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In this episode, we'll discuss the difference between mental health and mental illness and attempt to discover why people with disability are more likely to experience high levels of psychological distress than those without disability.

Our guests are Patrice O'Brien, Beyond Blue’s Chief Community Officer, and Danni Di Toro, six-time Paralympian representing Australia in both wheelchair tennis and table tennis. She's also won 10 Australian Open titles and a bunch of Grand Slam crowns.

Duration: 26 minutes
Release date: 23 September 2020
Produced by: Black Me Out Productions

Additional information

The Beyond Blue Support Service is available via phone 24/7 on 1300 22 4636 or via beyondblue.org.au/get-support for online chat (3PM – 12AM AEST or email responses within 24 hours).

The new Coronavirus Mental Wellbeing Service is available 24/7 at coronavirus.beyondblue.org.au. Its dedicated phone line, staffed by mental health professionals briefed on the pandemic response, is now open on 1800 512 348.

Beyond Blue's Podcast, 'Not Alone’, is a podcast where everyday Australians talk about their mental health journey to help you with yours.

Other links

Growing Bold and Mental Wellbeing

Pete and Tristram: Welcome to the Grow Bold with Disability podcast brought to you by Feros Care, a podcast dedicated to smashing stereotypes and talking about the things people with disability care about most. To help us live bolder, healthier, better connected lives. I'm journalist Pete Timbs and I'm Tristram Peters. I work for Disability Service Directory, Clickability, and am a wheelchair user living with spinal muscular atrophy.

PETE: Today's episode of Grow Bold with Disability is growing bold and mental health and our guests are Patrice O Brien, Beyond Blue’s Chief Community Officer, and Danni Di Toro, six-time Paralympian representing Australia in both wheelchair tennis and table tennis. And she's also won 10 Australian Open titles and a bunch of Grand Slam crowns.

In this episode, we'll discuss the difference between mental health and mental illness and attempt to discover why people with disability are more likely to experience high levels of psychological distress than those without disability. Patrice and Danni welcome to grow bold with disability.

PATRICE: Thanks so much for having us.

DANNI: Thanks for having us boys.

TRISTRAM: So, Patrice and Danni, before we start, let's get a little bit of background on both of you. First off, Danni, you are co-captain of the Australia Paralympic team, have represented Australia at the games at not one but two different sports, tennis and more recently table tennis, which is an incredible feat. Can you share a little bit of your story with us?

DANNI: Yeah, thanks. That just makes him sound super old. I am super old let's be fair. So, I kind of, you know, just typical, grew up as a kid down in the southeast suburbs in Victoria, heaps into sport. Really just across all stuff. Had an accident when I was 13. I had a brick wall faull on top me at a swimming carnival. It broke my spine and it put me in the spinal unit at the Aulston Hospital. And, you know, I've never met anyone in a wheelchair, never met anyone with a disability, and it was an interesting time. I was 13. And my family, there was a lot of the impacts across the whole community. But I was incredibly blessed to have Sandy Blythe as my Recreational Officer. For those who are kind of into sport he's a total legend within the community. But he was the Rec Officer there, and he just kind of showed me what's possible. You know, he led this incredible independent life and it changed, well I guess it allowed me to see what's possible, and to kind of reach for those things and myself and, you know, went on to do a lot of stuff within the sporting world, but also just really balanced that with work, particularly in community service and more recently, working within Paralympics Australia in a bit of a welfare role where we are just kind of supporting athletes work who are currently competing, as well as those who have retired to pretty much just get the best out of their every day.

PETE: Nice one. And Patrice you've been with Beyond Blue since I think 2014. Tell us a little bit about your role there and what Beyond Blue does?

PATRICE: Yeah, sure. So, yeah, that's right. I've been at Beyond Blue since 2014 and it's an incredible job. I can't really imagine what I'll do next. But for people who don't know Beyond Blue is a national not for profit organization and our vision is for all people in Australia to achieve their best possible mental health. So, we aim to really work closely with the community. To improve mental health and more importantly, to prevent suicide. And we do that by providing a range of tools and resources and support services to people across all the mental health continuums. So, from people who are doing really well and we want to keep people, you know, being well and thriving all the way through the people who are really struggling with their mental health and need some more support. My role is Chief Community Officer, which means that I oversee a whole range of our community programs. Both where we work directly with the community and then we've got programs focusing on people at work, people in education and people at home because, you know, mental health is everywhere that we are. So, across lots of exciting parts of what we do at Beyond Blue.

