22 August, 2018 by Dr Stephen Carbone, Director
When Luke and Lachlan and I first decided to set up Prevention United we were greeted with some very quizzical expressions from our colleagues, friends and family. Their concerns seemed to fall into two broad categories: a) Why do we need another mental health charity? Don’t others already do that? and b) What do you mean you want to prevent mental health conditions? That’s impossible!
Now while I can’t speak for Luke and Lachlan, I can explain why I gave up a great job at one of Australia’s leading mental health organisations to establish ‘another’ mental health organisation.
First, like many people, I have experienced first-hand the anguish mental health conditions can create in people’s lives – among my friends and family and in my professional life as a GP. Over the last 30 years I have known hundreds of people living with a mental health condition and I have seen them endure some awful times. And while I know these conditions can be treated and that recovery is the norm, I still wish that the people I know and care about didn’t have to experience these conditions in the first place. Just as some doctors want to prevent infections, or heart disease, or cancers, I want to prevent depression, anxiety, behavioural disorders, eating disorders and psychoses because I don’t like the pain they can cause, even if it can be alleviated by treatments, supports and services.
Second, there are of course many fantastic mental health organisations in Australia and I’ve had the privilege to work for many. But when you’ve worked in the sector for over three decades you know who’s who and who does what and… where the gaps are. The reality is that the vast majority of our mental health organisations are geared towards supporting people already affected by a mental health condition and there are less than a handful that focus on preventing these conditions from occurring in the first place. Furthermore, for most of these, prevention is a partial focus rather than the only focus and as far as I am aware, only one other mental health charity in Australia focuses exclusively on primary prevention. Given this gap, it seemed perfectly reasonable to set-up ‘another’ NFP to advance the cause, because just like any other field of endeavour one organisation can’t do it all and a bit of (friendly) competition can often drive innovation and better outcomes.
The other major reason why I’m with Prevention United is because I like a challenge! While health conditions like infections, cardiovascular disease and some cancers are on a downward trajectory, the prevalence of mental health conditions hasn’t changed for decades. There are many reasons for this. A lack of investment in prevention is a big part of the problem, but so too is the complexity of the task. The traditional public health approach to prevention focuses on reducing people’s exposure to risk factors for a condition, but the problem we face is there are so many risk factors for each mental health condition and our understanding of how these factors operate and how best to address them is nowhere near as sophisticated as our knowledge for other health conditions. There’s a lot to learn. But the fact that this is such a nascent field is one of the things that makes it exciting to be a part of. We know we may be several decades away from being able to successfully prevent the majority of mental health conditions, but we also know that it’s not impossible. There are already some good examples of how it can be done. We just need time, creativity and support to develop more.
So basically, I’m part of Prevention United because I want to play my role in alleviating suffering and I also want to do my bit to advance knowledge. I realise some people will remain puzzled, but at least I can tell my colleagues, friends and family that’s why I’m doing this – and I hope they get on board!