mental health | 2020 vision for a sustainable society

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2020 VISION FOR A SUSTAINABLE SOCIETY MELBOURNE SUSTAINABLE SOCIETY INSTITUTE

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Chapter Eleven - Mental Health

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Page 1: Mental Health | 2020 Vision for a Sustainable Society

2020VISION FOR A SUSTAINABLE SOCIETY

MELBOURNE SUSTAINABLE SOCIETY INSTITUTE

Page 2: Mental Health | 2020 Vision for a Sustainable Society

The Melbourne Sustainable Society Institute (MSSI) at the University of Melbourne, Australia, brings together researchers from different disciplines to help create a more sustainable society. It acts as an information portal for research at the University of Melbourne, and as a collaborative platform where researchers and communities can work together to affect positive change. This book can be freely accessed from MSSI’s website: www.sustainable.unimelb.edu.au.

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Cite as: Pearson, C.J. (editor) (2012). 2020: Vision for a Sustainable Society. Melbourne Sustainable Society Institute, University of Melbourne

Published by Melbourne Sustainable Society Institute in 2012 Ground Floor Alice Hoy Building (Blg 162) Monash Road The University of Melbourne, Parkville Victoria 3010, Australia

Text and copyright © Melbourne Sustainable Society Institute

All rights reserved. No part of this publication may be reproduced without prior permission of the publisher.

A Cataloguing-in-Publication entry is available from the catalogue of the National Library of Australia at www.nla.gov.au 2020: Vision for a Sustainable Society, ISBN: 978-0-7340-4773-1 (pbk)

Produced with Affirm Press www.affirmpress.com.au

Cover and text design by Anne-Marie Reeves www.annemariereeves.com Illustrations on pages 228–231 by Michael Weldon www.michaelweldon.com Cover image © Brad Calkins | Dreamstime.com

Proudly printed in Australia by BPA Print Group

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The last two centuries have seen extra-ordinary improvements in the quality of

human lives. Most people on earth today enjoy access to the necessities of life that was once available only to the elites. Most people enjoy longevity, health, education, information and opportunities to experience the variety of life on earth that was denied even to the rulers of yesteryear. The proportion of humanity living in absolute poverty remains daunting, but continues to fall decade by decade. The early 21st century has delivered an acceleration of the growth in living standards in the most populous developing countries and an historic lift in the trend of economic growth in the regions that had lagged behind, notably in Africa.

These beneficent developments are accom-panied by another reality. The improvements are not sustainable unless we make qualitative changes in the content of economic growth. The continuation of the current relationship between growth in the material standard of living and pressures on the natural environment will undermine economic growth, political

stability and the foundations of human achievement.

The good news is that humanity has already discovered and begun to apply the knowledge that can reconcile continued improvements in the standard of living with reduction of pressures on the natural environment.

The bad news is that the changes that are necessary to make high and rising standards of living sustainable are hard to achieve within our current political cultures and systems.

Hard, but not impossible. That is a central message from this book, drawn out in Craig Pearson’s concluding chapter.

This book introduces the reader to the many dimesions of sustainability, through well-qualified authors.

Climate change is only one mechanism through which current patterns of economic growth threaten the natural systems on which our prosperity depend. It is simply the most urgent of the existential threats.

Climate change is a special challenge for Australians. We are the most vulnerable of the

Foreword

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developed countries to climate change. And we are the developed country with the highest level of greenhouse gas emissions per person.

There are roles for private ethical decisions as well as public policy choices in dealing with the climate change challenge.

This book is released at the time of ‘Rio+20’, a conference in Brazil to review the relatively poor progress we have made towards sustainability in the past 20 years, and soon after the introduction of Australia’s first comprehensive policy response to the global challenge of climate change. Australia’s emissions trading scheme with an initially fixed price for emissions permits comes into effect on 1 July 2012. The new policy discourages activities that generate greenhouse gases by putting a price on emissions. The revenue raised by carbon pricing will be returned to households and businesses in ways that retain incentives to reduce emissions. Part of the revenue will be used to encourage production and use of goods and services that embody low emissions.

The policy has been launched in controversy. Interests that stand to gain from the discrediting of the policy argue that it is unnecessary either because the case for global action to reduce greenhouse gas emissions and the associated climate change has not been proven, or that the new policy places a disproportionate burden on Australians.

The health of our civilisation requires us to bring scientific knowledge to account in public policy. Everyone who shares the knowledge that is the common heritage of humanity has

a responsibility to explain the realities to others wherever and whenever they can.

