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Mental Health and Wellbeing
Mental Health and Wellbeing

Precis

63% of performers earn less than the National Minimum Wage of $34,112

10% of professional singers have attempted suicide

59.5% of entertainment industry workers have sought help for mental health issues

40% of performers have been diagnosed with a mental illness

36% of roadies reported “suicide ideation” in their lifetime

Lack of sleep, low pay, drug and alcohol abuse the contributing factors

Source: Working in the Australian Entertainment Industry survey, Victoria University

 

‘Mental health’ is often used as a substitute for mental health conditions – such as depression, anxiety conditions, schizophrenia, and others.

According to the World Health Organization, however, mental health is “a state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.”

So rather than being about ‘what’s the problem?’ it’s really about ‘what’s going well?’

 

If you’re feeling suicidal or are concerned about someone who is, or affected by your own or someone else’s suicidal thoughts, call Suicide Call Back Service on 1300 659 467 for free counselling, 24 hours a day, 7 days a week.

 

If you or someone you know is experiencing depression or anxiety, please call Lifeline on 131 114 or beyondblue on 1300 224 636 for help or information.

NOTE: Mental Health is a very serious issue that affects all of us.  The purpose of this chapter is not to provide solutions, it is here to help identify problems and ways to seek help.  Throughout the chapter are links to organisations that can provide professional help.  Mental Health is not a self-help area!

21.1      Referenced documents:

WHS Regulation 2011

Working in the Australian Entertainment Industry: Final Report – Victoria University 2016

BeyondBlue website (https://www.beyondblue.org.au/)

HeadsUp website (https://www.headsup.org.au)

Entertainment Assist website (https://www.entertainmentassist.org.au/)

Health Direct (https://www.healthdirect.gov.au/mental-health-and-wellbeing)

Australian Society for Performing Arts Healthcare (www.aspah.org.au)

21.2      Definitions

21.2.1    ”Mental health is about wellness rather than illness”

To make things a bit clearer, some experts have tried coming up with different terms to explain the difference between ‘mental health’ and ‘mental health conditions’. Phrases such as ‘good mental health’, ‘positive mental health’, ‘mental wellbeing’, ‘subjective wellbeing’ and even ‘happiness’ have been proposed by various people to emphasise that mental health is about wellness rather than illness. While some say this has been helpful, others argue that using more words to describe the same thing just adds to the confusion.

As a result, others have tried to explain the difference by talking about a continuum where mental health is at one end of the spectrum – represented by feeling good and functioning well – while mental health conditions (or mental illness) are at the other – represented by symptoms that affect people’s thoughts, feelings or behaviour.

21.2.2    What is depression?

While we all feel sad, moody or low from time to time, some people experience these feelings intensely, for long periods of time (weeks, months or even years) and sometimes without any apparent reason. Depression is more than just a low mood – it’s a serious condition that affects your physical and mental health.

21.3      The benefits of staying well

Research shows that high levels of mental health are associated with increased learning, creativity and productivity, more pro-social behaviour and positive social relationships, and with improved physical health and life expectancy. In contrast, mental health conditions can cause distress, impact on day-to-day functioning and relationships, and are associated with poor physical health and premature death from suicide.

But it’s important to remember that mental health is complex. The fact that someone is not experiencing a mental health condition doesn’t necessarily mean their mental health is flourishing. Likewise, it’s possible to be diagnosed with a mental health condition while feeling well in many aspects of life.

Ultimately, mental health is about being cognitively, emotionally and socially healthy – the way we think, feel and develop relationships – and not merely the absence of a mental health condition.

21.4      Nine signs of mental health issues

What are the symptoms of a mental illness? If a friend or loved one doesn’t seem themselves, how do you spot the difference between a bad mood and something more serious? Drinking too much, being a party pooper, crying all the time or any other ongoing, significant change in a person’s behaviours, thoughts or feelings could be tell-tale signs of a mental illness. Learn the signs that could prompt you to think that a friend or family member is among the 1 in 5 Australians dealing with a mental health issue. Often it’s not a single change but a combination.

