She's On The Money - The True Cost Of Mental Healthcare

Episode Date: April 25, 2023

Aussies are among the most under insured people in the world, our “she’ll be right” mentality puts us at risk of being in dire straights when unexpected things happen with our health.  45.5% of the Australian population experience a mental health condition at some point in their lifetime. This means it shares the stage with cancer and heart disease the most common of medical life disrupters. Today we take a truthful look at the cost of mental health care so you’re not caught out, and shut out of the care you deserve! Acknowledgement of Country By Natarsha Bamblett aka Queen Acknowledgements. The advice shared on She's On The Money is general in nature and does not consider your individual circumstances. She's On The Money exists purely for educational purposes and should not be relied upon to make an investment or financial decision. If you do choose to buy a financial product, read the PDS, TMD and obtain appropriate financial advice tailored towards your needs.  Victoria Devine and She's On The Money are authorised representatives of Money Sherpa PTY LTD ABN - 321649 27708,  AFSL - 451289.  See omnystudio.com/listener for privacy information.

Hello, my name is Natasha Nabanunga-Bamblett. I'm a proud Yorta Yorta, Kernai, Wolperi and Awadjeri woman. And before we get started on She's on the Money podcast, I would like to acknowledge the traditional custodians of the land of which this podcast is recorded on Awadjeri country, acknowledging the elders, the ancestors and the next generation coming through. As this podcast is about connecting, empowering, knowledge sharing and the storytelling of you to make a difference for today and lasting impact for tomorrow. Let's get into it. She's on the money.

She's on the money. Hello and welcome to She's on the Money, the podcast for millennials who want financial freedom. Two weeks ago, we did an episode on the cost of care with Rhiannon Tracy, who was so good. That was such a great episode. We covered a whole range of diseases and injuries and looked at the real and very hidden costs of living with these conditions. It was such a huge episode and so eye-opening. So I recommend taking a listen if you haven't already. But we just wanted to do a few more episodes focusing on particular conditions because there is so much to learn and discuss. Today, we're looking at mental health, the stats, the hidden and real

costs, and so much more. My name is Bec, and with me is Victoria Devine. Hello, my love. How are you? You know, I'm pretty nice and chill. Oh, you're pretty nice today. I feel like, you know, when you're like slightly sleepy, but not enough to be like tired, tired, you're just kind of in a chill. No, the second I get slightly sleepy, I'm like, does this mean I get to go to bed? Any excuse to go to bed. Mental health, Bobeck. Because I am wildly passionate about this topic, but also just about talking about insurance and talking about protecting ourselves and putting ourselves in the best possible position. And you already know, because I have drummed this into you, that as Australians, we are some of the most underinsured people in the entire world.

But also, I really hope that by talking about the realities of the costs behind these illnesses, and conditions, we can actually really help open up conversation about the realities of living with these conditions and the stigma that currently and still unfortunately surrounds them. And mental health is something that is so close to my own heart. So before we get even further into this, I do think that this episode deserves a content warning. So if the discussion around mental health and the topic of suicide is not going to be a conversation you want to have today, that is totally fine, my loves. I have put some resources in our show notes to make sure that you can reach out for the support that you need and deserve. But also don't feel bad to just skip this episode.

Skip ahead. Turns out, Beg, we've got a lot of other episodes you can listen to that won't talk about those topics. You won't be missing out. No, you won't be missing. I mean, hopefully you will be missing out because it's a really good topic. I think that, yeah, there's a time and a place for conversations like that. And if you're not in the headspace for it, don't do it because it's not worth it. Totally fine. That's very well said, V. So there actually is a lot to get to today. But what is a snapshot of the prevalence of mental health conditions in Australia? So I've gone on and on about this. The cost of care white paper by Zurich is one of my favourite white papers ever produced because we really didn't have enough insight into the cost of

these conditions before that. We could Google it and like there was, I guess, you know, eclectic resources on this, but there wasn't like one paper that had really focused on it. And I mean, this paper was done a few years ago and I'm absolutely certain that they are probably going to re-release one at some point. I would love to see one on the cost of mental health during COVID. I feel like that would be a really interesting read. And as an ex-financial advisor, I obviously had a lot of exposure to this side of it. And I don't think the general public goes, you know what I'm going to do? I'm going to go to an insurer's website. I'm going to read their white papers on the cost of care. But I promise it's really exciting, riveting stuff. And this

white paper, I guess to go more into it, it talked about the cost of care of mental health. So 45.5% of the total population, Bec, experience a mental health condition at some point in their life. Half of us. Wow. It's lower than I thought. I kind of think it's lower. And I know that it should be like it's a big number and it should be like oh my gosh that's a lot yeah I just feel like it's I don't know I'm not going to disagree with Zurich because they're actual genuine researchers and I'm just a pleb ex-financial advisor who was given a podcast like I don't even know how that happened still but no one does I just feel like mental health yeah no I really don't get it like it's like imposter syndrome but like it's not imposter syndrome I'm genuinely I mean an imposter

