System fails mentally ill

Nearly half of people with serious psychotic illness have used street drugs or non-prescribed medications and more than one-third have substance-abuse problems, according to a new national survey.

The national survey of health and wellbeing, released yesterday, found that 25 per cent of the 980 people surveyed had a disorder due to cannabis use and 13.2 per cent abused other drugs. Forty-eight per cent had used illicit drugs at least once. The report, People with Psychotic Illnesses, found that many people with chronic psychotic illness had a poor quality of life. Sixty-seven per cent had considered killing themselves and 48 per cent were experiencing psychotic symptoms such as delusions.

Seventy-two per cent were unemployed and 11 per cent were homeless or living in marginal accommodation such as crisis shelters. Half had problems trying to perform daily household activities, and 30 per cent had difficulties with self care. Sixty-three per cent were impaired in their daily lives due to the side-effects of medication.

The report said professionals over-used anti-psychotic drugs to try to control symptoms in ways that did not improve patients’ lives, and that many people’s disability and distress could be decreased by access to rehabilitation programs and other social supports.

“Many of the services available to them tend to be provided on a crisis-response basis,” the report said.

Mental health workers said there were a variety of reasons for people with mental illness using illicit drugs: as consolation for other problems in their lives such as loneliness, unemployment or poverty; to try to control their symptoms; to give themselves a sense of belonging to a community (the drug community); or to ease the sense of emptiness or emotional flatness that can be associated with mental illness or with some of the medications used to treat it.

“We have got to offer people other ways to deal with those feelings,” says Ms Barbara Hocking, the executive director of SANE Australia.

“This report is very damning of the system of care. Even when people are known to the services that are available, far too many still have awful lives.”‘

Ms Hocking said many of the people surveyed were aged under 35 and a number were caring for children under 13; two-thirds of those on medication were on older, more toxic drugs that had better alternatives.

First published in The Age