The following 9 signs are not to help you diagnose a mental health issue, but instead to reassure you that there might be good reason to seek more information about your concerns.

21.4.1    Feeling anxious or worried

We all get worried or stressed from time to time. But anxiety could be the sign of a mental health issue if it’s constant and interferes all the time. Other symptoms of anxiety may include heart palpitations, shortness of breath, headache, restlessness, diarrhoea or a racing mind.

21.4.2    Feeling depressed or unhappy

Have you noticed that your friend has lost interest in a hobby you used to share? If they’ve also seemed sad or irritable for the last few weeks or more, lacking in motivation and energy or are teary all the time, they might be dealing with depression.

21.4.3    Emotional outbursts

Everyone has different moods, but sudden and dramatic changes in mood, such as extreme distress or anger, can be a symptom of mental illness.

21.4.4    Sleep problems

Generally, we need 7-9 hours of sleep each night. Persisting changes to a person’s sleep patterns could be a symptom of a mental illness. For example insomnia could be a sign of anxiety or substance abuse. Sleeping too much or too little could indicate depression or an sleeping disorder.

21.4.5    Weight or appetite changes

Many of us want to lose a few kilos, but for some people fluctuating weight or rapid weight loss could be one of the warning signs of a mental illness, such as depression or an eating disorder. Other mental health issues can impact appetite and weight too.

21.4.6    Quiet or withdrawn

We all need quiet time occasionally, but withdrawing from life, especially if this is a major change, could indicate a mental health issue. If a friend or loved one is regularly isolating themselves, they may have depression, bipolar, a psychotic disorder, or another mental health issue. Refusing to join in social activities may be a sign they need help.

21.4.7    Substance abuse

Are you worried a loved one is drinking too much? Using substances, such as alcohol or drugs, to cope can be a sign of, and a contributor to, mental health issues.

21.4.8    Feeling guilty or worthless

Thoughts like ‘I’m a failure’, ‘It’s my fault’ or ‘I’m worthless’ are all possible signs of a mental health issue, such as depression. Your friend or loved one may need help if they’re frequently criticising or blaming themselves. When severe, a person may express a feeling to hurt or kill themselves. This feeling could mean the person is suicidal and urgent help is needed. Call Triple zero (000) for an ambulance immediately.

21.4.9    Changes in behaviour or feelings

A mental illness may start out as subtle changes to a person’s feelings, thinking and behaviour. Ongoing and significant changes could be a sign that they have or are developing a mental health issue. If something doesn’t seem ‘quite right’, it’s important to start the conversation about getting help.

21.5      Mental illness stigma

A stigma is a mark, a stain, a blemish. People with mental illness may face stigma – they may be treated as different, as if they are somehow less than other people. The stigma is not true or fair, but it still hurts.

If you have or have had a mental illness, finding a way to deal with stigma is important. If you know someone with mental illness, helping them deal with the stigma is a great way to help. Either way, support and help is available.

21.5.1    What is mental illness stigma?

Stigma occurs whenever there are negative opinions, judgments or stereotypes about anyone with any form of mental illness. Stigma shows when someone with a mental illness is called ‘dangerous’, ‘crazy’ or ‘incompetent’ rather than unwell.  Stigma can lead people with mental illness to be discriminated against and miss out on work or housing, bullied or to become a victim of violence.

21.5.2    Why does stigma exist?

Stigma exists mainly because some people don’t understand mental illness, and also because some people have negative attitudes or beliefs towards it. Even some mental health professionals have negative beliefs about the people they care for.

Media can also play a part in reinforcing a stigma against mental illness by:

  • portraying mentally ill people with inaccurate stereotypes
  • sensationalising situations through unwarranted references to mental illness
  • using demeaning or hostile language.

