The COVID-19 pandemic is forcing us to re-evaluate our response to mental health as the incidence of stress, anxiety and depression increases exponentially.
The World Health Organization foreshadowed the rise in the number of mental health problems due to the global pandemic. They could see that the increasing number of infections and uncertainty would induce substantial fear and concern.
Not all governments responded appropriately, often downplaying the crisis and adopting a haphazard approach to controlling the spread of the virus. Their ineptitude did little to inspire confidence and their people were forced to endure widespread infections, soaring death rates and overwhelmed health systems.
Some governments were more vigilant, imposing strong restrictive measures to avoid COVID-19 infection. Nationwide lockdowns were a preferred strategy leading to lack of physical contact with other family members and friends, loneliness, job loss, financial breakdown, and in some instances, reduced access to health care services.
Coping with the effects of the COVID-19 pandemic has been emotionally challenging, especially for vulnerable individuals with underlying mental illness and low socio-economic status.
Here in the state of Victoria, Australia, we are enduring our sixth lockdown. The social dislocation and economic upheaval have decimated some sectors of the economy. The tourism industry and the Arts have been hit hard while many small businesses have closed their doors.
The lockdown restrictions are severe, limiting movement, social contact, exercise, and conducting business. There are exceptions with essential services being prioritized.
It is evident that people are growing weary. Some through overwork, but for many it is negotiating lockdown. The loss of personal freedoms, the demands for compliance with testing, vaccinations, QR codes, and quarantining have redefined our priorities and reshaped our lives in ways we could not have imagined.
The constant messaging about infections, numbers in hospital and ICU, daily deaths, and detailed explanations as to why the lockdown cannot be eased are numbing, producing feelings of resignation and despair.
The following quotes attributed to Dan Andrews, the Premier of Victoria reflect the harsh and uncompromising approach adopted by many political leaders.
“Extreme measures will be taken when there is a significant number of transmissions of the disease within Victoria.”
“The disruption will be significant, it will hurt our economy, it will inconvenience many, many people.”
“There might be more cases than we know about – if we wait for that to be proven correct, it will be too late.”
“I am confident that this short, sharp circuit breaker will be effective. We will be able to smother this.”
“Victorians are well acquainted with this. We’ve done this before.”
What has often been missing in the public announcements is hope. Where is the hope for people who have lost their jobs, for businesses who have had to shut down, for children who are unable to go to school, for young people who are unable to complete their training, for people in nursing homes who are denied visitors, for couples who want to celebrate their marriage with friends and family, for medical staff who are exhausted, for musicians who want to perform.
People are losing hope. It is understandable given the circumstances. We have been living with the pandemic for eighteen months and there is no clear end in sight. The uncertainty and the unknowns have been dragging on for too long and we are tired. Hopeful people are confident in their belief that there is the possibility of a better future.
In ‘The Comfort Book’ compiled by author and mental health advocate Matt Haig, there are a collection of thoughts and sayings which have helped him through hard times. Haig stands by hope. He says,
The mental health effects of the COVID-19 pandemic are profound. Some experts are suggesting suicide rates will rise. Whilst researchers have found this to be true in resource limited countries like Nepal and Bangladesh, where poor economic status is compounded by inadequate welfare support there are early indications that suicide rates in more prosperous countries will largely stay the same.
Dr Cathy Andronis, the current chair of the RACGP Special interest group in psychological medicine, believes that in Australia early government interventions may have helped, as well as the way people responded. She points out,
- The homeless were housed – that would have led to less suicides, as homelessness is a risk factor for suicide
- The Federal Government’s JobSeeker supplement and JobKeeper wage subsidy scheme provided generous support to people who had lost their jobs. It would have made a big difference given the association between the risk of dying by suicide and poorer socioeconomic outcomes.
- People rallied together, providing help to the vulnerable and disadvantaged
However, these are challenging and unprecedented times. We may be certain the full effects of this crisis have not played out. The pandemic will cause distress and leave many people vulnerable to mental health problems and suicidal behaviour. Mental health consequences are likely to be present for longer and peak later than the actual pandemic.
New data from the Australian Institute of Health and Welfare gives an insight into exactly how the pandemic has affected the mental health of Australians.
Figures from the AIHW’s National Suicide and Self-Harm Monitoring System show more people are using crisis lines like Lifeline and other mental health services since the crisis began. Lifeline typically receives 2500 calls a day but during COVID-19 it has reached 3200. Initial concerns related to catching the virus and dying. Now callers are anxious about regaining employment and surviving financially when the worst is over.
Suicide is described by some as a silent pandemic. It is the leading cause of death for Australians aged between 15 and 44. Unlike the pandemic there is no possibility of it ever going away.
Comparing COVID-19 deaths with the current rates of suicide does raise some difficult questions about our response to crises.
In March 2020 Australia recorded its first COVID-19 related death. Early September 2021, eighteen months later, the total deaths had risen to 1044. Most deaths were people over the age of 70. The total deaths attributed to COVID-19 equates to an average of 58 deaths per month.
The number of suicide deaths recorded in 2019, was the highest in Australia, growing from 3093 in 2015, to 3318 in 2019, of which 75% (2502) were men. Suicide Prevention Australia chief executive officer Nieves Murray said,
“There have never been more lives lost to suicide in this country.”
The total number of suicides equates to an average of 276 deaths a month.
Some would argue that our response to the COVID-19 crisis has been disproportionate, that the costs outweigh the benefits.
Mental health advocates fear a surge in suicides. They implore governments to remain vigilant and be poised to respond if the situation changes as the longer-term mental health and economic effects of the pandemic unfold.
The consequences of the pandemic and lockdown on socioeconomic, mental health and other aspects of society are immense. These alarming conditions may exacerbate the suicide rate, particularly among young people who are disproportionately affected by the COVID-19 pandemic.
Professor Ian Hickie, from the Brain and Mind Centre says,
“We already know that rates of psychological distress are markedly increased. And rates of suicidal ideation have also gone up.
We know what factors lead to suicide, particularly in young people. They are anxiety, depression, unemployment, and social dislocation in education and training, and they are widely distributed throughout the community.”
Suicide is like a virus, he says, it operates in clusters and in places. Regional areas are particularly at risk, where there is high unemployment and a lack of targeted mental health services.