like I don't get it. No syndrome. Yeah I guess when we talk about 45.5% of the total population experiencing a mental health condition 100% of us from my perspective have mental health like whether we have a condition or not is going to depend a lot on our medical history and the circumstances we are exposed to and the environment that we grow up in and the environments that we experience and the events that we go through and the trauma that we experience and there's so many things, right? But from my perspective, every single one of us has mental health and we either have really good mental health and you're very, very lucky, or you experience some mental health issues along the way. So I think that's important to differentiate at the start. You don't just not

have mental health like we all do. The prevalence means it actually shares the stage back with cancer and heart disease as a group of high impact medical life disruptors. And mental health conditions are present in all ages and in all socioeconomic groups, which I don't think is going to come as a surprise to any of us. Mental health conditions can include affective disorders, so things like depression and bipolar and schizophrenia, anxiety disorders, including panic attacks and stress disorders, and substance abuse disorders. So alcohol and drug dependencies fall under this. One in six women and one in eight men, Bec, will experience depression during their lifetime. And one in three women and one in five men will experience anxiety. Mental health

conditions are most common in those aged between 25 and 34 years old, affecting nearly one in four. And this then declines with age. And they affect women more than men across all age groups and those living in rural areas. And individuals spend an estimated $1,350 per year out of pocket for mental health conditions with medications accounting for one third of this cost. Wow. Isn't that wild? Have you had any experience with kind of like the, I'd say, prescribed mental health drug? Yes, I have. I guess you're new here. So welcome to, you know, a little bit of a deep dive into

Victoria's medical history. So I have been diagnosed with clinical depression and anxiety. I also have ADHD and have a mental health history of eating disorders. So I was hospitalized in my teenage years for a significant period of time for anorexia. And that is something that, you know, on previous episodes I've spoken about, and I think it's just so important to just address it. I don't think it changes my value as a human being. I don't think it changes anything about the way you should view me. In fact, I think that those experiences have just made my experience richer, right? And when I talk about a topic like this, I am speaking from experience. I have been medicated since the age of 14 for depression and anxiety. I've tried a number of different

medications and I'm still on a medication today. And I take what I guess doctors would deem a relatively high dosage of depression and anxiety medication. And I strongly believe I'm never coming off that. I have tried coming off that because there have been periods of my life where I go, I don't want to be medicated. And there's the stigma that you apply to yourself and you're like, I don't need this medication anymore. But I guess now the period of my life that I am in, I have come to the realization that my medication for my anxiety and my depression is actually a bit like the medication a diabetic would have. Right. And a diabetic who doesn't have enough insulin to make their body function properly, right? So you would go, okay, diabetic, here's

some insulin. And I mean, that's a very basic way of explaining it. They get that and their life can carry on as normal. In fact, you would know you don't just get better and then all of a sudden start producing insulin as a diabetic. You just take that for the rest of your life and monitor of those levels and make sure they're okay, right? I believe the same happens in my brain because my depression and anxiety isn't trauma related. It's actually just, I think it could potentially be just in my genetics. It's in my DNA and I just don't have enough dopamine and I don't have enough serotonin in my brain and I take those drugs to make sure that I can function at the same level as you can. So from my experience, yes, I have had a lot of experience with drugs. I have

drugs that have worked for me. I've had drugs that haven't worked for me. I've had to go through a drug withdrawal program because my depression drugs were really messing with me. And I also take stimulants for my ADHD, but I am not good at taking those stimulants because I don't like how they make me feel. Sure. So I avoid them. And that like would be really, really tough if there's something that you, I guess, maybe need. Is need a strong word? Yeah, no, no, no. I definitely need them. You need to take them. Yeah. And you don't like the way you feel when you take them. And that's just, that seems like a really unfortunate kind of like catch-22. It's a massive catch-22. And I suppose I'm so lucky in that for me, medication, I mean, I talk about the stigma,

right? And I say, oh, I went off them because I just didn't want them back. I just didn't want to be on medication. Like at the end of the day, it's just something I didn't want, but no one really wants that, right? Like you don't want to be taking insulin for the rest of your life, but you do it because you want to be healthy. And that's just the key to it, right? So I think for me, my need, I don't have a choice if I don't take my anxiety and depression drugs. I'm not a functional member of society. I just am not. I am not happy. I am not kind. I am not any of those things. But then if I don't take my stimulants, I'm just not as productive. and I mean I feel very lucky to live in 2023 and I have access to a plethora of research and I've

said this before and it's not you know I don't want to name the supplements I take because we've talked about it before I'm not a doctor and this is me sharing my anecdotal experience not me sharing medical information and I would hate for you to go oh my gosh well Victoria said on a podcast that this particular supplement helped her like that's not from my perspective responsible of me to share that. Just because it works for me doesn't mean it'll work for you. But I have done so much personal research into different supplements and like mushrooms, like the non, not magic mushrooms, like different types of mushrooms and supplements and things that I can take that kind of act in a way that a stimulant does. And if you're in that circumstance and you

want to do that research, it's really easy to find. Like it's not, it's not hard. It's all over TikTok. It's all over Instagram. It's all over Google. You just Google it and you can start going down that rabbit hole and working out what might work for you but yeah my stimulants I rely on maybe like a couple of times a week when I really have to set my mind to something or I'm feeling extra agitated or I'm feeling extra bouncy sure yeah yeah just like that but like even in this moment I'm not on my stimulants because I think there's so many things going on and there's so much structure yeah yeah it's an interesting concept and we can talk about I guess totally My experience is in more depth at some point in the future.

