Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697645574920.pdf (Australia)
info@smilingmind.com.au smilingmind.com.au Date: 23 March 2021 SELECT COMMITTEE INTO MENTAL HEALTH & SUICIDE PREVENTION SMILING MIND SUBMISSION TO INQUIRY Dear Committee Members, Thank you for the opportunity to respond to this inquiry, and in particular for the inclusion of preventative mental health approaches in your terms of reference.
As an organisation which is recognised for its innovative and evidence-based approach to supporting the development of the critical skills young Australians require to thrive in life, Smiling Mind appreciates the opportunity to advocate on behalf of 3.3 million Australians who use our products and benefit from developing good mental health habits.
Recently the Prime Minister's National Suicide Prevention Adviser, Christine Morgan, observed, “I see [the pandemic] as being a classic tutorial in the benefits of prevention and early intervention, we are focusing in on that classic phrase of ‘getting ahead of the curve’.

Let’s apply that to mental health as well.” Smiling Mind could not agree more with this statement: to solve the wicked problems blighting our mental health sector, we must build from a solid foundation of prevention.
Yet while Christine Morgan’s sentiment is welcome, getting ahead of the mental health curve is not a new concept.

Analysis undertaken by EY and ReachOut in 2014 warned that a business as usual approach would require an additional 8800 professionals and an “unsustainable” cost burden to meet the sector’s objectives.
This modelling recommended that Australia must urgently establish a 21st century mental healthcare system underpinned by mental health promotion and prevention to respond to demand and keep people healthy before they reach crisis point.

Recent reports into the state of Australia’s mental health sector have produced similar conclusions.
The Productivity Commission Inquiry Report into Mental Health found there is “under-investment in prevention and early intervention — the result is that too many people live with mental ill-health for too long”, while the Royal Commission into Victoria’s Mental Health System recommended investment in social and emotional wellbeing in schools and better utilisation of digital technology and other innovations that provide care and support.
Yet these clearly stated findings have not translated into funding commitments or system reform.

According to Beyondblue CEO Georgie Harman, only 1% of the health budget goes to prevention.
This is well below the OECD average of 2-4% of all health spending and runs against the advice of public health experts including the World Health Organisation, which has long expressed the benefits of an integrated approach to mental health which includes prevention and promotion strategies to reduce stigma and improve cost-effectiveness.
The twin catastrophes of the Black Saturday bushfires and COVID-19 pandemic have emphasised the need for proper consideration of the value of interventions designed to prevent mental ill-health.

Before either public health disaster took place, rates of youth psychological distress and youth suicide were at ten year highs.

Now things are even worse, with Smiling Mind’s own research indicating young Australians, women and people living in rural areas are doing it particularly tough.
Of particular concern is that 41% of young people do not have sufficient funds to care for their own mental health.

Much has been made of the spike in calls to crisis services since the pandemic began, but there is cause for optimism in an alternative form of individual action.
When the pandemic began, demand for the Smiling Mind app went through the Mental Health and Suicide PreventionSubmission 112 info@smilingmind.com.au smilingmind.com.au roof: there were 1.25 million new downloads of our freely accessible app, 1 million wellbeing check-ins and 8.5 million meditations completed in 2020.
With more than 90% of Smiling Mind users achieving at least one health benefit -- including improvements in sleep, anxiety and depression -- and more Australians than ever willing to use self-directed tools to manage their own mental health, the opportunity exists to build resilience in millions more Australians (especially young Australians) and prevent the next spike in calls to mental health crisis services.
Lack of access to support is another consistent finding of recent reports into Australia’s mental health sector.

While it is concerning that people who need help are unable to find it, Smiling Mind is encouraged by recent recommendations by the Royal Commission into Victoria’s Mental Health System to incorporate technology and innovation in the sector’s reform.
Having produced and distributed a freely available mental health mobile app to 6 million people, and seen first- hand the overwhelmingly positive impact of digitally-led mental health support in schools, homes and workplaces, we believe that investment in support delivered via smartphones should be a key focus of government policy to provide affordable and universal access to mental health support.
Finally, we would like to share with the committee our system-wide strategy that improves the health of millions of young Australians by engaging the influential people in their lives.

Smiling Mind is Australia’s leading digital preventative mental health organisation but, these days, we are much more than the producer of a mobile application used by more than 4 million people under the age of 25 and by as many as 500,000 people every month.
Our evidence-based and award- winning schools program is utilised by almost half of all Australian teachers.

