Telehealth service Pilot last week took a swing at mental health awareness initiative RU OK?, claiming Thursday’s event was all about talk when what’s needed is action.
Pilot, which focuses on men’s health issues, combined some fighting words on its website with large billboards, using R U OK’s corporate branding and positioned at an airport and a beachside location. The billboard action was designed to coincide with the flagship annual event R U OK? Day.
“No, we’re not OK,” the billboard text shouted. “Every day Australia loses 7 blokes to suicide. Keep your cupcakes, it’s time for action.” Pilot included its website URL below the main text.
The group’s delivery of this message has had both its critics and its supporters.
“This hugely misses the mark in so many ways,” Tori Edwards of free legal service provider Justice Connect said on LinkedIn. “If you [Pilot] were genuinely concerned with the cause, and not the promotion of another commercial brand, there are so many other things you could do.
“This also ignores the numerous pieces of research that support the fact that speaking about suicide helps people reach out before a point of crisis. Not to mention: whoever suggested that crisis support and early intervention are mutually exclusive?”
However, Dr Rod Gutierrez, a psychologist and emergency medicine RMO, said calling for less talk and more action was the right strategy.
“It’s well established that the issue is not with awareness,” Dr Gutierrez said. “Far from it – we’ve never been more aware of our mental health and that of those around us.
“With access to mental health services in primary care reserved for the most acutely ill, the majority of people with a mental health condition are left to navigate their own care through their GP, and to find specialist assistance via a psychologist which is hard at best. This is the crisis we must talk about.
“When we discharge patients presenting to ED to ‘community care’ because their suicidal ideation is not acute enough, this is the crisis.”
But most commentators reflected a middle ground.
“It’s not an either or,” Professor Sam Harvey, executive director and chief scientist at the Black Dog Institute told Wild Health. “I would agree we have passed the time when talk by itself is enough. It is only justifiable to keep on going after that message of encouraging people to get help if at the same time we’re taking action to make sure we’ve got a mental health system that can support these people.
“The number one priority has to be helping people who need help today, whether it be by calling Lifeline or presenting to their GP for treatment of their anxiety or their depression. Alongside that, we are at a point where we can begin to try and prevent some people becoming overwhelmed. We have to be able to walk and chew gum at the same time.”
On the website, Pilot outlined its case for early intervention in mental health cases – taking a swipe at Australia’s two most respected helplines in the process.
“As a nation, we’re more aware of the mental health problems facing Aussie men than ever before,” Pilot said. “Awareness isn’t the problem. The lack of focus on early intervention, as opposed to critical response, means that blokes have limited tools and knowledge of how to get their head right before things get out of hand.
“RU OK? Day is a good start, but we’ve known the answer for years – no amount of corporate breakfasts and branded cupcakes can make a bad day better, or instigate real, tangible change for men in need of better care.”
The GPs who provide the Pilot service consult and prescribe treatments for erectile dysfunction, premature ejaculation, hair loss and weight loss, as well as mental health. Patients complete an online form, pay a $20 consultation fee, and should expect to hear back from the GP within 24 hours.
Treatments are delivered direct to the patient’s door.
Pilot said GPs will only consult with a patient if they believe telehealth is appropriate for them, and have the option to recommend they see another GP face-to-face.
However, the organisation’s treatment plans appear to focus on pharmaceutical treatments, which aren’t sold at PBS prices, rather than on counselling, with links to product purchase pages found on the “What we treat” web page.
The consultation and business model are not dissimilar to those of Midnight Health in which NIB purchased a majority stake last month, following a $12 million investment.
Pilot founder Charlie Gearside denied the billboards were a marketing initiative to promote its own brand and products, or devalue the services of other mental health organisations, such as Lifeline.
“This is not a criticism of those organisations and they’ve played an important role in the past,” Mr Gearside said. “We are pushing the idea of early intervention and a lot of the funding and a lot of support mechanisms are in place for when people are experiencing their lowest lows.
“Awareness is great, but it’s our view that it’s time for more tangible solutions. I guess it felt like we had to enter the conversation and say something.”
Mr Gearside said Pilot’s “long term” goal was to be more active in mental health and have more patients taking their GP referrals to Commonwealth-supported mental health plans – whether from Pilot’s telehealth GPs or from community based practitioners.
And while the general practice community has frequently raised concerns that online approaches risk missing crucial diagnostic details, the telehealth environment still offers an attractive and flexible alternative to some GPs.
The group’s GPs work independently and are not employed directly by Pilot.
“In Australia, huge sums of public money are dished out every year to crisis support services such as Lifeline and Beyond Blue,” Pilot said on its site. “You wouldn’t wait until a cancer is in its final stages to act, so why do we place so much emphasis on these services that do nothing to address and ameliorate mental health concerns in their earliest stages?”
While the organisation has attacked R U OK’s urging people to talk to people if they consider they might be having problems, earlier this year Pilot donated $120,000 to the free phone counselling service, This is a Conversation Starter (TIACS). Pilot branded TIACS an “early intervention service”.
For out of hours support, TIACS recommends calling Lifeline.
“Going to the doctor for a physical check-up before you get sick is encouraged,” Pilot said. “Let’s normalise talking about our mental health in the same way.”
Which sounds a lot like what R U OK Day is about.