Absolutely. Those mine. What about your experiences? I'm very lucky. I don't actually have any, not to say that I'm- You're a little unicorn. I'm like, yeah, like I don't have any medication that I take regularly for anything. Money win.

Money win, big money win. I feel like there was a moment maybe for a year or two there where I was like really discovering myself and I had some pretty bad social anxiety, but I didn't diagnose it. I didn't know what it was. I didn't know why I felt really introverted and stuff. So I spent a lot of money on, like, nootropics and all this weird, like, you know, not necessarily weird, but just, like...

No, it's weird. I was just obsessed with, like, how do I make my brain feel uninhibited again? And so that was probably the most expensive thing. But as far as... It is really expensive, right? It can be expensive. I was like, yeah, I was going down the mushroom train as well myself.

But that's the only thing, really. I'm very, very fortunate to say that I don't have to take anything for anything for any reason. and it's very cheap I would think and we will find out actually. Yeah I mean that's a money win that you're not on any medications and don't have any of those associated costs but it's a money loss if you were experiencing mental health and you weren't taking the right medications because it ultimately impacts every other aspect of your life right. It's true. And I think it's interesting conundrum to be in as well like even I mean complete tangent again me talking about

taking a whole heap of supplements. I, again, so privileged to be able to afford these supplements, but like one of my bottles that I purchase online, by the way, when I'm talking about mushrooms, I feel like I'm crazy. No. Because it's like something that a lot of people might not have heard of. We're not talking medicinal like magic mushrooms. No. We're talking mushrooms that have a whole heap of... We're not talking portobello. No, no, no, no. We're also not talking about cut mushrooms that you buy cut or halved at the supermarket yeah anyway we won't go on and on about that but that's like 110 a bottle for me and i go through a bottle every month and that's a privilege for me to be able to rely on that instead of on my stimulants because that

helps me get through yeah but like i'm also a bit of a health nut and i make sure i have all my amigas and i make sure that i you know a lot of naturopaths are going to be like you don't need to take a multi-vitamin victoria but like there are a whole heap of things that i do tape that i do feel lift brain fog and make me more clear and put me in a better mental state. And that costs money, right? Absolutely. And we're not talking about that today. What we're talking about is the literal medications and the actual healthcare system, not Victoria's hippy dippy mushroom vibes. I'm riding that wave with you, babe. But I guess that we should really get back on topic. That was our experience. But what did the Zurich White Paper find that Australians on

the whole experience when it comes to the cost of mental health conditions. Yeah. So the estimated total health system expenditure on mental health was $12.8 billion, comprising of $974 million in healthcare costs and back $11.8 billion in productivity loss. Wow. Wow. Wow. Isn't that wild? Like to just break that down, obviously that's a lot of billions of dollars, but it was $974 million in healthcare costs and $11 billion in productivity costs. Bec, 10% was the actual healthcare cost. 90% is sitting in productivity loss when it comes to mental health.

Oh my gosh, you don't even think about that cost. Isn't that wild? I say those billions and I think that everybody just kind of like it flies over your head and you go, oh, so much money. You're right. Let's talk about this. but like 90% of that cost or around 90% of that cost is loss of productivity due to mental health. Yeah.

What? That's wild. Isn't it wild? Mental health conditions have large economic and social costs. We already know that. The conditions are often lengthy, leading to career disruption, instability, loss of skills, and social isolation, which is why economic costs are not limited to lost work, but also to long-term lost opportunities. Yeah, okay. Which we need to talk about as well. And I'm just so glad that it's being taken into consideration

now because I think if we had gone back, let's say 10 years and we talked about mental health and someone was trying to calculate my cost of mental health, they'd be like, well, how much do you spend on medication each month? Yes. How much was your doctor's appointment? Full stop, end of story. That's the cost of my mental health. And that's not the case. And I feel like I am, um oh I feel like I've said I'm privileged already this episode but I just I feel so genuinely lucky that the circumstances I am in are favorable like I don't know how to say this without sounding like an absolute wine cup ick my career has been successful I have been so lucky that things have lined up for me and that I have worked my butt off and done all these other things

but there are so many people in this world who have worked their absolute butts off and are at a loss when it comes to their career or what has happened. And I mean, I'm not saying that I have lost any of those things. And I think personally, if you were to quantify my loss, I actually think that my mental health has really played into my success. Like I was talking about my ADHD the other day with a friend and they're like, oh, how do you really think that your ADHD has impacted She's On The Money and, you know, Zella and creating Zella Money and all that. And I just said, I don't think I would have She's On The Money and Zella Money without my ADHD. They are a product of me being obsessed with something, which is one of the things that happens when you