For example, if a part of the media associates mental illness with violence, that promotes the myth that all people with a mental illness are dangerous. In fact, research shows people with mental illness are more likely to be victims than perpetrators of violence.

21.5.3    How does stigma affect people with mental illness?

A person who is stigmatised may be treated differently and excluded from many things the rest of society takes for granted.

People with mental illness may also take on board the prejudiced views held by others, which can affect their self-esteem. This can lead them to not seek treatment, to withdraw from society, to alcohol and drug abuse or even to suicide.

21.5.4    Where to get support

If you suffer from stigma or know someone who does, help is available from:

  • general health practitioner
  • mental health professionals, such as psychologists, counsellors or psychiatrists
  • local community health centres
  • local community mental health centres.

You can also learn more here about how to deal with any stigma you face. If you want to report stigma, visit the SANE Australia website and fill out an online report form or call 1800 18 SANE (7263).

For immediate counselling assistance, contact Lifeline on 13 11 14.

21.6      Starting a conversation

21.6.1    Have you noticed a workmate behaving differently? Do they not seem their usual self?

Many people will be hesitant to starting a conversation out of fear of

  • causing offence or making things worse
  • harming their working relationship
  • not wanting to get involved
  • not being sure how to respond

If you’re concerned about someone, approach them and start a conversation. Try to understand their situation and encourage them to seek support.

Helping the person find further information and support services can also be really useful, as this step can seem overwhelming for someone with anxiety or depression.

Remind yourself that this is no different to talking about how someone’s feeling – the topic is just a bit more delicate. Remember you may be the only person to have noticed changes in their behaviour or have the courage to start a conversation.  This may be pivotal in them getting the help and support that they need to get and stay well.

21.6.2    Planning the conversation

When you’re preparing to approach someone, it can be helpful to:

  • Find out what help is available within your workplace. If you work in a larger organisation, does it have an Employee Assistance Program (EAP)?
  • Find out what other support services are available
  • Consider who should be having the conversation. Are you the best person or would another workmate or someone from HR be more suitable?
  • Think about the most appropriate time and place. Find somewhere private where the person will feel comfortable.

21.6.3    What to say

Whether you’re a manager concerned about someone in your team or speaking to another workmate, the following tips will help you have the conversation. Don’t worry if you don’t quite know what to say. Just by being supportive and listening, you’re helping to make a difference.

21.6.3.1    How to start

  • There’s no one right way of expressing things – the main thing is to be thoughtful and genuine.
  • You don’t need to have all the answers – it’s about having the conversation and the support you offer by talking.
  • Say what feels comfortable for you.
  • If what you say doesn’t sound quite right, stop and try again. It doesn’t have to be the end of the conversation.

21.6.3.2    Listen

  • Remember that this is their story, so don’t try to guess how it plays out. Instead, listen and ask questions.
  • Be aware of your body language. To show you’re listening, try to maintain eye contact and sit in a relaxed position.
  • Repeat back your understanding of what they’ve said and make sure it’s accurate.

21.6.3.3    Respond

Think about the best way to respond. You can’t fix things, but you can help them along the way. You might:

  • decide that today you’re just there to listen and offer support
  • talk about it again another time
  • keep checking in with them
  • reassure them that you’ll respect their privacy
  • think about what they need now and ask what you can do to help.

21.6.4    Next steps

  • Discuss options for further support.
  • Finish the conversation with a plan/next steps.
  • Appreciate that they opened up and shared their story with you.
  • Make a note to check in with them again in a few days.

 

21.6.5    Unexpected outcome?

  • If they don’t want to speak about it, respect their choice, but leave the door open for another conversation at another time.
  • You may need to have a few tries to open a conversation.
  • Just by showing support and offering to talk, you can make a difference. The person might take action at a later stage or continue the conversation with others.
  • If they disclose that they are at are feeling suicidal or they are planning on taking their own life seek guidance from a manager, HR professional or EAP immediately, or contact Lifeline.

