say that, I think it'll be a very natural shift in terms of evolving what things could look like in a place of employment to make things safe for everyone.
54:02
Thanks, Dov.
54:03
And that's it.
54:03
You really brilliantly brought together that important combination of leadership, appetite, cultural willingness, and the fundamentals.
54:14
Because similarly, someone asked a question about, you know, what, what about intersecting types of disadvantage and discrimination, people who are experiencing racism or people who are facing other conditions.
54:28
Someone's mentioned PMDD should be included possibly as a stigma in future reports.
54:34
You know, a lot of what actually makes the difference is the is doing the work that is slow and hard to implement and takes time of proper process of inclusion, accessibility and reasonable adjustment in the workplace.
54:47
To, you know, allow people to have a safe workplace and get the adjustments they need to turn up to work and make, make that room for individual circumstance.
54:57
And doing that in an environment where leaders are also willing to open and have conversations and, and make room for people and, and educate people about these topics.
55:08
Where I think as you said earlier, there's still a lot that people either don't know or have stereotyped outdated beliefs around the more complex mental health issues.
55:19
So I might, just to wrap us up, ask Amy or David, do you have any sort of final comments?
55:26
One thing you'd like to leave our audience with, what are you hoping people will take away from this report and the discussion we've had today?
55:34
I'll start with you, Amy, and then David.
55:37
I think I just want to say I'm encouraged by the renewed focus on reducing stigma and discrimination.
55:43
It, you know, it was one of the priority actions in the productivity report and then it and then we have the draft strategy and then it sort of disappeared.
55:52
And so now I'm really grateful that it does seem to be getting more attention so we can actually make some change.
55:58
Thanks, Amy.
55:59
David. Obviously support Amy's comments and it's really important that we renew the focus on this.
56:06
There has been a hiatus as a result of the strategies positioning.
56:11
And so I'm really, really grateful for the interest and the attention of everybody its part of this process.
56:17
But it's really important that we continue it.
56:20
I, I just reiterate that one of the remarks I made at the start in my opening comments, which is it's tremendously important that people with mental health challenges have the same opportunities to participate in society in the same way that everybody else does and can live the sorts of lives that they wish to live, chasing the same sort of dreams and opportunities that matter to them.
56:44
It's just not acceptable that we can have a situation where those opportunities are closed off to people for whatever reason.
56:50
And I, I think from this point forward, you know, we've established a baseline to measure whether that's occurring or not.
56:58
We're going to follow up on it and we're going to keep the conversation going to apply that pressure to get those changes to prevent those opportunities from being withheld.
57:06
Thanks so much.
57:08
These conversations can be difficult.
57:10
They can bring up a lot of big feelings for all of us.
57:14
If you need crisis support, Lifeline is there for you 24/7.
57:18
On 13 11 14.
57:20
We can call 13 YARN on 139276.
57:24
The same forums also offer a warm and inclusive space for peer-to-peer discussions 24/7.
57:29
We've also set up a special thread if you want to chat to other peers about what you heard and what you were interested in from this webinar or what you're reading in the report.
57:39
And you can access that forum at saneforums.org.
57:42
This webinar has been recorded and you can you will be able to see it online just as soon as we get the video link up.
57:49
But you will also be able to download the full report and read it right away and watch a video of Dov on the National Mental Health Commission website.
57:58
We encourage you to go and check it out, read it, share it with people, share it with your workplace, share it with your community, with your PNC, and share it on social media.
58:08
Get more people talking about these issues and keep the conversation going.
58:12
Thank you so much for being with us today.
58:14
Thank you so much to my panelists, Dov, David, Amy, wonderful to have you here.
58:19
Thank you to the SANE team quietly behind the scenes, pressing all the buttons.
58:23
And for everyone for joining in and helping us make this a national conversation.
58:28
I'm Rachel Green. Thanks for joining me.
