By Melissa Davey
The past fortnight in health news has revealed the backlash that can occur when health reporting ignores evidence, and that workplaces and managers still don’t always get it when it comes to mental health.
Still stigmatising – mental health
What would your boss say if you called in sick, citing mental illness as the reason? Workers are still so fearful of what would happen if their employer found out they have depression that an alarming number of them won’t disclose mental illness as being a reason for taking time off work, the Herald Sun reports. A large, national study released by SANE Australia found half of Australians who had taken time off work because of depression kept this reason hidden from their employer.
And almost double the number of Australians had not told their employer their depression was the reason for their time off compared with workers surveyed in Europe, the SANE report found. Managers need more support too – they are far behind their European counterparts when it comes to knowledge of the days lost due to depression. Over half of managers have no support from a human resources department.
There were other sad findings from the Impact of Depression at Work: Australia Audit. About half of more than 1000 workers surveyed were worried revealing their depression could jeopardise their jobs, and a similar number believed they shouldn’t have to disclose their mental illness because it was a private issue.
Professor Lyn Littlefield from the Australian Psychological Society says there has been a continuous decline in workplace wellbeing since the surveys began two years ago, reports the ABC. “If stress isn’t identified and adequately managed in the workplace, it can greatly impact overall workplace productivity and the long-term health of employees,” she says. The lowest levels of wellbeing were reported by those aged between 18 and 25, the ABC reported, while those aged between 18 and 35 were more concerned about being able to pay for essential needs because of uncertainty about the ongoing availability of work.
Myriam Robins reports for smartcompany that the leading cause of stress was family issues for women and financial concerns for men. And Jessica Martin writes for The Hoopla that the SANE survey and report brought back painful memories of her own experiences coping with depression. Jaelea Skehan, who is director of the Hunter Institute for Mental Health, writes while there are many issues we, as a community, find difficult to discuss, suicide would be at the top of the list for many. Food for thought as National Psychology Week draws to a close.
Lifeline 13 11 14 |Suicide Call Back Service 1300 659 467 | Kids Helpline 1800 55 1800 | MensLine Australia 1300 78 99 78
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Health reporting controversy
If you haven’t been following the controversy that arose from the airing of a two-part documentary, The Heart of the Matter, on ABC’s science show Catalyst, then this analysis of the program by Media Watch provides a nice wrap-up.
“… reporter Maryanne Demasi suggested that high cholesterol does NOT cause heart disease and most people are wasting their time taking cholesterol-reducing drugs called statins,” Media Watch explains.
Experts have objected to this stance on statins showing a complete disregard of the evidence – evidence that was not presented as part of the Catalyst program. A survey of GPs following the documentary indicates “huge numbers of people on potentially life-saving cholesterol medication may have stopped taking it without consulting their doctor” after watching the program, Fairfax reports.
And host of the Health Report on ABC Radio National, Dr Norman Swan, says the show went too far, because for many people, disregarding medical advice on lowering cholesterol could kill them. Listen to his balanced response to the Catalyst program here.
Still on health reporting, Croakey asks what medicine and journalism have in common. The post was inspired by the AN Smith lecture in Melbourne given by Guardian Australia editor-in-chief Katharine Viner. Writing for Croakey, GP Dr Tim Senior says Viner’s description of journalism as “truth teller, sense-maker, explainer” was uncannily similar to a description he used in an article for the British Journal of General Practice last year, called “I’m just a sense-making analyst.” He explores other similarities between the professions of medicine and journalism – and lessons in doing so for both – in his piece.
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Health inequality and health systems issues
The National Health Performance Authority’s Hospital Performance report into the length of stays in public hospitals, and this follow-up report , have revealed unnecessarily long stays in hospital. And avoidable admissions are an obvious area of waste in the health system, writes Alison Verhoeven Chief Executive of the Australian Healthcare and Hospitals Association, for Croakey.
“Before launching into another round of major, yet inevitably watered-down reform, governments and service providers would do well to consider the existing models of care that have steadily been gaining support and credibility over recent years,” she writes.
Her piece explores what it would take to overcome barriers to implementing Hospital in the Home programs, which provide acute and post-acute care in the patient’s home and are an efficient, cost effective and safe substitute for being in hospital. While Medicare Locals have played an important role in facilitating Hospital in the Home programs, Federal Health Minister Peter Dutton appears to be backing away from his commitment not to disband them, she writes.
The Authority’s report has seen Melbourne top -the-list in a concerning area – people there are being admitted to hospital at the highest rates in the nation for conditions that do not need hospital treatment, The Age reports.
In other health system headaches, Western Sydney has fewer family doctors, fewer hospital beds with fewer staff to care for more patients and higher than average emergency waiting times than anywhere else across Sydney, reports the Daily Telegraph. “Demand for some services is so overwhelming that families are forced to spend years on waiting lists just to get an appointment,” the report says.
Meanwhile, the ABC reports that the NSW Government has been accused of using DisabiltyCare Australia as a smokescreen to avoid its disability funding obligations and to close the state’s few remaining large residential centres – or “institutions”. The report says: “Disability advocates fear the State Government will use the clause as a way to avoid funding any services in the future. In particular they fear there will be no provider of last resort if the non-government sector is unable to cope with complex cases.”
So what does successful leadership in health look like? Jennifer Doggett asks this as she reports on an interview with Dr Peter Fuda, a management consultant who will be a keynote speaker at the forthcoming Health Workforce Australia conference, to be held in Adelaide from November 18-20. He will bring insights from his research and experience to discuss how health sector managers can become great leaders, she writes for Croakey. Dr Fuda has observed a need for health services to shift from a “burning platform” or a crisis and fear-driven environment to imperative for change to a “burning ambition” environment that encourages reflection, collaboration and innovation, she writes.