The argument that the new policy places a disproportionate burden on Australians can be answered by seeking honestly to understand what others are doing.

The critics of Australian policy argue that the world’s two largest national emitters of greenhouse gases, China and the United States, are doing little or nothing to reduce emissions, so that it is either pointless or unnecessary for us to do so.

China has advanced a long way towards achieving its target of reducing emissions as a proportion of economic output by 40 to 45 per cent between 2005 and 2020. It has done this by forcing the closure of emissions-intensive plants and processes that have exceptionally high levels of emissions per unit of output, by imposing high emissions standards on new plants and processes, by charging emissions-intensive activities higher electricity prices, by subsidising the introduction of low-emissions activities, and by new and higher taxes on fossil fuels. China has introduced trials of an emissions trading system in five major cities and two provinces. This adds up to a cost on business and the community that exceeds any burden placed on Australians by the new policies – bearing in mind that the revenue from Australian carbon pricing is returned to households and businesses.

The US Government has advised the inter-national community of its domestic policy target to reduce 2005 emissions by 17 per cent by 2020. President Barack Obama said

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to the Australian Parliament that all countries should take seriously the targets that they had reported to the international community, and made it clear that the United States did so. United States efforts to reduce emissions are diffuse but far-reaching. They now include controls on emissions from electricity generators, announced in March 2012, effectively excluding any new coal-based power generation after the end of this year unless it embodies carbon capture and storage. From the beginning of next year they will include an emissions trading system in the most populous and economically largest state, California.

The United States is making reasonable progress towards reaching its emissions reduc-tion goals, with some actions imposing high costs on domestic households and businesses.

Australia has now taken steps through which we can do our fair share in the international effort, at reasonable cost. It would be much harder and more costly to do our fair share without the policies that are soon to take effect.

What Australians do over the next few years will have a significant influence on humanity’s prospects for handing on the benefits of modern civilisation to future generations. This book will help Australians to understand their part in the global effort for sustainability.

Ross GarnautUniversity of Melbourne

15 April 2012

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ContentsForeword by Ross Garnaut v

Table of Contents viii

Author Biographies x

Drivers 1

1 2

2 10

3 17

4 27

5 37

People 47

6 48

7 57

8 64

9 70

10 79

11 86

12 94

13 104

14 114

PopulationRebecca Kippen and Peter McDonald

Equity Helen Sykes

ConsumptionCraig Pearson

GreenhouseGasEmissionsandClimateChangeDavid Karoly

EnergyPeter Seligman

EthicsCraig Prebble

CultureAudrey Yue and Rimi Khan

AwarenessandBehaviourAngela Paladino

LocalMattersMatterKate Auty

PublicWisdomTim van Gelder

MentalHealthGrant Blashki

DiseasePeter Doherty

CorporateSustainabilityLiza Maimone

GovernanceJohn Brumby

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NaturalResources 123

15 124

16 132

17 141

18 150

Cities 161

19 162

20 170

21 177

22 184

23 192

24 200

25 210

Outcomes 221

26 222

Further Reading 234

Index 241

Ecosystem-BasedAdaptationRodney Keenan

WaterHector Malano and Brian Davidson

FoodSunday McKay and Rebecca Ford

ZeroCarbonLand-UseChris Taylor and Adrian Whitehead

ChangingCitiesPeter Newman and Carolyn Ingvarson

AffordableLivingThomas Kvan and Justyna Karakiewicz

BuiltEnvironmentPru Sanderson

InfrastructureColin Duffield

TransportMonique Conheady

AdaptiveDesignRay Green

HandlingDisastersAlan March

TwentyActionsCraig Pearson

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Mental HealthGrant Blashki

Locally and globally, stress, anxiety and depression are very common. Many of

the contributing factors relate to the fact that we live in an accelerated culture where instant gratification can hardly come quick enough. We are caught in a cycle of hyper-consumption and in the back of our collective minds (not yet at the front, unfortunately) is the ominous feeling that things just can’t keep going on like this. A more sustainable, nurturing society will promote the mental wellbeing of our communities. This chapter explores the role of sustainable societies in nurturing this mental wellbeing.

A Fragile MindThe human psyche is a fragile thing. Mental illnesses are incredibly common and disabling for many, often disrupting people’s capacity to work and maintain loving relationships. They creep up on the young, the old, people from all different sorts of cultural and socio-economic background, and no one is exempt. Though often trivialised, poor mental health is the biggest contributor to the worldwide ‘burden of disease’ from disability, an estimate calculated by the World Health Organisation to assess how much good quality life is lost from the various global diseases.