We have partnered with major technology platforms such as Google and health providers such as Medibank to enable families to practice mindfulness at home.

We have also produced one of Australia’s biggest workplace mental health programs, with 55,000 employees in companies like CSL, ATO and BP reaping the benefits.
Our vision is to help every young mind thrive and, based on the available evidence, the only way to achieve this is through mental health promotion and prevention.
Our programs are focussed in these areas, with a strong emphasis on skill development and healthy habit formation, and have been demonstrated through peer-review publication to reduce depressive symptoms among university students, to improve sleep, emotional awareness and emotional regulation skills among teachers, and to improve wellbeing and performance in the workplace.
We believe there are enormous benefits to governments and the mental health of every Australian via proper investment in mental health promotion and prevention, as the World Health Organisation recommends, and we believe the findings of recent reports into mental health lay the foundations for this investment to be made.

We are living in an extraordinary moment for our collective state of mind.
Just as multiple groundbreaking reports present the roadmap for sector reform, more Australians than ever before now understand the value in maintaining good mental health.

We commend the Australian Parliament on establishing this important committee, and would welcome the opportunity to further engage with this inquiry by presenting at the public hearings to come.

Let’s get to work on helping every mind thrive!


Kind regards, Dr Addie Wootten CEO, Smiling Mind Mental Health and Suicide PreventionSubmission 112 info@smilingmind.com.au smilingmind.com.au PS: Despite holding enormous promise for the future of Australia’s mental health system, we understand that the terms “mental health promotion” and “mental health prevention” are not commonly understood outside the mental health sector.
As an organisation committed to advancing the understanding and uptake of each term, we think it’s important to provide a short explanation as part of our submission.

What is mental health prevention and promotion?

In Australia, when you say “mental health” most people hear “mental illness”.

This is inaccurate, and has significant flow on effects when it comes to designing and supporting the mental health sector.
Right now, Australia’s mental health sector could be called the “mental illness sector” and, in practice, the medical model on offer is a “mental illness service” – not a mental health service – which in turn fails to reach a large section of the community that stands to benefit from programs, services and resources dedicated to improving their mental health.
Similarly, improving your mental health is often labelled “wellbeing”, but this label downplays the importance of the preventative and health promoting stages of service delivery.

The flow-on effects of this inaccurate label cannot be underestimated and, with acute services unable to cope with demand, it is imperative that investment is made earlier up the stream to prevent the need for these acute services.
Globally, the World Health Organisation provides us with precise and appropriate definitions for each term: “mental health prevention is concerned with avoiding disease, while mental health promotion is about improving health and well-being”.
Put another way, mental health promotion often refers to positive mental health, rather than mental ill-health, and mental health promotion involves promoting the value for mental health and improving the coping capacities of individuals rather than amelioration of symptoms and deficits.

Prevention or promotion, or both?

The World Health Organisation definition of mental health should be considered in order to truly understand the notion of prevention, or more broadly, mental health promotion.
They state that: “Mental health is a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”.

This definition of mental health encapsulates all areas of an individual’s life and re-frames the focus from one of ill-health to one of thriving.
Framing mental health in this way provides a framework that all Australians can understand and engage with.

Many Australians do not understand that we all have mental health and we all need to ensure that we promote good mental health in each of us and those we care about, before signs or symptoms of poor mental health emerge.
We currently have an opportunity within the sector to reframe mental health – to shift the narrative around mental health – starting from children and all the way through to adulthood.

There is a belief that preventative mental health approaches need to integrate into the mental health system – but this may not be the best approach.
We need to consider prevention before the system – acute mental health care should be seen as a last line of defence and everything we do before people need to access the system should be optimised and supported to reduce the burden on the acute services.

In this way, the system needs to change to broaden the notion of what the system is.
According to the World Health Organisation, “combining prevention and promotion programs in mental health within overall public health strategies reduces stigma, increases cost-effectiveness, and provides multiple positive outcomes”.

Smiling Mind is well placed to lead a nation-wide approach to mental health promotion, in a similar way to the Cancer Council or VicHealth are responsible for championing health promotion activities, it is now time to invest in mental health promotion.
This approach needs scale and should be facilitated as a digital led approach with pathways into existing mental health treatment services and crisis support services clearly identified.

This would require a large collaborative effort, but one that Smiling Mind is already working towards and is well placed to lead.

Mental Health and Suicide PreventionSubmission 112