 

21.6.6    Look after yourself

If the conversation has worried you, think about how you can relax or debrief. Talk to someone for support and/or advice but remember to respect the person’s privacy.

Recognising symptoms

21.7      Depression

You may be depressed if, for more than two weeks, you’ve felt sad, down or miserable most of the time, or have lost interest or pleasure in usual activities, and have also experienced several of the signs and symptoms across at least three of the categories below.

It’s important to remember that we all experience some of these symptoms from time to time, and it may not necessarily mean you’re depressed. Equally, not everyone who is experiencing depression will have all of these symptoms.

Mood disorders
Mood disorders refer to conditions that disturb our mood to the point where it becomes difficult to function in relationships or at work. Depression and bipolar disorder are both classified as mood disorders. People’s lived experience with mood disorders vary greatly, however mood disorders can cause a person to withdraw from social contact or hide their real feelings from people close to them.

21.7.1    Behaviour

  • not going out anymore
  • not getting things done at work/school
  • withdrawing from close family and friends
  • relying on alcohol and sedatives
  • not doing usual enjoyable activities
  • unable to concentrate

21.7.2    Feelings

  • overwhelmed
  • guilty
  • irritable
  • frustrated
  • lacking in confidence
  • unhappy
  • indecisive
  • disappointed
  • miserable
  • sad

21.7.3    Thoughts

  • ‘I’m a failure.’
  • ‘It’s my fault.’
  • ‘Nothing good ever happens to me.’
  • ‘I’m worthless.’
  • ‘Life’s not worth living.’
  • ‘People would be better off without me.’

21.7.4    Physical

  • tired all the time
  • sick and run down
  • headaches and muscle pains
  • churning gut
  • sleep problems
  • loss or change of appetite
  • significant weight loss or gain

If you think that you or someone you know may be experiencing depression, completing our checklist is a quick, easy and confidential way to give you more insight. The checklist won’t provide a diagnosis – for that you’ll need to see a health professional – but it can help to guide you and provide a better understanding of how you’re feeling.

21.7.5    Treatments for depression

There’s no one proven way that people recover from depression, and it’s different for everyone. However, there are a range of effective treatments and health professionals who can help you on the road to recovery.

There are also plenty of things you can do for yourself to recover and stay well. The important thing is finding the right treatment and the right health professional for your needs.

21.8      Anxiety

Anxiety. From the entertainment workers who participated in the survey, 44% of the respondents appear in the moderate to severe symptomatology category, whereas Kilkkinen et al. (2007) report from their Australian data, only 3.7% were in the moderate to severe range for anxiety symptoms. As anxiety is a serious and debilitating condition, this is an area of concern for the psychological wellbeing of the entertainment industry workers.
Anxiety is more than just feeling stressed or worried. While stress and anxious feelings are a common response to a situation where we feel under pressure, they usually pass once the stressful situation has passed, or ‘stressor’ is removed.

Anxiety is when these anxious feelings don’t go away – when they’re ongoing and happen without any particular reason or cause. It’s a serious condition that makes it hard to cope with daily life. Everyone feels anxious from time to time, but for someone experiencing anxiety, these feelings aren’t easily controlled.

Anxiety is the most common mental health condition in Australia.

On average, one in four people – one in three women and one in five men – will experience anxiety at some stage in their life. In a 12-month period, over two million Australians experience anxiety.

Anxiety is common, but the sooner people with anxiety get support, the more likely they are to recover.

21.8.1    Signs and symptoms

The symptoms of anxiety conditions are sometimes not all that obvious as they often develop slowly over time and, given we all experience some anxiety at various points in our lives, it can be hard to know how much is too much.

