Volume 195 - Issue 1
The changing profile of mental disorders among Disability Support Pension recipients
Authors: Peter Butterworth, Philip M Burgess and Harvey Whiteford
Med J Aust 2011; 195 (1): 53-54. || doi: 10.5694/j.1326-5377.2011.tb03196.x
Published online: 4 July 2011
Published online: 4 July 2011
To the Editor: Amid debate about growth in the number of Disability Support Pension (DSP) recipients and the increasing percentage of recipients with mental disorders,1,2 the recent federal Budget announced further welfare reforms and significant investment in mental health services.3 There are, however, limitations in the data informing the current discussion.
Administrative data are restricted to coding the primary disability of DSP recipients, and do not assess comorbidity. Further, data on the health of recipients receiving other welfare payments are lacking, precluding thorough understanding of the context of the growth in the DSP population.
We recently published an analysis of the 2007 Australian Bureau of Statistics National Survey of Mental Health and Wellbeing, in which we estimated the prevalence of common mental disorders in different categories of working-age welfare recipients.4 The main results showed that just over one-third (34%) of income-support recipients had a 12-month affective, anxiety and/or substance use disorder, compared with 20% of non-recipients; that, despite a decade of reform of the welfare and mental health systems and improved economic circumstances, there had been little change in the overall prevalence of mental disorders among welfare recipients since 1997 (Box, A);5 and that most income-support recipients with mental disorders received payments other than DSP.
We compared data from the 1997 and 2007 surveys, focusing on welfare recipients with a mental disorder (12-month common mental disorder assessed by the World Mental Health Composite International Diagnostic Interview). Of the 10 641 and 8841 survey respondents in 1997 and 2007, 667 and 362, respectively, were identified as working-age welfare recipients with a mental disorder.5 We estimated that 31% of income-support recipients with mental disorders were DSP recipients in 1997, but in 2007 this had increased to 45% (Box, B). The increased concentration of recipients with mental disorders receiving the DSP was significant in logistic regression models controlling for age and sex (odds ratio, 1.72; 95% CI, 1.05–2.83).5
The increased profile of mental disorders among DSP recipients may reflect shifts between payments within the welfare recipient population. Although this could be due to financial incentives to receive DSP rather than lower-paying allowances (eg, Newstart Allowance), the results may reflect that some income-support recipients with a mental disorder are unable to comply with the new activity or work requirements introduced by recent policy changes.6
Careful consideration is needed of the potential adverse unintended consequences of welfare reforms for the large number of income-support recipients with mental disorders. Changes that promote DSP as the most appropriate option for people with mental disorders risk entrenching their alienation from the workforce.
Acknowledgements
Peter Butterworth was supported by a National Health and Medical Research Council Career Development Fellowship (no. 525410).
References
- Dunlevy, S. Benefits tighten to get more working. The Australian 2011; 6 Apr. http://www.theaustralian.com.au/national-affairs/benefits-tighten-to-get-more-working/story-fn59niix-1226034353857 (accessed Jun 2011).
- Karvelas P. Julia Gillard told to overhaul welfare. The Australian 2010; 23 Dec. http://www.theaustralian.com.au/national-affairs/julia-gillard-told-to-overhaul-welfare/story-fn59niix-1225975206718 (accessed Jun 2011).
- Australian Government. Budget overview. Canberra: Australian Government, 2011. 0_i1095872
- Butterworth P, Burgess PM, Whiteford H. Examining welfare receipt and mental disorders after a decade of reform and prosperity: analysis of the 2007 National Survey of Mental Health and Wellbeing. Aust N Z J Psychiatry 2011; 45: 54-62. 0_i1095876
- Butterworth P. Estimating the prevalence of mental disorders among income support recipients: approach, validity and findings. Department of Family and Community Services Research Policy Paper Series. Canberra: Australian Government Department of Family and Community Services, 2003: 1-58. 0_i1095877
- Harmer J. Pension review background paper. Canberra: Australian Government Department of Families, Housing, Community Services and Indigenous Affairs, 2008. 0_i1095879