TRISTRAM: And Patricia, you mentioned mental health there. Broadly speaking, what is it exactly? What is mental health?

PATRICE: Yeah, great question. And I think this is one of the things that can be often really misunderstood because I think often when we use the term mental health, what people are trying to say is mental ill health. The way I like to look at it is Mental health is the same as physical health. And we all have mental health the same way that we all have physical health, and it exists, I just mentioned that continuum. It exists on a bit of a continuum. So mental health is really a state of wellness where we're able to, you know, really thrive and to be well. But sometimes we get that terminology confused and we say mental health when we mean we're not thriving. And we're not well, and we're not at our best. And when I talk about that continuum, it's like if you think about someone who's really mentally well, you can think about it as like a traffic light system, so they might be at the green end of the continuum and that's when you sort of really well on top of your game. You wake up in the morning and you're ready to face the day. You've had a good sleep. You're not getting any sort of negative thoughts intruding. And then if people aren't doing so well, they can gradually move into sort of the amber part of the continuum. And that might be where you're starting to have some sort of nagging doubts or some intrusive thoughts. You might be sort of questioning yourself a bit. You might find that you are kind of turning to alcohol or other drugs to get through. You're not managing to sleep as well. You're getting a bit disconnected from your community. And then it can move from there to the kind of red end of the continuum. And that's where people are becoming really unwell and really need some support.

PETE: So, what's the difference between mental health and mental illness?

PATRICE: So, with mental illness, it's again, if you use that physical health analogy, I think it really helps. So, you know, we can be really, we can have really good physical health. Um, but then if we have a really bad few weeks at work, and we've worked too much and, um, we haven't done enough exercise and we've fallen into a bit of a bad habit of getting Uber Eats every night, not eating the best diet, even though we're really mentally well, we can, you know? Sorry, we're really physically well, normally we can become unwell. So mental illnesses is the same kind of thing. So on that mental health continuum, um, when people actually get to a point where it's more than just that kind of moving up and down that continuum that we all do a little bit every day and when people actually have a diagnosable mental health condition, that's when it moves into mental illness and in terms of what that looks like. That's usually when some of these signs and symptoms persist for longer than four weeks and we can't shake it. And that's when we have to start to say, “Okay, hold on. Is there something a bit more going on here?” Is this not me just, you know, you're feeling a bit flat because of what's going on in my life, and is there actually something going on here that I need some treatment for?

TRISTRAM: Absolutely. And love the continuum there. That's a really great way to envisage it. And I'm in terms of ABS stats from 2019, it says that generally adults with disabilities more likely experience high or very high levels of psychological distress, than those without disability. Danni. Do you have any idea of why that might be? Why do we think this is?

DANNI: Well, I'm certainly not an expert in this field, but definitely the work that I do and the work that I've done on myself I think as humans, like each and every one of us, whether you've got a disability or not, we all want to be happy. We all want to be living a life that's free from suffering. And I think in order to do that, the things that we look for are things around purpose and community. And when you think about how we live purposeful, meaningful lives there's no doubt that people with disability that's a real challenge for so many within our community. And there's lots of barriers. There's lots of reason why those things become really problematic and you don't have to look too far. You know, our unemployment rates for people with disability are twice as high as anyone without a disability. Just generally such reduce choices for people living with a disability, and while they're around employment, there also around just getting amongst community like being able to access places. Um, lots of stuff. You know, when you talk about, gosh trauma, you know, I guess the Commission's kind of really shown that, like the rates of physical, sexual financial abuse for so many within our community, and that becomes a problem. There are so many things that so many people with disabilities are experiencing on a daily level that really impact this stuff and, you know, being active. They just came through with some of those results around people with a disability are amongst the least active within Australian community. And exercise is part of it, like I've used sport as a way to not just, like, improved my mental health, but to connect with community. And I'm not talking about everyone needing to get onto the Paralympic team, but being physically active and kind of having a group of people that you're able to connect with and knowing your own passion and knowing your purpose, like we all need a reason to set an alarm. And I think that's really important and there's lots of ways to do that. And when you don't have those capacities and you're not doing that I think that really starts to really impact in so many really challenging ways.