have ADHD. I get so fixated on one particular topic that that's why we've deep dived into it. That's why I created it. I don't think I would have been able to commit to something like She's on the money without my mental health issues. So I'm very lucky, but that's not the reality of everybody else because we go back to that number of $11.8 billion in lost productivity. So my experience is not the norm. No. My experience is so far from the norm, it's not funny. We know social costs include increased rates of divorce, domestic violence and substance abuse. Treatment costs include most medications under heavily government subsidized with public subsidies available through general practice mental health care plans medical consultation rebates and the

pharmaceutical benefit scheme the pbs which we talked about in our last episode public hospital admissions are reserved for the most serious mental health conditions and are provided free of charge and then moderate medical health conditions including substance misuse are treated largely by the private hospital system and inpatient treatments are often lengthy and moderately expensive with private health providers offering some subsidies for inpatient care. But there's always, always, always a lot of out of pocket when it comes to treatment like that. Right. Unfortunately. It's crazy, isn't it?

It is crazy. Did they find any other direct links to physical conditions? So apparently many people with back problems, especially chronic back pain, have poor mental health and are more likely to report conditions like depression, anxiety and psychological distress. And when it comes to getting treatment for other conditions, Adults with depression, anxiety and other mental health conditions are seven times more likely to skip health care than people without a mental health condition. Oh, my gosh.

Oh, it's so frustrating. It is frustrating. And this conversation in particular really just slapped me in the face because my best friend has a chronic back issue and her mental health is so poor and she thinks it's because of other reasons. But I'm going to send her this. I'm going to send her this episode and tell her to have a good listen.

and it breaks my heart as well because I think so many people think that their mental health is so in their control like it it frustrates me and I ended a friendship recently actually back and I ended it because this person couldn't see my side of the tracks right like we were talking about mental there were so many other things right but just be happy was something she said or why don't you just focus on doing more Pilates or why don't you like she just could not conceptualize that the issue that I was having you know and have had for a number of years like she just thought it was like a choice like people choose right to be unhappy and I think when you have a chronic health condition you assume that your mental health is it's just in your

control but once you're able to get back out there you'll be happy again right and it's really not the case. Like your mental health is, it can be in your control, right? Like I'm taking control of my mental health by going and getting mental health care practitioners involved and talking to my GP and being on the right medication and doing all these things. But it's not just a choice you make. You don't get out of bed in the morning and go, do you know what? I'm just going to choose to be happy today. Yeah. I'm just going to choose to have a good day. I feel like I want to have anxiety today. Yeah. Do you know what? I'm just not going to have anxiety today. I'm just going to go do this thing. And like, it's funny because I think when I start to share my mental health

journey and what that means, I think people look at me and go, absolutely not, Victoria. You're so confident. That doesn't mean it doesn't manifest in other areas of my life. Can I get up on stage and talk to a room of 5,000 people? Absolutely, I can. Easily. Can I sometimes not get myself out of bed though and spend days in my bed not being able to get out? I refuse to answer the phone. I refuse to check my emails. I refuse to do a whole heap of things. I don't even get in the shower if I've forgotten a medication yeah absolutely but people don't see that side of things and I think they only see you know like let's go back to this social media thing they only see the social media highlights they only see what you know I'm

putting out on online I'm not going to get my phone and take a photo of me in bed after three days like it's just not going to happen because I'm not in that mental space like it's just not going to happen yeah so I think it's it's wild especially if you've got a chronic health condition like your friend of course you're a bit down because you're not being supported in the way that you need to be mentally supported and stimulated there's another thing that people don't think about when it comes to mental health and that's the kind of the pressures on carers and caregiving so we know that informal caregiving often falls to family members but what are the costs to families and carers yeah so carers for people with mental health conditions spend an

average of 36 hours per week providing care. That's two hours short, my love, of a full-time job. Wow, wow, wow. 24% receive carers payments. 34% don't receive any assistance in their caring role. And 35% don't know the services that are available to support carers, which is the number that I really want to focus on here. So I just, they don't know what they don't know because we don't talk about it. And then if we don't talk about it, you don't know what you can access. Exactly. The more we have these conversations and the more we normalize this, the more we can advocate for others as well. And I think that, you know, especially when it comes to mental health, there's such a stigma around it still, where if somebody is experiencing depression and anxiety,

they might not want to talk about it. And then that might extend to their carer. and like a carer could be your husband it could be your sibling it could be a parent it could be literally anybody it could be your housemate that kind of picks up the slack when you won't get out of bed and they then don't talk about it because they know that you're a bit like closed off and don't really want to talk about the issues and then that extends to them not being able to get the support that they need and then maybe then experiencing their own mental health conditions because they feel like they aren't open and honest about the realities of their circumstance so I think it's just, it goes on and on and it's a cycle that we really need to break and we really

need to talk about more honestly and more openly and with a lot more kindness than we currently approach it with. Totally. Let's end the taboo. But I think this is a really heavy topic. Let's go have a little break and come back in 5.2 seconds. All right, V, we are back. How do you feel? I feel like that was longer than 5.2 seconds. That was a little bit longer than 5. I feel like it was 5.7. Yeah, okay. So maybe next time we'll shorten it a little bit. Do you know what? I'm going to stay on the counting side of the table. You stay on the content side of the table. I'll do the maths. You're not involved in that. Deal. Because at this point, I'm not even sure if you can tell the time. I don't know what time it is. So let's have a little bit more of a closer look

