It was the title of the article that caught my eye.
“The mental health system caught my sister each time she fell but never saw her coming.”
The words told the story. They needed no explanation.
But what made me linger wasn’t only the tragedy of a beloved family member lost to suicide.
It was the deeper question being raised: why do we lack the systems to pick up the early warning signs that someone’s mental health is deteriorating – and act before they reach crisis point?
As the author Lucas Murrins Marques wrote, “we need systems to better sustain the conditions people need to live with meaning, connection and dignity.”
My reflection here being the same applies for all of our health and wellbeing.
We’re brilliant in a crisis
Our medical system is superb at managing the acute.
Appendicitis? We’ll operate now.
Heart attack? We’ll get you a stent and admit you to CCU.
Car accident? We’ll fix your broken bones.
Walk into any intensive care unit and you’ll notice the hum and beep of the equipment, the bright lights, and the doctors and nurses wholly focused on what needs to be done for the patient.
They do fantastic work, saving lives and restoring health.
But what about the people living with chronic disease that interferes with everyday life? And what about those living with recurrent mental illness, such as depression?
We need to recognise slow decline earlier
The author, a mental health researcher, calls for better recognition of the gradual erosion of wellbeing.
This is crucial – but our health system isn’t designed for it.
We’re reactive rather than proactive because the system was designed for acute care.
Or, we wait and see, to see if something truly is broken, rather than asking the harder question: “What does this person need to stay well?”
Sometimes it’s the person themselves who recognises they’re not quite their usual self, and uses the strategies they’ve learned through experience to stop the downward spiral.
Other times it’s family or close friends who spot the change and name it.
And sometimes the changes are so subtle they go unnoticed, or the person isn’t ready to admit something’s not right.
For lifestyle medicine practitioners and specialist GPs, this is where knowing your patient allows you to ask the better question:
“How are you… really?”
Three truths from 16 years in mental wellbeing
I’ve worked in the health and mental wellbeing space for more than 16 years, and along the way I’ve learned a few truths.
1. Mental wellbeing is always a work in progress.
It takes time, effort and consistency to maintain. There’s no free ticket to ride.
2. It’s easy to believe “I’ve beaten this.”
You may have recovered for now, but recurrence is common.
- After one episode of major depression, the risk of another is around 50%.
- After two episodes, it rises to 70%.
- After three, it’s around 90%.
- In anxiety, up to 58% of people will relapse.
- In schizophrenia and bipolar disorder, relapse rates reach 80–90%.
Two in five Australians will experience a mental disorder at some point in their lives. It can happen to anyone – and for many, it will happen more than once.
3. At work, the strongest protector of mental wellbeing is having someone to talk to.
That doesn’t have to be a counsellor, psychologist or EAP. It’s a buddy or a peer – someone you know well enough to trust with your thoughts.
That’s why the foundation of workplace wellbeing has to be a culture of care: a community where everyone pulls together and modelled by a leader unafraid to name the elephant in the room and talks openly about mental health.
Keeping mentally well beyond the GP clinic
Marques argues that healthcare, schools, workplaces, cities and social policy all share responsibility for tracking wellbeing over time, recognising its gradual erosion, and treating relationships, environments and everyday living conditions as central to mental health.
I agree.
At the recent #CEOVoiceSeries Forum, there was consensus on the need for more vulnerability, empathy and humanity in leadership to build a culture of care.
Leaders also recognised that a systems-driven, consultative approach is an effective way to make sure every voice is heard and the right action is taken.
Our mental health system is failing, and we deserve better.
As Professor Sam Harvey, Executive Director and Chief Scientist at the Black Dog Institute, says, it’s time for bold reform.
Tinkering around the edges and hoping things improve, without the systemic change needed for an integrated, properly funded mental health system, is taking us nowhere – except towards rising rates of mental ill-health and a growing burden of intentional self-harm.
Prevention is key
Prevention starts with evidence-based behavioural and environmental interventions built on the six pillars of lifestyle medicine:
- Healthy nutrition
- Physical activity and exercise
- Restorative sleep
- Effective stress management
- Social connection
- Avoiding risky behaviours such as smoking and excess alcohol
The RANZCP recognises lifestyle modification as a first-line approach that improves both mental and physical health, builds self-efficacy, and helps manage co-existing conditions such as type 2 diabetes and sleep disturbance.
As Dr Sam Manger sets out in his chapter on mental wellbeing in a new Cambridge University Press lifestyle medicine text, lifestyle medicine can both prevent and treat mental health disorders by addressing their biopsychosocial drivers.
Here, by building on what’s working well, rather than only fixing what’s broken it also offers a way to avoid over-prescribing and to promote holistic, non-drug approaches that empower individuals and communities.
Where to from here?
Better mental health won’t come from one program, one service or one prescription. It comes from all of us noticing earlier and acting sooner.
So, this week, I invite you to take one step:
- If you lead a team: open your next meeting by sharing one thing you do to look after your own mental wellbeing. Your openness gives others permission.
- If you’re a clinician: ask one patient the better question – “How are you… really?” – and explore one lifestyle pillar they could start with.
- For everyone: check in with someone you haven’t heard from in a while. A simple “I’ve been thinking about you” can matter more than you know.
What’s one thing your workplace or practice is doing to spot the early signs – before crisis hits? Share it in the comments so we can learn from each other.
If this article has raised concerns for you or someone you know, support is available 24/7 from Lifeline on 13 11 14 or Beyond Blue on 1300 22 4636.
References
Manger S. Chapter 9 – Mental Wellbeing. In: Pinder R, Harvey C-J, Fallows E (eds). Section 3 – The Lifestyle Medicine Pillars. Cambridge University Press; published online 1 May 2025.
Harvey S. Addressing Australia’s mental health crisis: time for bold reform. Black Dog Institute. blackdoginstitute.org.au
Link to article: https://lnkd.in/p/gBWS_qWr