Normal anxiety tends to be limited in time and connected with some stressful situation or event, such as a job interview. The type of anxiety experienced by people with an anxiety condition is more frequent or persistent, not always connected to an obvious challenge, and impacts on their quality of life and day-to-day functioning. While each anxiety condition has its own unique features, there are some common symptoms including:

  • Physical: panic attacks, hot and cold flushes, racing heart, tightening of the chest, quick breathing, restlessness, or feeling tense, wound up and edgy
  • Psychological: excessive fear, worry, catastrophizing, or obsessive thinking
  • Behavioural: avoidance of situations that make you feel anxious which can impact on study, work or social life

These are just some of a number of symptoms that you might experience. They’re not designed to provide a diagnosis – for that you’ll need to see a doctor – but they can be used as a guide.

21.8.2    Treatments for anxiety

A range of health professionals and services offer information, treatment and support for anxiety conditions, as well as a number of things you can do to help yourself.

Effective treatment helps you learn how to control your anxiety so it doesn’t control you. The type of treatment will depend on the type of anxiety you’re experiencing.

For mild symptoms your health professional might suggest lifestyle changes, such as regular physical exercise and reducing your stress levels. You might also like to try online e-therapies, many of which are free, anonymous and easily accessible for anyone with internet access. Where symptoms of anxiety are moderate to severe, psychological and/or medical treatments are likely to be required.

The important thing is finding the right treatment and the right health professional for your needs.

21.9      Suicide

Suicide is the leading cause of death for Australians aged between 15 and 44, with around 3,000 people dying by suicide every year. That’s an average of eight people every day.1 For every suicide, there are tragic ripple effects for friends, families, colleagues and the broader community.

If someone you know seems to be struggling, reach out and connect with them. Showing that you care could make a huge difference. If you find that you are struggling, it might feel better to reach out for support, talk to someone and make some positive changes, rather than doing it alone.

21.9.1    What are the warning signs?

Sometimes, when someone is having a hard time, they may consider harming themselves or taking their own life. Suicidal behaviour indicates deep unhappiness, not necessarily a mental health issue. Many people living with mental health issues aren’t suicidal, and not all people who take their own lives have a mental health issue.

When someone talks about harming themselves or suicide, they’re usually saying ‘I’m not coping right now’ or ‘I need some help’. They may harm themselves because they want to stop or release some of the unbearable pain they’re experiencing.

21.9.2    Things to look out for

Someone who is thinking about suicide will usually give some clues or signs to people around them, even though these might be subtle. Suicide prevention starts with recognising the warning signs and taking them seriously.

Warning signs might include:

  • A sense of hopelessness or no hope for the future.
  • Isolation or feeling alone – “No one understands me”.
  • Aggressiveness and irritability – “Leave me alone”.
  • Possessing lethal means – medication, weapons.
  • Negative view of self – “I’m worthless”.
  • Drastic changes in mood and behaviour.
  • Frequently talking about death – “If I died would you miss me?”.
  • Self-harming behaviours like cutting.
  • Risk-taking behaviours – “I’ll try anything, I’m not afraid to die”.
  • Making funeral arrangements.
  • Giving things away (clothes, expensive gifts) – “When I’m gone, I want you to have this”.
  • Substance abuse.
  • Feeling like a burden to others – “You’d be better off without me”.
  • Talking about suicide – “Sometimes I feel like I just want to die”.

 

The video below features extracts from interviews with beyondblue’s blueVoices members reflecting on the warning signs they saw with family and friends who died by suicide.

Noticing the warning signs (video link)

“Her mood would change dramatically. One minute she would be her bubbly self and the next she’d get really dark”

21.9.3    Responding to warning signs

21.9.3.1    Speak up if you are worried

Talking to someone about his or her suicidal thoughts can be challenging but if you are unsure whether someone is going to kill him or herself, the best way to find out is to ask.

You might be worried that you will ‘put the idea of suicide into a person’s head’ if you ask about suicide. However, you cannot make a person suicidal by showing your concern. In fact, giving a suicidal person the opportunity to express his or her feelings can give relief from isolation and pent-up negative feelings, and may in fact reduce the risk of suicide.