PETE: So, Danni, what about you? What are some of your experiences with mental health personally?

DANNI: It’s funny isn’t it? Like I kind of feel like as a person with a disability, there is this weird stigma like either like your life is, you are not able to live a meaningful life and questions around I could never do that or that's so bad. So, there's this extreme that your life has no value to then oh you just such a superhero because you've overcome so much. There are these like weird extremes. And so, I feel like as a young person dealing with a disability I kind of went through all those things and as an athlete, excelling in a ton of different areas that I've worked hard. But when I was struggling with mental health, when it was quite poor and I was finding myself being in states of anxiety and even panic attacks, when I spoke about those, it was like, well, surely that's not happening for you because you've overcome so much. And it's hard because that stigma kind of stops you from being able to empower yourself to reach out to the organizations and to your community and to the people that you know who can actually support you through those times. And I've had to work really hard to back myself, to knowing myself, to understand when those red flags in my own behaviour and my mental thoughts in my mind to kind of see them early enough so that I can kind of pick up on them and then being able to reach out earlier than I probably did when I was a kid and I didn't know how to do those things, and that Stigma is huge. So I've worked really hard on those things, and now I'm really grateful that I've got a great community around me that I'm able to speak to openly and honestly, even within my sporting team, like we’ve created a really beautiful team there that supports that vulnerability, allows you to be really honest and open about where you're at, so that we can all kind of grow from that experience. And that allows us to really reach for the best in ourselves. It's been a real journey, but I feel like I'm in a good place with it, even though those struggles are daily and we're constantly working on it. But at least I know I have the tools now.

TRISTRAM: For sure. And you touched on just then sport, community and purpose. This is you on your journey. What supporter is out there specifically for others with disability? Is it about finding those purposes themselves, or what organizations can assist them in that?

DANNI: Yeah, look, I think that's a real key isn't it? Like the purpose, you need to find your reason to set an alarm in the morning, and I think there's lots of, there's a lot of support in order to do that. And the role of the community, I think is a big one. Is knowing your passion and being able to, being empowered to go and explore that and whatever that is. You know, whether that's art education, advocacy, doggold parks, like sport, obviously is a part of it. But you know, when you're starting to look at places to support you in your mental health, I think that's a big problem. Is that there's not a lot of specialized services that kind of work with people with disability and certainly within our community what we're finding within our community, sporting community, we've kind of worked really hard to create people within that who have some lived experience either as someone with a disability kind of providing those services, um, or at least have experience with disability, and that's a big part of it. You do a bit of a look online, you can see that there's an organization called WellWays Australia and certainly they were the only one that I kind of found, that were actually doing work. That were working with mental health and people with disability out in the community. But there's not a lot of them, and I think that's a big part of the issue.

PETE: Patrice, back to you, you were talking earlier about some of the signs that people experience when they're getting poor mental health. If you see someone, and you think “oh he's drinking a bit more than normal” or he doesn't seem like himself, what can we do? Instead of just saying, “are you okay?” it's not sort of something where you can physically see they've cut themselves and suggest going to see a doctor if you try to get where I'm coming from?

