Brain Disorders Burden

Brain Disorders Burden

Mindgardens Neuroscience Network (Mindgardens) has commissioned a white paper on the burden of disease and cost of brain disorders in Australia.

The burden of all brain disorders in Australia accounted for 20.5% of disability adjusted life years, nearly twice the global figure of 11.1% illustrating the scale of the health care challenge. The white paper reports the disease burden associated with neurological, mental health and substance use disorders is in excess of $74 billion. Between 2010 and 2017 substance misuse (drugs, alcohol) grew at 24.7%, followed by neurological disorders at 15.6% and mental health disorders by 8.6%.

Formed in 2018, Mindgardens sought to determine the current burden of brain disorders in Australia, the associated costs and where innovation and collaboration could help build a new healthcare architecture for all Australians over the next ten years.

The white paper titled 'Review of the burden of disease for neurological, mental health and substance use disorders in Australia', highlights the economic costs associated with the rise in the spectrum of brain disorders – neurological, mental health and substance use disorders. Mental health disorders and suicide cost the nation over $33 billion each year.

Neurological disorders cost over $31 billion and substance use disorders almost $10 billion. Together brain disorders in Australia cost over $74 billion per annum and will shortly represent a greater cost to the Australian economy than heart disease, cancer, and respiratory disease combined.

"Our aim is to become an international leading precinct for innovative research and compassionate healthcare for all brain disorders" says Professor Peter Schofield AO, Interim Co-CEO of Mindgardens.

"We wanted to understand the current burden of disease and associated costs that arise from the spectrum of brain disorders - neurological, mental health and substance use disorders. With this knowledge, our focus, actions and solutions can be targeted to better understanding, treatment, cure and prevention of these great societal challenges," says Professor Schofield AO.

Working together the Australian Comprehensive Brain Disorder Centre plans to establish a new healthcare architecture using "Apex Clinics" that examine, simultaneously, the whole health of the person - from physical health, neurological, mental health and substance use and will encourage and support collaborative care approaches to ensure quality health care outcomes.

Says Prof Helen Christensen AO, "the approach to care must aim to review brain disorders in totality not in isolation. Often these disorders are connected and coexisting, they share brain mechanisms and behavioural patterns. We need to take a helicopter view that cuts across siloed' service provision, creating better and more comprehensive care.

This white paper combined with other recent reports (e.g. Investing to Save1) highlight how the national research agenda should be providing an evidence base from which new and improved interventions can be adopted. Workplace interventions, assertive support after a suicide attempt, and dementia support services, result in both economic returns on investment and positive health and wellbeing outcomes for individuals.

Mindgardens is based in Sydney, Australia and aims to become the Silicon Valley of brain disorder research and innovation where pilot programs can be developed and then rolled out nationally to support all Australians living with a brain disorder.

Key points
• This new white paper illustrates the magnitude of burden associated with the neurological, mental health and substance use disorders in Australia and the vast negative impact they have on patients, families, the community, health costs and lost national productivity.
• Globally, the burden of neurological, mental health and substance abuse disorders account for 11.1% of the total burden of disease, approximately half the Australian share which sits at 20.5% over the overall disease burden highlighting the relatively high burden of these disorders within Australia.
• In 2017, the burden of neurological, mental health and substance use disorders was nearly 1.2 million DALYs2 or 20.5%of Australia's total burden of disease. Compared to 2010, this figure has increased by 13.5%t from 1.04 million DALYs.
• The Australian cost of burden of disease has increased by 13.5%since 2010.
• In 2017, mental health disorders accounted for the highest burden of disease (46%), followed by neurological disorders (37%) and substance disorders (16%).
• Substance use disorders have the highest growth rate between 2010 and 2017 at 24.7%, followed by neurological disorders at 15.6% and mental disorders at 8.6%.
• The burden by disorders is disproportionality spread across age groups. For mental health and substance abuse disorders, the burden peaks early in life (before the age of 30), is maintained through middle age before tapering in later years, contrastingly neurological disorders which predominantly impact on later senior life.
• Mindgardens is focused on research-led and clinically tested solutions driven by patient and community involvement. Our white paper has clearly identified the enormity of the issue – but by working together with state and federal governments Mindgardens is developing innovative and technological solutions where new models of care can be scaled and rolled out across Australia.

Question: Why is Mindgardens important to all Australians?

Answer: Mental health, neurological and substance use disorders currently account for over 20% of the burden of disease in Australia. Our burden of brain disorders is almost double that of the global figures which is extremely concerning and calls for immediate action.

Question: What is the proposed new model of care?

Answer: The new model is built around an "integrated system of care" to address physical, mental health, drug and alcohol and neurological disorders concurrently. Linkage to community care hubs provides critical time sensitive patient information, to model individual support and therapeutic adjustments that deliver a complete 360-degree picture of the patient, needs and progress.

Question: What effective health interventions were identified in the white paper?

Answer: The white paper identified examples where high-quality evidence is available to support improved health care interventions that provide a positive return on investment (ROI). Mindgardens will implement these interventions in pilot programs to evaluate their impact in real-world clinical settings. Examples include;
- exercise therapy for neurological disorders which has an ROI of 3.9
- internet-based cognitive behavioural therapy (iCBT) which has an ROI of 2.1 for mental illness

The positive ROIs from these interventions suggest that, in the long-term, cost savings from the investment will make a comprehensive difference to prevalence and burden of disease.

Question: Why Sydney, Australia? – the statistics add up.

Answer: The Southern and Eastern areas of Sydney have some of the highest rates of suicide in the country. The national suicide rate is 12.6 per hundred thousand. In Randwick, the standardised rate was 20.3 in 2016. Within this local health district area, South Sydney has a rate of 18.6 and Waverley a rate of 25.4, more than twice that of Australia.

Question: What are the aims of Mindgardens?

Answer: Mindgardens aims to become the Silicon Valley of brain disorder research, using innovation and technological solutions to develop new models of care that can be developed and tested and then rolled out into trials using best practice hubs across Australia.