at some of the costs and stats and break down the specific disorders. Okay. All right. So let's talk about affective disorders. So affective disorders are things like depression, bipolar, and schizophrenia. The cost of depression is $17,190 on average per individual. Average number of days off from work each year if you have an affective disorder adds up to 75.4 days per year, Bec. do you know how many sick days most people get in their work contracts barely anything 10 usually you get 10 sick days that is wild seven times more than the average that we are allocated fewer than two in five people with anxiety and depression seek treatment and recovery rate is actually up to 50 percent in the first six months but the relapse rate is between 30 and 50 percent

for those who initially recover, which ends up putting a lot of people in a cycle of feeling like it's never going to get better. And as much as those numbers feel low, they're actually, from my perspective, relatively high. Indirect spending for affective disorders includes non- health services and social costs. So family breakdowns, going through a divorce, legal costs, stuff like that. If an individual were paying $450 per session for psychiatric treatment weekly, which is a very normal amount of money, unfortunately, to be spending on seeing a psychiatrist, which my background's in psychology. I have two psychology degrees, so I do know what I'm talking about when it comes to this. A psychologist is not able to prescribe medication

a psychiatrist is. A psychologist can talk you through things and, you know, help you get through a lot of situations I see a psychologist regularly, but when it comes to managing my ADHD and when it comes to managing my depression, which is always going to be with me, I see a psychiatrist because I am on medications that have been prescribed by my psychiatrist. So you can't go to a psychologist and they go, oh, I'm going to diagnose you with depression. Here's a medication for that. They don't do that. So if you have an affective disorder and you are on a medication for that, or you are clinically diagnosed, you actually have to see a psychiatrist. So this isn't like a choice, right? But it can be about $450 a session. We're using that number because it

seems to be an average and it's actually what I pay to see my psychiatrist. They would be $296 per session out of pocket because you get $154 on a Medicare rebate for that session. after the seventh week of treatment, the individual would have already reached the Medicare safety net threshold, which is $2,093.30 out of pocket in seven weeks. That is so awful, V. Can you imagine, like, the costs just add up? Like, how do you survive? How do you feed yourself? How do you afford that? How do you afford to live? And then, but also, like... That's rent money. That's right money. But imagine like you had a full-time job, so you could technically be

affording all of these things if you had a really well. You're not affording it. I don't think people might be paying for it, but there's a difference between being able to pay for something and being able to afford it. Because if you're saying you're affording it, you're able to service every other goal in your life and that is not impacting those things. But from my perspective, even if you have an emergency fund and then you have to see a psychiatrist on a weekly basis and you're spending $450 a week, you're technically able to pay for it, but you're not able to afford it because your bigger goals aren't being met. You might not be saving. You might not be investing for your future. You might not, you know, you might be

foregoing social activities or other things that are helpful for your mental health. And I think we've all been there, right? Like I shouldn't see it this way, but I always see it as like a me cost and you shouldn't do this, right? Like I always go, oh my gosh, well, I had a psych appointment or a psychiatrist appointment this week. No, I won't buy a Pilates pass this week. I think I might wait a bit because that was an expensive week when in reality the Pilates pass and me getting physical activity is probably equally as important but I see it as a different like I see it as a choice and it shouldn't be like that was a cost I had to incur so I think it's really interesting and that's why often you end up with mixed care so often when you have a

mental health condition and I mean disclaimer again this is just anecdotal personal experience I'm not a doctor and I'm not recommending that this is the right mode of care, but my GP knows how expensive my psychiatrist is. So he keeps in contact with my psychiatrist and my psychiatrist sees me, well, maybe once every six months to approve my medications. And then I go every three months to my GP to get prescribed my medications, but then I don't have to go to the expensive psychiatrist appointment so often. But then on top of that, I have a psychologist as well that's in that mix that I, I guess, do the more therapy side of things with. Like we don't really talk about medication. Like my psychiatrist is quite, quite transactional. You could say it's kind of

like a GP appointment. We do talk about my mental health, but I'm not talking about how I'm feeling or what I'm doing because she checks in with my psychologist to make sure I'm on track with that. So you often end up with not just one psychiatrist appointment. You've got GP, you've got psychologist, you've got psychiatrist, and they all mix together. And then that becomes even more expensive and you cap out your Medicare rebate real quick. I'm telling you that right now. Isn't it wild? That's really wild. And let's say in a hypothetical world, you made trillions of dollars per hour and you could afford all of those things. But that's only if you get to go to work every single day and you don't use up your sick leave. You know that like when you're

hungover or just feeling tired and you can't be bothered going to work, imagine that times a trillion but you have to go to work every single day you only have 10 days of sick leave per year but you feel like that all the time that's your reality yeah and you've got to pay for all these things how are you meant to work and just survive and go into work every day and like be your best self if you're feeling so like you just can't you just can't it's kind of like people who experience chronic pain conditions they just get so used to managing it that that becomes the new normal and a new expectation and it's not right it's not right it's not right and when something else goes wrong they compare it yeah and so like i've got a few friends and even family members with