21.9.3.2    How to start a conversation about suicide

  • “You haven’t seemed yourself lately and I’m worried about you.”
  • “I have noticed that you have been doing (X/Y/Z), and I’m wondering how you are going?”

21.9.3.3    Questions you can ask

  • “What can I do to help you?”
  • “I’d like to help you get through this, is there something I can do for you?”

21.9.3.4    What you can say that helps

  • “I want to help you and I am here for you when you want to talk.”

21.9.3.5    The following questions can be used to establish if the person may be suicidal:

  • Do you intend to take your life? (INTENTION)
  • Do you have a plan to take your life? (PLAN)
  • Do you have access to the means to carry out your plan? (MEANS)
  • Do you have a timeframe for taking your life? (TIMEFRAME)

Visit the Conversations Matter website for helpful tips on how to talk about suicide. 

If someone is planning to take their own life they need to be linked into help immediately and not left alone. In an emergency see below for immediate support or visit the Get support now page for more options.

21.10   Stress

Types of stress
Stress is a normal part of life and can be positive or negative. Types of stress include:
Good stress
This type of stress is good for you. It comes from facing a positive challenge and can cause us to feel nervous or excited. Good stress can improve motivation and performance.
Short term stress
Short term stress is a brief period of stress related to a specific situation.
Chronic or ongoing stress
Chronic stress can be caused by ongoing pressures or demands that go on for a long period with little hope of improving. Chronic stress can be very damaging to health and relationships.

Stress is an expected human response to challenging or dangerous situations. Humans have evolved over time to be able to experience a range of stressors and recover from them.

Experiencing stress is part of being alive. A small amount of stress, such meeting a challenge or deadline can actually be helpful, it can lead to increased alertness, energy and productivity. A complete lack of stress can lead to reduced motivation and performance.

Stress triggers off the ‘fight or flight’ response, preparing the body to take action against potential danger. Hormones such as adrenaline and cortisol are released, causing the heart rate, metabolism and breathing rate to speed up. This works well for short-term threats but if the stress response goes on for too long, it can have damaging effects on the mind and body.

Stress can be caused by our circumstances or by our own attitudes and expectations. If stress is greater than our ability to cope, it can lead to physical and mental health issues and cause problems with relationships and work.

 

There are many different ways to manage stress, including identifying your triggers, relaxation techniques, lifestyle changes and seeking support from others. If you are feeling overwhelmed by stress and unable to cope, seek advice from a counsellor or health professional.

21.10.1  Stress Symptoms

Too much stress can affect mental and physical health, particularly if it becomes chronic (ongoing) or overwhelming. Stress can affect your body, your thoughts and feelings, and your behaviour.

If you are experiencing any symptoms of stress, it’s best to see your doctor as it can contribute to health problems, such as high blood pressure, heart disease, obesity and diabetes.

21.10.1.1 Body

The symptoms of stress and changes with your body that you may notice include:

  • headaches
  • other aches and pains
  • sleep disturbance
  • fatigue
  • upset stomach, diarrhoea
  • high blood pressure
  • weakened immune system
  • muscle tension
  • change in sex drive (male or female)

21.10.1.2 Mind

The symptoms of stress affecting your mind, thoughts and feelings include:

  • anxiety, worry
  • anger, irritability
  • depression
  • feeling overwhelmed and out of control
  • feeling moody, tearful
  • difficulty concentrating
  • low self-esteem, lack of confidence

21.10.1.3 Behaviour

The symptoms of stress that impact your behaviour include:

  • overeating or undereating
  • outbursts of anger
  • relationship problems
  • alcohol, smoking or drug abuse
  • avoiding people

Chronic and severe stress can increase the risk of developing depression, anxiety, substance abuse or a range of other mental disorders. If you are concerned you may have a mental health issue, visit a health professional.