Apart from the formal, medically defined anxiety disorders there is a big slice of our population that experiences unhealthy levels of stress, be it related to work, home life or just everyday living. Such people walk around highly strung and on edge that something terrible is about to happen. Not surprisingly we’ve seen a huge surge of interest in stress management approaches including meditation and yoga and mindfulness to name a few.

Drugs and alcohol also are big problems in our culture as found in the Australian National Mental Health survey reported by Burns and colleagues in 2002. Australians consume un-healthy levels of alcohol and take drugs such as marijuana, ecstasy, ice, speed and other psycho-stimulants, either for recreation or in attempts to calm troubled minds. Young people are overrepresented, messing with their minds at just that critical stage of life when they could be studying, forming long-term relationships or building a career.

An alarming research finding by Tucci and colleagues in 2007 in a survey of Australian children was that ‘a quarter of children are so troubled about the state of the world that they honestly believe it will come to an end before they get older’. And who can blame them for

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coming to this conclusion? The media is littered with stories of environmental apocalypse, of human indifference and political failure. Not exactly a fairytale with a happy ending for our young people to contemplate.

And these worries do play on the minds of children. In the same way that nuclear war loomed in the minds of the previous generation and children were being drilled in nuclear war scenarios such as the famous educational video showing children hiding under the wooden school desks (I sometimes wonder if this would really have made much difference in a nuclear attack!).

Many of these mental health problems are determined by factors other than how sustainably we live – for example, genetics, family upbringing and socio-economic status. And it would be naïve to think that going green would somehow magically solve society’s mental health problems. Yet, how we live, the

The human spirit needs places where nature has not been rearranged by the hand of man. Author unknown

As a general practitioner seeing patients over the last 20 years I sometimes ask myself, ‘What do people want from their short time on this earth?’ Fame? Wealth? Maybe for some. Though for the majority in my experience, if you’ll excuse the cliché, health and happiness trump everything. People don’t lie on their death bed saying, ‘I wish I’d just topped up my superannuation a little more!’ or, ‘If only I’d had a few more likes on my Facebook page.’ It’s their time with loved ones, with family, travel and holidays and meaningful achievements in their work life that people reflect on. And I guess it’s fair to say, most people in their latter years are more concerned with the lot of future generations, and most hope that the world they leave behind will be better than the one they were born into, for their children and grandchildren.

way we set up our societies, our cities, our homes, our schools, and our transport and recreation all determine the experiences of our citizens in their day-to-day lives. When we acknowledge the delicate nature of mental wellbeing and accept that mental health emerges from patient nurturing by families and societies living in our modern-day villages, the choices we make become critically important. Engaging our young people in helping solve these issues is an important way to give them a sense of hope and make them feel empowered rather than passive in the face of these immense environmental challenges.

A Fragile Earth Stepping away from mental health for a moment, imagine you’re an alien looking down on at humans on earth. Wouldn’t it be striking how rapidly they are diminishing their environmental capital. Wouldn’t you

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wonder what humans are planning as they pump billions of tonnes of fossil fuels into the atmosphere until it starts heating up their planet. You might be perplexed as they overfish their oceans to the point of near ecological collapse, and think it strange that their forests – which apparently they need to replenish the oxygen they breathe – are being chopped and flattened into paper to wipe their bottoms and distribute annual reports.

So, what can we do (you’re back on earth now) as we face the dual dilemmas of environmental catastrophe and the burden of mental illnesses? Like all monumental problems, we have to start with small steps. I present here the cases for three societal reforms: more active transport; more healthy sustainable workplaces; and more green spaces.

More Active Transport What a dry term for such a joyful slice of the day. ‘I’m just going to “Active Transport” to work now dear,’ somehow lacks zest. Yet this term has become the accepted terminology for getting around by means other than by driving – to walk, run, ride, tram, train or bus. Movement is such a basic need that our bodies crave and our minds too often forget. A reminder to me of the simple delight of getting around by foot is the sheer excitement dogs have when their owners suggest a walk – tails wagging, chests panting, hearts pounding.

And Australians desperately need to move more; obesity, diabetes, high blood pressure, arthritis and osteoporosis are at epidemic proportions. We are getting fatter and more unfit as we sit in our cars, and sit in front of our computers and sit at home watching bigger

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and better TV screens. No surprise that the Australian government is spending millions of dollars on the Preventive Taskforce with one of its three major planks to reduce obesity. State governments recognise the problems of a sedentary population too and are urging people to get off the bus or the tram one or two stops earlier and walk more each day.