chronic health conditions and it's interesting because if something else goes wrong i can i'm going to use an example that i'm making up yeah but like chronic health condition let's call it really really awful back pain it's consistent it's crippling but then they break their ankle they look it's not that bad but it like literally changes the way that they're living their life but in comparison they're kind of like oh it's not that bad in comparison like I got it all passed it up she'll be right like what anybody else breaking their ankle would be like this is you know life ending I can't believe this I'm in a cast for the next six to eight weeks like you know there's so much I need to do and then I need to do rehab they just don't see it as that

big of a deal and that's not okay like it's not okay to be in that position because you should be mentally well and you should be you know able to be fit and healthy and happy and all of those things. And it just, yeah, it really frustrates me. Like sometimes I want to shake these people and be like, it's actually okay that that's a bad thing. Like we can say it's a bad thing. Like don't compare it or compartmentalize it in the way that you are. Totally. Moving on to another disorder. Let's talk about anxiety disorders. So that's things like panic, angoraphobia, social phobia, generalized anxiety, obsessive compulsive disorder, and post-traumatic stress disorder. Average individual cost is between $186 and $264 if combined with another disorder.

The average number of days off per year are 53.6 days per year. So a bit less than depression, but also we need to recognize comorbidity exists. So often if you have anxiety, the likelihood of you having depression is increased. As I mentioned before, I have both, like por que no los dos. There is for anxiety disorders, a 50 to 60% recovery rate and a 50 to 66% relapse rate of those who initially recover, which again, just makes you feel like you're stuck in a cycle and that's not cool at all. No, that would be very, very, very tricky to live with. I'm sorry, Bea. No, don't be sorry. I'm okay. I'm literally okay. And I just see it as part of me and I'm okay we're just talking about the costs and I think that it's really important and I don't

want people to listen to this and think that Victoria is trying to make this all about her no I don't think that's the case at all I just believe that the best way of you know breaking down stigma is actually to open the doors and open the conversation up around yourself and as somebody who I'm just grateful to be in this position where I do get to talk to you guys about these things I can't just stand here and be like it's important to talk about mental health Bec? Because you'll be like, call Victoria. Everybody else is saying that. But if I go, it's important to talk about mental health and I actually experience these things. Here's my experience. This is what this looks like. You go, wow, I didn't realize, you know, that not only

would there be psychiatric costs, but a psychologist and your GP involved and there'd be like this mix and this triangle of people that have to talk to one another to manage your condition. Like, I just think it's so much more practical to have practical and pragmatic conversation where it's just like, well, Bec, it is what it is. Moving on to substance use disorders. So average individual cost is between $186 and $258 per year if combined with another disorder. And the average number of days off per week are 40.2 days per year. Recovery rate is up to 80%, which is chef's kiss. Could be higher, but that's, you know, they're the numbers we want to start seeing. Unfortunately, relapse rate is between 40 and 60 percent and people with substance use disorders are often frequent users

of psychiatric services. Although many services are publicly funded, there are still and there may still be payment gaps for individuals seeking counselling or medication or rehabilitation centres and self-help programs or support networks. The other thing I want to say about substance use disorders is, I guess, the underlying cost of the substance that you have a dependency on. Because obviously when it comes to depression, like I'm not going out and getting a substance that is costing me a lot of money that results in depression. I am, you know, if you have a substance use disorder, it's usually really expensive, especially here in Australia. Like it's not accessible, obviously, for good reasons, because usually they're illegal. But it's one of

those things where that average individual cost is not including how much you're spending on those substances. And that can be financially crippling for many, many people. And obviously there's a lot of conversation around that because substance use disorders are the disorder that leads to the highest levels of homelessness in Australia. And obviously there's a lot of comorbidity there as well when it comes to having another disorder. Yes. Moving on to the topic and the, I guess, subheading of suicide, Bec. Suicide is the leading cause of death for Australians between the ages of 15 and 44. Wow. And is the second leading cause of death for Australians aged 45 to 54 years old. That is pretty eye-opening. I had no idea that it was so high. Yeah. It's insane because suicide

I think doesn't get the conversation happening around it that it deserves. And I mean, there are so many beautiful charities and forums that discuss this, but we just don't discuss it as a community as a whole. It's kind of like, oh, yeah, let's talk about Beyond Blue and the work that they're doing. But I feel like it's always really niched down to a particular campaign. It's not an ongoing conversation. And suicide is an outcome of mental health conditions. and all the conversations that we've just had and all of the disorders that we've been talking about today, they lead to or can lead to suicide and somebody going through that process. And I just think that we need to care about these things more because people just deserve more

from our community. We really, really do. I completely agree with that. Now, just moving on slightly can we now talk about mental health care plans how the hell do they work absolutely we can and i am the biggest advocate of a mental health care plan we talked when rianne and tracy was on our episode a lot about insurance and the importance of insurance and i think that the first thing i want you to do as a human being i'm not saying before a mental health care plan but i am saying you need to consider your personal insurance needs sooner rather than later and the reason I say that is because insurers in Australia take into consideration exclusions right so an exclusion is where they don't include something in your insurance cover so Bec you might have broken your

ankle a couple of times playing netball and then you go and do your survey to get new insurance and they go Bec have you got any health conditions and you say nah got nothing have you had anything happened to you historically and you go, yep, broke my ankle playing netball. And then they come back and say, no worries, Bec, we would love to insure you. But here are our conditions. What we're going to do, we're going to insure your whole body and your whole mind, but we're not going to insure that one ankle. And we're not going to do that. Don't want anything to do with the ankle because you've already broken it once. So because it's already been broken once, it's a bit compromised. It means that you're more likely to break it again. So we just don't want that.

