Real Cost to Cover Informal Care of Family with Mental Illness

The cost of a “hidden mental health workforce” is more than the cost of all mental health services in Australia, according to new research.

A new study has for the first time placed a dollar value on how much it would cost the government to replace those people who unofficially care for family members with mental illness.

The report The Economic Value of Informal Mental Health Caring in Australia, published by Mind Australia and the University of Queensland on Thursday, found that in 2015, informal mental health carers provided 208 million hours of care nationally at a cost of $13.2 billion – more than the cost of the entire Australian health services budget.

According to the researchers, Adjunct Professor Sandra Diminic and Professor Harvey Whiteford from the University of Queensland and Professor Peter Brooks from the University of Melbourne, the informal hours of care are equivalent to the direct support-work of nearly 180,000 full-time mental health workers per year.

“Were this care not provided informally, our report found national and state governments would need to fork out an estimated $13.2 billion to provide the same level of support in the mental health service sector,” the researchers said.

“For comparison, spending on mental health services was $8.5 billion in 2014/15.”

Lead researcher, Diminic told Pro Bono News that the finding was “certainly surprising” given that the cost of a “hidden mental health workforce” was more than the cost of all mental health services in Australia.

“We have heard from many carers working in mental health about their own experiences and they say they are doing a lot of care but this is the first time that we have actually been able to quantify what that actually looks like,” Diminic said.

“One of the interesting things we were able to do with the study was compare mental health carers with carers for people with other disability types and people who care for other cognitive or behavioural conditions like dementia and traumatic brain injuries and people with other physical and sensory disabilities.

“When we looked at the profile of the types of care they do and the way they spend those hours of caring, mental health carers were more likely to do emotional support work.

“This is compared to only 20 per cent of physical health carers. Yet fewer mental health carers assist their care recipient with practical tasks and activities of daily living.”

The report said that in 2015 there were about 240,000 informal mental health carers in Australia. The majority of them were female and most were of working age.

“But a concerning 15 per cent were young people under 25, some as young as eight years old. Even more concerning is the significant mental health impact on these carers themselves, particularly those in the developmental stages,” the researchers said.

“People with more severe and ongoing forms of mental illness, such as psychosis, often need assistance to live and function in the community. Some may need support to manage practical tasks such as shopping, cooking and managing their medication schedule.
“Around 68 per cent of mental health carers report that they provide emotional support and encouragement to manage crises. On average, these tasks account for two-thirds of the time they spend providing care.”

The researchers said mental health carers also faced challenges in accessing services to support their caring role.

“The report tells us roughly $1.2 billion was spent on these services in 2015, mostly on income support payments. But only 24 per cent of primary mental health carers receive carer payments; only 34 per cent receive any assistance in their caring role; and a concerning 35 per cent do not know what services are available to support them,” they said.

Diminic said: “The report found mental health carers usually provide support to a partner or child, who most frequently have common mental illnesses like depression or anxiety.

“They often have at least one other health condition, particularly drug and alcohol problems or physical health conditions.

“The message coming from the carers is that they are doing a lot and they do need to be supported to ensure that they continue to do that and their own mental and physical health doesn’t suffer as well.”

The researchers said the findings had important implications for the current review of assessment processes for receiving the carer payment and carer allowance which include:

• Eligibility for the carer payment is partially determined by completion of the Adult Disability Assessment Tool. This is designed for all types of disability and may not adequately capture the different types of care provided by mental health carers.

• The National Disability Insurance Scheme (NDIS) is ramping up to provide targeted support and better coordination and access to services for people with disabilities, including those with mental illness. The NDIS may reduce the burden on carers by improving mental health care coordination, but it is important services to support the vital role of mental health carers are not forgotten in the reorganisation of the system.

• While the health workforce in Australia is now the largest employment sector, it gives very little recognition to carers. Yet without them the mental health system would be even more stretched than it is.

• The gap between supply and demand for all carers, including mental health carers, will likely widen significantly over the next few decades. Carers are to a large extent the “hidden workforce” in the Australian health system and this report sends a clear message.

“We need to recognise, appropriately train and support these mental health carers. We also need to ensure health professionals include them as vital members of the health care team,” the researchers said.