PATRICE: Yeah, absolutely. And I think it's interesting with the R U OK because I’m really loving their latest ads. I don't know if you guys have seen them, but they're sort of saying, “what do you do if you ask someone are they OK and they say no?” And they're sort of picking up on, you know, at the moment with what we're going through with the pandemic and the impact that it's having on people's lives. You know whether it be people who was still in lock down and feeling isolated, or people who have lost their jobs or people who were feeling more anxious. It's about us all having the conversation, having the confidence to have the conversation if the answer to that R U OK question is no. But I think in terms of the practical things that people can do if they're looking out for someone around them, it is about picking up on, if it's someone you know well, it is about picking up on “do they seem different?” Does something not feel right? And then if that is the case, it's having the confidence to check in on them. And when you do that, you don't have to expect yourself to suddenly become a mental health expert. You just have to genuinely care for them, and you don't have to have all the answers. You just really need to approach the conversation with going and saying, “Hey listen, I've noticed you don't seem yourself lately. Do you want to have a chat about anything?” And all of the research that we've done with the community when people are struggling, what they mainly want is someone to listen and show that they care rather than having all of the answers. And then if people do start talking and it is really clear that they are struggling then there are supports and services that you can direct them towards and Beyond Blue is a great place to start. So, lots of our resources are available online and then we've also got our 24 hour a day, seven day a week support service. And just back to that point that Dan was making around what supports are available for people with disabilities from a mental health perspective. We try to ensure that all our supports that we provide at Beyond Blue are as accessible as possible. But we know we can always get better at that. So, part of what we really want to do is keep talking to people within the community and people with disabilities about how can we get this better? And that's one of the reasons we've got a partnership with Paralympics Australia, which is how Dan and I know each other. It’s a fantastic partnership. And part of the reason behind that is because we want to understand more about what this is like and how we can get our services and supports better and better so that they are as accessible as possible for people when they need them.

TRISTRAM: And you mentioned Paralympics Australia there. Danni in 2017 you were appointed the Athlete Engagement Wellbeing Officer and Vice Chairperson of the Athlete Commission. It's a really fascinating term “Wellbeing Officer”. What is it exactly? Why does our Paralympian Team need one/require one?

DANNI: Yeah, that's a great question. So, wellbeing for me is lots of things, you know it's our financial wellbeing, it’s our physical wellbeing, our mental wellbeing. Are we able to just be the best versions of ourselves on and off the field? And what does that look like? And certainly, within the sporting structure, there's a lot of awareness around these things, with a lot of athletes, but not necessarily with athletes with a disability. And for the most part, certainly in the past, in the last 21 years, those services have not been made available to athletes with disabilities. So there's a kind of an advocacy role within that which kind of brings to light, particularly with a lot of organizations who make the big decisions that when you start thinking about what welfare looks like, what wellbeing looks like to start really, considering athletes with a disability and not just in generally, but also some of the nuanced things that the challenges that athletes with disabilities and disability people, people with a disability in general experience. So there’s a lot of learning in that and part of that is around, it's educating the people that we are working with, the people that were training with, the people that we are in disabled communities with. But it's also, I guess, encouraging and supporting our athletes to start reaching out. And you know, each and every one of us live the life we live because so many people have come before us and done all of the incredible work to allow us to have the life we have. I think we all play a role in kind of pushing that forward. So, while it's encouraging athletes to reach out for the support, it's also encouraging athletes and people with a disability in general. And if you're not finding the thing that you need, start creating it. You know the thing about people with disabilities that we're awesome at adapting. Like we're awesome about finding ways to kind of make things work. Like put a box of chocolates on the bloody top cupboard and I’ll find a lot of ways to get that. I'm sitting in a wheelchair, but you know like, we’re legends at adapting. So, I think if you're not finding the thing that you need, it's important to go out and really advocate for yourself and for others. And I think that's the best thing we can do. You know you've got a meaningful life when you're when you're doing something that benefits yourself and other people. And we all have the capacity for that.

TRISTRAM: I find it interesting that you talk about adapting. If I drop a TV control and I struggled for 20 minutes to try and pick it up, reaching down from a power chair. If someone comes in and picks it up for me in the 20 minutes, I always tell them to put it back down because I'm going to find a way to do it. It's that innovation, is it? We want to do it ourselves, and we're going to adapt to find a way to do it.

DANNI: Yeah, 100%. And that's powerful. And as I'm getting older, I'm also appreciating the value in assistance as well. Like, you know, in independence is huge, and I think that's a very powerful thing when we can leave independent and richer and full lives. But I also didn't build my own wheelchair. I didn't build the house I live in. You know like, I appreciate that I in order for me to live a rich and independent life I also need to be able to rely on other people, and that's taking me a really long time to kind of appreciate that and really welcome that. But I'm grateful for that. So while I'll happily tell someone to sod off while I'm trying to get the box of biscuits at the top of the thing, if it's like way too high and I really can't do it, I'm like, oh my God, that would be great, if you could that be awesome. So, I know it's a little bit of that gratitude piece and bringing everyone along, you know, like I think that's a really important part of it.