and you go, all right, well, when it comes to insurance, that makes sense, right? Like it's kind of like car insurance. If you're a bad driver and you keep crashing, they're going to say, probably going to charge you a little bit more, Bec. Your premiums are going to go up because you keep crashing. Yeah, you're a bit of a risk. You're a bit of a risk, right? And that's exactly how personal insurances work. Yeah. And there are lots of different risks involved in personal insurance. But the younger you are when you apply for personal insurance, the less likely you have experienced a significant life and health event, which means the less likely you are to have exclusions in your cover. So, hypothetically, in the future, you can claim on more stuff.

I want insurance to be the biggest waste of money you've ever spent money on, Bec. Like, I want you to be paying for insurance every single month and I want you to look at that cost and be like, didn't claim on that. That's not great. Like, I want it to be a waste of money. I see what you mean. I want you to be wasting your money on insurance. Wow. But hypothetically, if something did happen to you yesterday and you needed to, I want that cover to be there.

Yeah. And I think that framing it that way, people go, oh, okay. Because how many times have you looked at your insurance? You go, that's a lot of money, but also I'm getting nothing out of this. Good. Yeah, true. I don't want you to get anything out of your insurance because if you're not claiming on your personal insurances, you know what that means?

You're probably happy and healthy and haven't broken anything and haven't been hit by a us and haven't had these awful things happen to you, that's a life win. True. Stop seeing it as a money loss. That is so true. I didn't even think about that. I guess segue to this is I really want you to think about insurance now and today and care about it because the sooner you get it implemented, the less likely you are to have a pre-existing health condition taken into consideration. And I say this before a mental health care plan because over the last, I would say seven years since the Royal Commission and everything about financial advice and insurance is really, I guess, got shook up. You could say mental health care plans are seen by insurers

and they do take them into consideration when offering you cover. And it's a really shitty thing to have to say that I really want you to be insured before you go down this pathway because it breaks my heart or it used to break my heart every single time I had to sit down with a client and say, I know that you did the right thing for you and you went and got a mental health care plan and now you are healthy and you are happy and you're not even seeing anyone and you're not even on any medications. But when we did your medical history, the insurer came back and said that you were on a mental health care plan so we aren't covering you for mental health in your insurance. Oh my God. Isn't that just like the most messed up thing ever? And it pisses me off

and I understand the risk behind it. I can see it from both sides. I can understand that as an insurer, mental health is becoming, and I won't say mental health issues are becoming more prevalent because I think that they've been there all the time, but we are now getting the help that we deserve for them. And that is costing insurers money because you're claiming on your income protection to take time off work to put you first and you should be able to do that. But when it comes to an insurer, their job is to kind of manage risk. And there's people called underwriters and their job is to have a look at the risk and I guess weigh up the pros and cons of offering BEC cover. And if you have had mental health conditions historically and seen a GP and then

maybe seen a psychiatrist for it, they're going to look at that and go, okay, cool. You know what, BEC, we're not going to offer it to you. Maybe we can reconsider this in two years. But if it's something like I have sat down with clients who have attempted suicide and then because they've attempted suicide, it's just an instant decline on mental health cover. Do you know what? There's nothing else to say about it except it's really shitty. And I hate the fact that as an ex-financial advisor, when you ask me about a mental health care plan, and I promise I'm about to explain exactly how they work, but I hate that I have to go on a tangent because I feel like it's the most responsible thing for me to do to say mental health care plans are really important. Please

talk to your GP. Please get the health care that you absolutely deserve and need. But please make sure that you have the insurances you need first, because if you go down that route, there is a very big probability that by disclosing that you have had a mental health care plan, you might get an exclusion. That is very solid advice. Isn't that awful? It's unfortunate. Because you shouldn't be thinking about your mental health right now and going, oh, well, I'm feeling pretty terrible. I should go to the doctor. But Victoria said, let's get our insurances sorted. Let's not do that. Let's be mentally healthy today and go and get our insurances sorted. So if we experience anything in the future, we don't have pre-existing conditions on our insurance applications.

