The difference in public perception of physical and mental health issues is plain to see in the recent outrage over allegations involving navy personnel and asylum seekers.
Much has been said and written
about allegations that Australian Navy personnel inflicted burns upon asylum seekers. But one aspect that has had little attention is what the furore says about our double standards around mental health.
Allegations that public employees may have inflicted physical harm upon vulnerable people in their care have drawn intense reaction and are seen as political dynamite. If proven, no doubt there will be serious consequences and opprobrium for those responsible.
By contrast, there is considerably less moral outrage surrounding the harm that is routinely inflicted upon the mental health of adults and children being held in immigration detention facilities. Yet the concerns about these injuries are not in the realm of "allegations", but are well documented in the pages of medical journals
Nor are these the sorts of injuries that are easily or quickly mended. The authorised assaults upon the mental health of asylum seekers create the sort of enduring trauma that crosses from one generation to the next.
Children are particularly at risk -- and the Australian Human Rights Commission, in today announcing another national inquiry
into the immigration detention of children
, says there are about 1000 children in closed immigration detention.
Everything we know about the impact of serious mental illness suggests we are sanctioning policies that will lead to many premature deaths, given the evidence of reduced life expectancy
for people with serious mental illness.
"The double standards at play here are diabolical," said Sebastian Rosenberg, senior lecturer at the Brain and Mind Research Institute at the University of Sydney. "Physical harm to refugees would elicit immediate concern and attention. Mental harm is permitted to fester."
Director of the Hunter Institute of Mental Health Jaelea Skehan says that as a community we are much more likely to legitimise physical pain over psychological pain.
"Is it just that physical harm can been seen and understood," she asked, "or does it relate to entrenched misconceptions we still hold that a person experiencing mental ill-health is someway weaker to or to blame for their illness? Perhaps because we still consider that people seeking asylum are to blame for what happens to them, our actions or lack of action can be dismissed."
Not everyone agrees, however, that attitudes to mental illness is the issue at stake. Medical writer and publisher Dr Mark Ragg said: "I think most people don’t care about the mental harm, and the same people don’t care about the physical harm. Those who care about mental harm also care about physical harm.
"I think Australia is divided into those who think refugees should be treated as human beings and those who think they should be treated as animals. Unfortunately, the latter seem to be in the majority."
To draw a distinction between mental health and physical health is in many ways misleading and unhelpful; they are intertwined
and we know, for example, that poor physical health is the major reason that so many people with mental illness die early.
It's no coincidence that the <a href="http://www.bmj.com/content/346/bmj.f2539 life expectancy gap for people with serious mental illness is comparable with the life expectancy gap for Aboriginal and Torres Strait Islander peoples.
History teaches that policies that confine, control and stigmatise populations -- whether people with mental illness, or Aboriginal and Torres Strait Islander peoples -- create a lasting legacy of trauma and poor health. History also shows that abuses flourish in institutions that are closed to outside scrutiny and that are focused on the interests of those in power rather than those in care.
Jack Heath, CEO of SANE Australia, said: "When it comes to asylum seekers in detention, we would do well to care more about their mental health and wellbeing. The Royal Commission into Child Sexual Abuse is graphically highlighting the extent to which institutions can be cruel environments that add to trauma and lead to severe mental illness. Inhumane situations like these persist when complainants are denied a voice and their concerns are dismissed out of hand by those in authority."
Health professionals have been sounding the alarm for years now about the mental health toll of our asylum seeker policies and the dehumanising rhetoric of so much of our public debate. I can hardly believe that it's 12 years since I wrote on this for the BMJ
(formerly known as the British Medical Journal
That such a large proportion of the population remains oblivious, uncaring or deliberately deaf to these concerns is revealing of many aspects of our national character. One of these readings (but not the only one) is the lesser priority we accord to mental health and wellbeing.