21.10.2  Stress Treatment (at a basic level)

It may not be possible to remove the stress from your life; however, managing your stress may help you to get things done. Below are some ideas for managing stress:

  • Be aware – monitor your levels of stress and ask whether they are helpful or getting you down.
  • Take stock – think about things in your life or pressures you place on yourself that may be increasing your stress.
  • Take charge – deal with unhelpful sources of stress before they build up and become a bigger problem.
  • Make choices – look at areas in your life where you could manage your situation better or change the way you respond.

Some examples of good ways to deal with stress:

  • Take some deep breaths.
  • Talk to someone you trust.
  • Create a stress diary, note down when you feel stressed and why.
  • Have a health check with your doctor.
  • Eat a healthy, balanced diet.
  • Try to avoid smoking, alcohol and caffeine.
  • Make time for things you enjoy.

These are ways to help you bounce back and become more resilient to stress.

You should talk to your doctor about ways to help you bounce back and become more resilient to stress if these simple ideas don’t work.

21.11   Self-harm

Self-harm is when somebody intentionally damages or injures their body. It is a response to deep emotional feelings such as low self-esteem, or a way of coping with traumatic events, such as the death of a loved one.

Self-harm may provide short-term relief from painful feelings, but they usually come back and the urge to self-harm returns. It can become compulsive and the cycle can be hard to break. People who self-harm are usually not trying to commit suicide, but they are at risk of accidentally killing themselves. Repeated self-harm can also lead to people feeling suicidal and hopeless. If you have feelings of wanting to harm or kill yourself, call Lifeline on 13 11 14..

Some ways people self-harm include:

People often try to keep self-harm a secret and may cover up their skin and avoid discussing the problem. The signs may include unexplained injuries and signs of depression or low self-esteem.

Someone who is self-harming can seriously hurt themselves, so it is important that they speak to a doctor about the underlying issue and about any treatment or therapy that might help them.

21.12   Paranoia

Many people feel paranoid at times. ‘Is she looking at me strangely? Is he talking about me behind my back?’ Sometimes these feelings can be justified.

Paranoia is a state of mind in which a person believes that others are trying to harm them. It could be a feeling of being watched, followed or monitored in some way. It might be a belief that there is some kind of conspiracy operating against them. Paranoid people sometimes have an increased sense of self-importance, believing that many others are taking notice of them when it is not true.

Mild paranoid thoughts are quite common in the general population and tend to recover naturally. Long-term paranoia can be a symptom of a mental disorder or be caused by recreational drug abuse, dementia or other medical conditions that affect the brain.

Paranoia is sometimes referred to as a persecutory delusion. A delusion is a fixed, false belief that someone continues to hold even when there is no evidence that the belief is true. Paranoid symptoms can range from a general feeling of distrust and suspicion of others through to bizarre and complicated beliefs such as conspiracy theories about the government, police or aliens.

21.1.1    Treatment for paranoia

Treatment for paranoia depends on the underlying cause and may include treatment with psychological therapy or medication. Stopping the use of alcohol or recreational drugs can be the first step and may solve the problem altogether.

People with paranoid thoughts can find it hard to trust a doctor or mental health professional, and may have difficulty accepting treatment. Developing a positive relationship with a health provider may take time, but can lead to recovery.

Psychotherapy (including cognitive behaviour therapy) can be helpful for mild cases of paranoia or paranoid personality disorder. This can help a person to develop insight into the condition, cope with symptoms of paranoia and develop a more realistic view of the motives of others.

For conditions such as psychosis, schizophrenia or delusional disorders, the main treatment is medication. These conditions are now more treatable than ever before, and many new antipsychotic medications are available. These conditions usually require treatment by a psychiatrist. Psychotherapy, rehabilitation or support groups may also be effective in conjunction with medication.

21.13   Healthy sleep habits

One of the serious, ongoing problems in the Australian entertainment industry, sleep and fatigue.