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Public health guilt-tripping
Time and time again, it has been shown that shaming and guilt-tripping someone into changing their health behaviour does not work. And so here is yet another piece questioning whether taking a hard-line attitude toward the unhealthy does any good.
The American Public Health Association has recognised it’s not people, but policy agencies, that often need a strong-handed approach when it comes to improving health. As part of a rebrand, the Association is refocussing its health focus into controversial areas, like urging a federal government repeal of the ban on safe syringe services. The Association is also calling on state and local governments to consider the health effects of noise, and to expand pedestrian-friendly transportation networks with land use policies that “prioritise access to natural areas and green spaces for residents of all ages, abilities and income levels”.
As for the Australian Public Health Association, Fairfax reports that its chief-executive, Michael Moore, has joined experts in calling for a ban on harmful trans fats. It follows an announcement from US authorities that the artificial fats, which are found in some fried and processed foods, would be phased out, the report says.
One healthy behaviour Australians need to be getting more of is sleep. In a post written for JournalWatch and reproduced by Croakey, Dr Melissa Stoneham writes that getting a regular eight hours of sleep a night can improve your memory, increase your ability to concentrate, strengthen your immune system and decrease your risk of being killed in accidents. Despite this, Australians have a massive sleep debt that costs the economy $5 billion annually, the Croakey piece says.
Croakey also addresses the issue of health literacy, asking the question; When six-out-of-ten Australians struggle to make sense of health information, how should researchers, policy-makers and services respond?
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Indigenous health success stories
A report from the Menzies School for Health Research addresses the complex challenges of re-orienting services and systems to provide high-quality chronic illness care to Indigenous Australians. The School evaluated the Indigenous Chronic Disease Package (ICDP) and, Croakey reports, highlighted the tendency of such programs to be of most benefit to higher performing health services. Professor Ross Bailie and Jodie Griffin from the School write that the ICDP delivered some notable achievements over the first few years of implementation, including improved access to primary healthcare services and to affordable medication, and improved orientation of the General Practice sector to the needs of Aboriginal and Torres Strait Islander people.
Also important to improving the health of Aboriginal and Torres Strait Islander people is ensuring they are strongly represented in the health and medical workforce. Six Aboriginal women –
all of them the first in their families to gain a university qualification – have graduated with public health degrees from the University of NSW, Fairfax reports. It is the largest group of Aboriginal people to graduate from a university medical faculty at one time. “Twenty years ago it was a very rare thing to have an Aboriginal person studying medicine or public health,” Lisa Jackson Pulver, professor of public health at UNSW, told Fairfax. ”These women have worked incredibly hard.”
Finally, Aboriginal actor Kylie Farmer and Noongar hockey player Nathan McGuire have leant their profiles to a new campaign aimed at encouraging Indigenous Australians to quit smoking. “The pair, using language that’s familiar to Aboriginal Australians, encourage people to think about the benefits of quitting smoking, in particular focusing on the benefits to children,” the ABC reports.
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Brilliant Aussie research
Breast cancer is the most common cancer in women, and Queensland scientists have identified a molecule that shows whether a woman’s breast cancer will spread and how quickly, the ABC reports. It’s a finding the researchers hope will lead to more targeted treatment of breast cancer as well as better treatments for other aggressive tumours such as liver, stomach, skin and brain cancer. Also on cancer, figures from the Australian Institute of Health and Welfare reveal men are increasingly likely to survive prostate cancer, according to another report from the ABC .
Tour de France champion and first Australian to win the gruelling cycling competition Cadel Evans is taking part in world-leading cardiopulmonary research – by pedalling inside an MRI scanner. NewsMedical reports that Melbourne’s Prince Charles Hospital is doing cutting-edge cardiopulmonary research by combining MRI imaging with an MRI bicycle ergometer. The report describes how: “while pedalling inside an MRI machine, Cadel will show the research team how the heart and lungs of an elite athlete operate under exercise conditions, thus providing a benchmark for researchers”.
Speaking of great research, The Conversation ran this piece about the crucial need for a science minister to foster fundamental Australian research. And a Croakey piece questions whether the Government’s medical research funding policies will position Australia for the future.
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Doctors who blog
Have you ever been in the situation where a client, patient or customer tries to “friend” you on Facebook? Dr Nathalie Majorek has, and she writes a post about the awkwardness of having to refuse patient requests here. But she wonders whether doing so will be so necessary in future, as patients increasingly seek ways to connect with health professionals in a timely yet efficient manner.
Other Croakey reading you may have missed this fortnight:
Previewing the Closing the Credibility Gap symposium with Professor Kerry Arabena
Research think tank challenges understanding of healthcare change
A timely call for eHealth investments to focus on primary care and community health settings
A call for health checks to help those in need, rather than the “worried well”
As Mexico raises the bar in public health policy, Australia contemplates an ever-expanding waistline
If you tweet an article you think might interest Croakey health wrap readers, cc me @MelissaLDavey or my colleague Kellie Bisset @medicalmedia
Melissa Davey is the Sax Institute’s Communications Manager. She was previously a health and medical reporter for the Sydney Morning Herald and the Sun Herald. She is completing her Masters of Public Health at the University of Sydney and has a strong interest in public health messaging, body image and mental health. The Sax Institute is a not-for-profit organisation that drives the use of research evidence in health policy and planning. Twitter:@MelissaLDavey