Exercise is good for mental health too. Salguero and colleagues in 2011 found that people suffering from depression who are undertaking exercise improve more than those who don’t. In 2006 Harris and colleagues found that people with active lifestyles experience less mental health problems in the first place. Monique Conheady addresses the opportunities for “active transport” directly in Chapter 23.

Healthier WorkplacesFor most of us, the workplace is our second home. We are immersed in a design and culture usually not of our own making for most of our waking hours, which can have positive or negative consequences for the environment and for our wellbeing.

Business leaders are more cognisant than ever of their social responsibilities and of their workers’ wellbeing. Health and environmental sustainability have become very real

considerations for corporate boards and CEOs, usually couched in the detached language of Risk Management. Yet the message is clear – neglect your employees and you’ll lose your best workers, neglect the planet and you’ll lose your brand.

In 2009, the Australian People, Productivity, Planet survey of about 11,000 business people and professionals explored their attitudes to their workplace in terms of how well it promotes health and sustainability values. It was undertaken online in association with the professional bodies, and provides a strong case for businesses to adopt sustainability practices, especially as this helps attract and retain employees and improves their levels of satisfaction.

Key findings of People, Productivity, Planet survey• 41 per cent of employees in organisations

already committed to sustainability said if they changed jobs they wouldn’t want to work somewhere that doesn’t tackle sustainability issues.

• 54 per cent of employees say that as a result of their organisation tackling sustainability issues, they feel more proud of their organisation

• 70 per cent of employees working in organisations that don’t report on sustainability say that they would feel they were promoting a healthier and more productive workplace if their organisation made a commitment to sustainability.

More Green SpacesAs the quote at the beginning of this chapter captures so aptly, there is something so basic to human happiness and spirituality about natural spaces. A park, a forest, a stream, an ocean –

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The benefits of green spaces Sugiyama et al. in 2008 found that people who perceive their neighbourhoods as very green are shown to have up to 1.6 greater chance of better physical and mental health, when compared to those who rate their neighborhood as lower in greenness (Sugiyama, Leslie et al. 2008).

A Danish survey in 2007 by Neilson and colleagues found that people who lived a greater distance from publicly accessible green spaces and who had less access to shared gardens experienced higher levels of distress and were more likely to be overweight.

Batt-Rawden in 2005 found that participating in health-promoting group activities such as hiking, physical activities and gardening had a range of benefits for health and wellbeing (Batt-Rawden and Tellnes 2005). Participants with psychosocial problems such as depression, anxiety, sleep disturbances and stress reported that involvement in outdoor activities contributed towards their understanding of ways to cope with the crises and challenges of everyday life.

natural rhythms, natural smells and sounds, they touch us all deep in our minds, sparking something from our childhoods or even from ancient memories somehow buried in our genes.

Though hard to capture, scientists have been able to measure some of the benefits of green spaces. For instance, Melbourne researchers such as Maller in 2006 have found that children suffering from Attention Deficit Hyperactivity Disorder (ADHD) who have greater exposure to nature-based activities in primary school are calmer, less disruptive and have an improvement in their neurobehavioral disorder. The box above overviews some facts about green spaces adapted from the report ‘Beyond Blue to Green’ that researchers Townsend and Weerasuirya undertook for beyondblue.

Living Together SustainablyOne side benefit of a more sustainable society is that it provides more opportunities for communal living and social interaction. In a

society of walking, riding, public transport, open workspaces and local green spaces there is more opportunity for people to build a sense of connection with the community. For people with mental illnesses, a sustainable society can provide a more supportive setting for healing and recovery.

Despite our sophistication, we are indeed social animals. A child denied love and affection from parents literally fails to thrive, actually physically fails to grow, like an un-watered plant. We depend on each other more than we’d care to admit.

There’s no doubt that social isolation or even insufficient social interaction has profound influences on our wellbeing. For instance,

research such as that by Leifheit-Limson in 2010 consistently shows that people’s level of social support after a heart attack predicts long-term survival. Similar research finds that support groups for a range of cancers improve long-term survival.

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Withdrawal from social engagement and social roles is a hallmark for most people suffering from mental illnesses. For instance, depressed people often withdraw from work, family and other social roles. Anxious people often avoid feared situations, eventually resulting in social seclusion. A large part of rehabilitation for mental illnesses is getting people to re-engage socially, and a sustainable

society provides more opportunities to do so. Beyond the hard science of improved health

outcome measures, there may be more subtle benefits in understanding the links between the way our minds work and the workings of natural systems. Appreciating the natural cycles

of our world may help us to better comprehend our complex brains, to appreciate what happens during mental illness and to understand what we can do to help restore mental wellbeing.