Many Australians don’t get enough sleep, surveys show, and they feel tired as a result. Research also shows that while sleep disorders like insomnia are sometimes to blame, poor sleep habits or choices are just as often the cause.

21.13.1  How much sleep do I need?

Most adults need about 8 hours of sleep per night. Children and teenagers need more sleep than adults, while older people tend to sleep more lightly and for shorter time spans than when they were younger, despite needing the same amount of sleep as they did as young adults.

21.13.2  What is good sleep hygiene?

Healthy sleep habits, also called good sleep hygiene, are habits you can develop to help you sleep well. While you can’t make yourself sleep, there are things you can do to increase your chances of getting a good night’s sleep.

Things you can do to improve your sleep include making some simple changes to your environment as well as changing the timing of certain activities, or what you eat and drink. See: Ten tips for healthy sleep.

In most cases, sleeping pills are not the answer – they aren’t suitable for regular use and don’t address the cause of sleeping problems.

Sources:

Sleep Health Foundation Australia (Ten tips for a good night’s sleep), Sleep Disorders Australia (Shift work)

21.14   Mental health professionals

There are many types of health professionals working in mental health care including:

They have different skills to support your mental health. Some will use different types of counselling, and some will be able to prescribe medications, while others cannot. Some are very practical, while others work to help you understand deep patterns in your life. Even within the same profession, different professionals can have different styles, so find the one that suites you.

21.14.1  How do I find a mental health professional?

If you’re searching for a mental health professional, try talking to your doctor first. They can assess you, and can refer you to another health professional if needed. In some cases, your doctor will treat you themselves.

You need a referral from your doctor to see some health professionals, such as psychiatrists.

21.14.2  What questions should I ask?

When choosing a health professional, ask questions such as:

  • Do I need a referral?
  • What problems can they help me with?
  • What results can I expect?
  • What qualifications do they have?
  • How much will treatment cost?
  • How often will I need appointments?
  • Are appointments available on days or at times that work for me?

All health professionals must be registered with the Australian Health Practitioner Registration Agency (AHPRA).  You can check if a health professional is registered or make a complaint about a health professional on the AHPRA website.

21.14.3  What can I expect when I visit a mental health professional?

At your first visit with a mental health professional, you will probably be asked a lot of questions about your mental health. This might include questions about:

  • why you have made an appointment
  • what you hope to achieve
  • whether you or anyone in your family has a history of mental illness, such as depression
  • your relationship with your family and friends
  • your stress levels and any particular stressful events in your past
  • your feelings about your job and your relationships
  • whether you use drugs and how much alcohol you drink
  • the risk of you harming yourself or others
  • other existing medical conditions.

The mental health professional may also take what is called a developmental history.  This is the history of all things that may have happened to you in your childhood, adolescence and adulthood so that they know something about who you were before becoming unwell, and any other contributing factors that may be relevant.

This may seem overwhelming but it’s important for your health professional to understand you so that they can provide you with the best care possible. At the end of your visit, your health professional may set up a management plan to assist in the long-term treatment of your mental health.

21.14.4  What if I need to change my mental health professional?

There are many reasons why you might want to change your health professional, such as:

  • you aren’t feeling better
  • they are difficult to travel to or the appointment times don’t suit
  • you just don’t get on.

It’s a good idea to talk to the person you’re seeing first. They might be able to change the appointment times or move the appointments to a different location.

If you still decide to change, you can ask for your medical notes to be transferred to your new health professional. This will help your new health professional understand you better and it will make the transition easier.

21.14.5  What does it cost to see a mental health professional?

The cost of seeing a health professional depends on the type of health professional you see. Medicare covers some or all of the costs of using some mental health services.

If you have a diagnosed mental illness, your doctor can provide you with a mental health care plan. This covers some of the costs of up to 10 therapy sessions a year with some mental health specialists.