Back to your question though, Bec, you asked a very good question. Actually, not back to that. You guys are going to slide into my DMs and say, I need insurance. And I'm going to reply, please go talk to my friend, Phil at Sky Wealth. He's not paying me to say this. I just don't want to reply to 600 different DMs of people going, Victoria, you talked about the importance of getting insurance sorted. Phil is a financial advice friend that I have had for many, many years now. He used to run a full service financial advice business and decided that he was really passionate about insurance and now does insurance only advice. And for, I think it's between three and $400 are his fees. So he's not going to charge you what a holistic financial advisor would charge

to implement your insurances, which would be around three and a half to $5,000. He is a lot cheaper because all he does is insurance. If you want to go to him and start investing, he's not going to do that. He's just going to say, cool, don't do that. All he does is insurance and his team are structured to make that as accessible as possible. And if you know somebody else that runs a business like Phil's where his financial advice is actually relatively accessible in terms of cost please let me know because I do not know anybody else running a business as accessible as Phil at this point with the quality of advice associated with it so that's yeah that's my plug I know that that sounds really salesy and it kind of was no it was meant to because I want you to

get insurance ah okay it was it was meant to because I wanted you to get insurance but also I just wanted to be really transparent about who Phil is he's like he's a nice guy that's fair Anyway, you asked a question and the question was, Victoria, can we now talk about mental health care plans? Yes, please. I was like, yeah, no worries. So if you would like a mental health care plan, your GP can write you one. It's very simple. You don't even need to, I think you do actually need to when booking, let your like GP know that it's going to be a bit of a longer appointment. You can't just book the 15 minute one because you do actually need to do a bit of survey so just heads up on that from the 1st of january 2023 with a mental health care plan you're

able to access a total of 10 medicare rebates for your appointments with your clinician in this calendar year so calendar not financial so it resets in december yep or at the end of december if you have sessions remaining on an existing mental health care plan and current referrals for your sessions from 2022, whether for the initial 10 or an additional 10, you'll be able to use the referral to access up to 10 sessions in 2023 without having to go back to your GP, which is very good. That is very good. Typically, following six Medicare rebated appointments, your clinician is going to write a progress report relating to your treatment goals, and you're going to, or you will be eligible to get a re-referral from your doctor for an

extra for Medicare rebated appointments, which does involve another trip to the GP. Following the four extra Medicare rebated sessions, your clinician will write a further treatment update to your doctor and it will go from there. So how much does this cost? This is she's on the money, Bec. I'm dying to know. If you qualify for the mental health care plan, you'll be eligible to receive a Medicare rebate of $131.65 for an appointment with a clinical psychologist, or $89.65 Medicare rebate for an appointment with a psychologist. Note the difference between clinical psychologist and psychologist there. Oh, yeah.

Not talking psychiatrist. It's important that there's a differentiation there. If you are booking an appointment and you just Google Medicare rebate with psychologist and it comes up as $131 and then, yeah, you just don't want to get those two mixed up in case you're not getting the rebate that you're expecting if you're like budgeting. This Medicare rebate amount will increase once you reach your individual slash family extended Medicare safety net threshold of $2,249.80, which is the general threshold,

where you will then receive back 80% of the out-of-pocket expenses for your ongoing sessions with a psychologist. Okay. On paper, I think that's good. On paper, it is good. I mean... It's still an expense. It's still an expense.

I've said this before on the podcast. I'm very grateful to live in Australia with the healthcare system that we have because we are so incredibly supported. Is it the best healthcare system in the entire world? No. There's better out there. Finland? Yeah, Finland's amazing.

I mean, Norway? Norway. Oh, so sexy. How do they do it? The government pays for it. So it's not as though, you know, their psychologists are cheaper or anything like that. it's just their governments have put more of a priority on having no gap health care and so they

they cover that it would be included in their taxes i see at the end of the day they are paying taxes and that's what their taxes are going towards and i mean when it comes to like our medicare rebates and stuff that's what our taxes go towards yeah so the money has to come from somewhere yeah so i guess talking about this stuff is really important to me because i care a lot about our community. I care a lot about mental health and I care a lot about making sure that you are well protected. And that's why I went on that insurance rant. I'll pop a whole heap of details in the show notes if that's something that you're like, oh, V, I hadn't really considered it. I really think it's important. But I also think it's important to continue this conversation

beyond just us doing an episode on a Zurich white paper. Like I think the white paper, They're so sexy, like so sexy. I've read it so many times. I can't tell you how many times I've forwarded it because it's in a PDF. I've shared it with heaps of my friends. I've sent it to advisors who are like, Victoria, I've already seen this. And I'm like, yeah, but read it again. It's really, really helpful. But I think that from this, what we should be doing is really opening the conversation up about the cost of mental health. And we don't have time today, but we will continue this conversation in our Facebook group and have honest, non-judgmental conversations about what it's costing you and what it's costing our community

and, you know, what are your hacks and tips and tricks and all of that. I want to know. Absolutely. And also, if this conversation has negatively impacted you, please reach out to your, would you say, GP for any advice? Yeah, reach out to your GP. We'll pop some resources in the show notes as we always do. Exactly. But yeah, I think this has been really Good. Heavy, but good conversation that needs to happen. So I feel like let's go and absorb this. Let's go have a tea as we usually do. Exactly. I guess leaving it here,

your mental health does not define you as a human being. Yes, exactly right. Full stop. End of story. We love you and we hope that you have the best day ever and we will see you for a Friday Drinks on Friday. Bye, guys. Bye, guys. the advice shared on she's on the money is general in nature and does not consider your

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