For example, our conceptualisation of what our minds actually are has been dominated for some decades by the powerful metaphor of the mind as a machine, indeed as a computer of sorts. And while there are similarities between

our minds and our laptops – data in, processing, data out – there are vast differences too.

In fact, the rhythm of our minds seems more akin to the rhythms of the many natural systems around us – the ebb and flow of tides, the growth and shedding of leaves, the annual

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cycles of seasons and so on. Our diurnal rhythms of sleep and wakefulness are critical for mental health and often the first to be disrupted during mental distress. Many mood disorders fluctuate with the seasons. Thoughts flow and link more like branches and roots than binary connections between computer chips.

This may be more than just an esoteric philosophical notion. Consider for a moment that mental illness can be thought of as a disturbance of the rhythm of the mind: depression/too slow, anxiety/too fast, the asynchrony of autism, and the syncopation of psychoses. Could it be that we need to consider troubled minds more like gardens in need of tending than mere glitches in a computer? Perhaps our treatments need to be more about re-establishing natural rhythms than rebooting faulty software.

No wonder history is filled with the mind-healing qualities of time spent with nature. For millennia, the Aboriginal walkabout or even the European country house have been havens for mental recovery and rejuvenation. Throughout the ages, our ancestors have returned to nature for calm and peace.

ACTIONS FOR 2020While the wishlist for a sustainable society is long, my hope is that before 2020 cities will have more green places: city planners will mandate small recreational areas within walking distance of everyone, preferably adjacent to sites that are, or will become, foci for community socialising such as schools and coffee shops.

The mental health case for green spaces is strong – fewer mental problems in kids, prevention of mental disorders and better recovery for people experiencing depression, anxiety or even just everyday stress. It will require smart urban planning and a real commitment from policy-makers in the face of financial pressures to accommodate growing populations. The public health and financial benefits from integrating green spaces in our cities, workplaces, and communities will become increasingly obvious.

So it’s up to our local, state and federal policy-makers to get serious about green spaces, through regulation and incentives, so that they become part of the culture for planners, developers and builders. And for our business leaders, whether they run small, medium or large enterprises, it’s time to transform their workplaces for the good of employees, customers, the organisations themselves and ultimately the society within which we all live.

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Further Reading

Mental HealthAustin, D., et al. (2005). ‘Managing panic disorder in general practice.’ Australian Family Physician 34(7), 563–571.Batt-Rawden, K. B., Tellnes., G (2005). ‘Nature-culture-health activities as a method of rehabilitation: an evaluation of participants’ health, quality of life and function.’ International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation 28(2), 175–180.Burns, L., Teesson, M. (2002). ‘Alcohol use disorders comorbid with anxiety, depression and drug use disorders. Findings from the Australian National Survey of Mental Health and Well Being.’ Drug and alcohol dependence 68, 299–307.Harris, A., et al. (2006). ‘Physical activity, exercise coping, and depression in a 10-year cohort study of depressed patients.’ Journal of affective disorders 93, 79–85.Kessler, R. C. et al. (2009). ‘The global burden of mental disorders: an update from the WHO World Mental Health (WMH) surveys.’ Epidemiologia e psichiatria sociale 18, 23-33.Leifheit-Limson, E., et al. (2010). ‘The role of social support in health status and depressive symptoms after acute myocardial infarction: evidence for a stronger relationship among women.’ Circulation. Cardiovascular quality and outcomes 3, 143–150.Maller, C., et al. (2006). ‘Healthy nature healthy people: ‘contact with nature’ as an upstream health promotion intervention for populations.’ Health promotion international 21, 45–54.Nielson, T., Hansen, K. (2007). ‘Do Green Areas Affect Health? Results from a Danish survey on the use of green areas and health indicators’ Health and Place, 839-850.People Productivity Planet. (2010). http://www.beatonglobal.com/documents/PeopleProductivity Planet-Business_Sustainability_Report_190410.pdfSalguero, A., et al. (2011). ‘Physical activity, quality of life and symptoms of depression in community-dwelling and institutionalized older adults.’ Archives of gerontology and geriatrics 53, 152–157.Sugiyama, T., Leslie, E., et al. (2008). ‘Associations of neighbourhood greenness with physical and mental health: do walking, social coherence and local social interaction explain the relationships?’ Journal of epidemiology and community health 62, e9.Tucci, J., et al. (2007). Children’s Fears, Hopes and Heroes: Modern childhood in Australia. Melbourne, Australian Childhood Foundation.