We’ve come a long way since the days when mental illness was treated like a shameful secret. But there is still a long way to go.
The system remains fragmented, chronically under-funded and not fit for purpose.
Getting timely, appropriate care can be a lottery that is too often predicated on your bank balance, postcode, or background.
These inequities have been exposed and amplified during the pandemic as fault lines in our society.
Just as the impacts of mental health and suicidality are not felt equally, the impacts of the Covid crisis have been unevenly distributed.
People in insecure work and housing, Aboriginal and Torres Strait Islander people, LGBTIQ+ Australians, young people, those from culturally and linguistically diverse backgrounds or living with disabilities or pre-existing mental health conditions have been disproportionately affected.
Women have also been heavily impacted – and we already know that gender plays a role in mental health outcomes.
Men die by suicide at greater rates than women. Women self-harm and attempt suicide at higher rates than men, and transgender and non-binary Australians at even higher rates.
Gender matters. It’s not everything, but it’s something. And during the Covid crisis, it’s been a significant factor.
We’ve seen the disadvantage women face become more entrenched. But history tells us these moments of disruption are often dividing lines.
When we look back, we see a clear distinction between the way we lived before and how we emerged on the other side.
As an active and committed feminist throughout my political life, I want to see advances in gender equality across the spectrum – from ensuring every girl has access to education right through to how many women are sitting in boardrooms as CEOs. I direct that energy to my work at the Global Institute for Women’s Leadership at King’s College London and now at the Australian National University.
Gender inequality was a persistent feature of our society before Covid and the impact of the pandemic has exacerbated it through what the Grattan Institute report released earlier this year described as the “triple whammy” suffered by women in last year’s recession.
Women were more likely to lose jobs, do more unpaid work, and get less government support.
At the peak of the crisis, women lost jobs at double the rate of men – almost 8% compared with 4% for men.
And they shouldered the increase in unpaid work, including supervising children learning from home, and taking on an average of an extra hour each day on top of their existing heavy load.
Mothers in couples, and single parents – 80% of whom are women – were more likely to leave the labour force than other groups.
Women of child-bearing age were also forced to give up study in record numbers.
These structural inequalities compound women’s lifetime economic disadvantage.
Six months out of work can add another $100,000 to the $2m average lifetime earnings gap between men and women.
As Australia contemplates a life beyond Covid, we must seize the moment to create a more equal playing field.
Access to quality education and gender equality are not only significant issues in their own right. These are also key social drivers that influence our mental health.
Applying a social determinant lens is at the centre of our work in the mental health sector.
The Covid crisis has underscored that, without secure work, a safe place to call home, social connection, access to childcare and education, people quickly start to struggle. And those who are already disadvantaged struggle the most.
The greater burden women carried through the pandemic meant they reported higher levels of anxiety, depression, distress and self-harm.
There was a particularly troubling spike in the number of teenage girls and young women presenting to hospital with self-harm injuries.
This tallies with research released in August from Monash University’s Centre for Health Economics, which found that, during economic downturns, women in their 20s were most likely to suffer poor mental health.
The trend is largely driven by insecure employment, particularly for those who already face greater adversity.
During Covid, female-dominated industries such as hospitality, tourism and retail were hardest-hit by lockdowns, suggesting the mental health effects for women were likely to be even greater in this downturn.
And yet, measures that went some way to alleviating women’s psychological load – such as free childcare and the jobkeeper supplement – were the first to be rolled back.
We need to think differently in the future if we are to reduce the disproportionate mental health burden women face. And of course, we must also acknowledge the toll placed on men – who are over-represented in the suicide statistics – and build a system that works for everyone.
Right now, Australia is at a reform crossroads.
Wholesale structural change to our mental health and suicide prevention systems is long overdue and has never been more urgently required.
But we must get reform right.
This is our opportunity to come together – governments, the sector and the community – with a laser focus on the social inequities that drive poor mental health.
Creating a compassionate, person-centred system where we listen to people’s lived experience and put it at the heart of the decision-making process will remove some structural barriers.
We must see the whole person and address their unique life circumstances.
I want to see an Australia where we achieve true equality, and women leaders are everywhere.
And I believe we have reason for optimism on that front.
I see the trailblazing spirit alive and well in young women like Brittany Higgins, Grace Tame and Chanel Contos, who are bravely challenging the status quo.
The ability of these women to take constructive action in response to life-changing events and challenges, has me both awestruck and inspired.
Chanel’s petition for earlier sex education in schools on consent – which led to disclosures of sexual assault from schoolgirls all over Australia – shows the power and resilience of the female collective.
I spent time with Chanel in London, where she’s currently studying, and I was delighted when she came to a dinner for my 60th birthday.
Inevitably at a birthday event, there was much talk of ageing, and in the course of that I asked Chanel when she was born and while it was sobering for someone born in 1961 to hear her say 1998. It struck me as wonderful that feminist activism and connection spans the generations.
These young women are harnessing this moment of social disruption, with a more impatient brand of feminism that grabs change with both hands.
We will only achieve gender equality if more women step into public life and shake things up, and men stand alongside us as firm allies.
That might seem a counter-intuitive wish, given my experience in politics.
But my experiences – while played out on the most public stage – are not unique.
They are emblematic of a broader problem every woman in Australia has faced – in her workplace, at home, in education, or just in day-to-day life.
My story struck a chord because every woman has felt the sting of being demeaned, undermined, or overlooked.
But I want to assure you all that my experiences have not bred disillusionment or resentment. They have only strengthened my resolve to make the path easier for tomorrow’s female leaders.
We cannot change the past, but we can learn from it and change the future. Indeed, times of adversity offer us a chance to grow and build resilience.
And that’s where we find ourselves as a nation after this period of great trauma.
You would all be familiar with the notion of post-traumatic stress. But there is also a lesser-known phenomenon when people have been through disruptive times, and that is post-traumatic growth.
These moments that set us back on our heels also give us pause to reassess how we’re living, and what’s truly important.
We’re all having those deep reflections – at an individual level and as a society – as we emerge from this period of turbulence.
We have an opportunity to use this collective contemplation to fix the structural problems that have for too long driven inequality.
If we get the settings right, we can redesign the mental health system, putting in place social guard rails that remove inequities and help keep people well.
Gender equality does not only benefit women. It empowers every person to live free from the suffocating constraints of gender stereotypes.
We need men to be part of the solution because power disproportionately remains in their hands. I would ask any men to reflect on how you can use that power for change. And I urge policy makers and sector leaders to think of all the layers of societal inequality that have been exposed and exacerbated by the Covid-19 crisis.
We cannot squander this opportunity for reform but seize it as a defining moment to reshape our nation’s future by tackling the root causes of disadvantage.
Julia Gillard is chair of Beyond Blue and a former prime minister of Australia
This is an edited extract from the Grace Groom Oration for Mental Health Australia, which will be delivered online on Wednesday night