PATRICE: And I think within that Dan, you know, bringing it back to the that sort of mental health perspective. I think kind of what you're talking about there. And when I talked about the mental health continuum before. You know what we all really aspire to is to be in that green kind of zone that I was talking about. You know, that's where we want to be, where we're feeling really mentally well and part of the way that we can strive to keep ourselves there is by creating those protective factors in our lives. So I think you know that thing that Dan's talking about about, you know, realizing when you do need to reach out and doing those things, like having a reason to set the alarm so that you've got something to get up for, knowing where you can go to check in on someone if you know you are having a bad run and having that community and that sense of purpose around you. All those things that give us great lives are also really huge protective factors for our mental health. So, I think part of the message around mental health is that, you know, take it proactively because prevention is always better if you can.

PETE: Yeah nice. Now ladies, our podcast is called Grow Bold with Disability, and we are kind of touching on that a little bit. But we do like to ask all our guests what growing bold means to them and Patrice I'm going to get you to start.

PATRICE: Sure. I really liked this question. So, I think for me the only way to truly grow is to be bold. And to really take on and embrace challenges and opportunities when they come your way. And I think to truly realise the greatest learnings sometimes we have to go through the greatest challenges. In my life, I don't have a disability, but I have been faced with some really big challenges that life has thrown at me along the way, as life tends to do. And what I've often land in hindsight is that the most difficult times in my life have actually provided me with the greatest opportunity for growth. And so, it is that boldness to be open to the opportunity that's important. And I think that's not always easy but it's part of the key to living a great life.

PETE: Nice.

TRISTRAM: Beautiful

PETE: And Danni?

DANNI: Growing bold, that's such a great one. I feel like I work to that every day, to be really honest. And I guess currently it is table tennis is where I'm doing that. I had a career in wheelchair tennis for 30 years, and when I started playing table tennis, the common thought that and people were saying it straight out to me was that I was too old and um and I was too set in a tennis mode to be able to really take this sport on. And of course, I love hearing stuff like that!

PETE: Challenge

DANNI: That stuff just fuels me. But it was more than that. You know, it's being able to take on something that is very different and requires you to almost rewire your brain is really a massive challenge. If you feel like you're not doing stuff well, and that's a horrible feeling. Being comfortable with being uncomfortable was a really massive part of that. And that's a boldness to be able to do that for me. And right now I'm really what I'm exploring is being OK with making mistakes, being okay with learning stuff and not getting it right the first time and being okay, exploring the different parts of me and being open to what that might look like. And it's presenting some really different scenarios, things that I could never have imagined. But if I was listening to all of those people saying that stuff and I was gonna limit myself to who I have been and not be prepared to just explore what I could be and what I would like to be then I'd kind of still be pretty much stuck where I was. So, you know, being bold for me is about exploring the new stuff and really very much being comfortable with the uncomfortability and seeing what comes from that because there’s some pretty exciting things there.

PETE: Fantastic. That was great. Now, ladies, thank you so much for being part of this amazing podcast. And of course, people get more information about Beyond Blue and about our Paralympian team in today's show notes. Danni and Patrice. Thank you so much. That was fantastic today.

DANNI: Thanks lads. Awesome to chat to you all.

PATRICE: Thank heaps.

TRISTRAM: Cheers.

PETE: This podcast is brought to you by Feros Care, an NDIS partner delivering local area coordination services in Queensland, South Australia, and the Australia Capital Territory. Feros Care is a people care organization committed to helping people leave bolder lives. We call it growing bold and for over 25 years Feros has been making it real for both older Australians and those living with disability. To find out more head to Feroscare.com.au

The content and views discussed in this podcast series are those of the individuals involved. They are not necessarily condoned by, or, are the views of Feros Care or its employees. 

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Patrice O'Brien & Danni Di Toro