Caring for Australians after the pandemic

The issue of mental health is one that frontline emergency services agencies across Australia have become all too familiar with, and after the pandemic, government must do more to support them, Vernon White writes.

Australia’s mental health care landscape has changed significantly in recent years. While it had many advantages, from a community response perspective, deinstitutionalisation and the resulting movement into the community of people with severe mental illness that occurred in Australia in the 1990s has resulted in emergency services, particularly police, becoming the default first point of response for managing mental health crises.

Currently, police spend an enormous amount of time responding to callouts related to a mental health incidents. These calls were expected to dramatically increase during the pandemic response, and could become an even more serious concern as the country moves its policy focus to life after the pandemic, according to experts. They are warning governments that they must expect that the pandemic will cause significant trauma in the community, and will both greatly impact those already battling mental health problems and create new mental health issues for people who were heavily affected.

The Royal Australian College of General Practitioners (RACGP) Health of the Nation report identified that 65 per cent of all patients who see a general practitioner speak about their mental health, and in March 2020 Australia’s national crisis support service Lifeline advised that they have seen a 25 per cent increase in calls compared to the same time last year.

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Demand for mental health response services has been eating away at frontline service providers, medical and non-medical. In fact, a survey of 1200 general practitioners conducted by the RACGP identified that two in three doctors reported psychological issues as the most common ailment they now treated. The expected and occurring demand is a further difficulty for these stretched resources.

The challenge in Australia has historically been a lack of dedicated resources, as seen by the high number of mental health patients being seen by General Practitioners. Clearly, the impact of mental health on the healthcare system is already extreme, let alone prepared to take on the surge in demand that is sure to follow a pandemic.

The president of the RACGP, Harry Nespolon, argues that there are few places for those battling mental illness to go, and as a result the impact on general practitioners is great. We can as well see that that impact of COVID-19 is already further burdening this system and will get worse as we move through the stages of the pandemic and toward a post-pandemic world.

The data already shows that mental health calls often involve medical emergencies, rather than crimes, and usually do not require a police presence except to facilitate access to medical care. On top of this, the brutal reality is that the police have not been provided with the right tools or training for such interventions, and their response is often inadequate.

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The past, current and future state of mental health in Australia appears to be problematic from a response and access perspective to mental health professionals.

Both frontline non-medical professionals and medical facilities alike will see an exacerbated situation due to COVID-19, and they need more support to deal with this.

Recently, the Federal Government invested in a $74 million mental health package to expand telehealth services and fund crisis hotlines, and although this has seen an uptake by people in need, the actual number of people accessing mental health resources has declined according to the National Mental Health Commission.

This is a troubling sign, as direct access will need to increase to deal with increased demand after COVID-19.

The flattening of the pandemic curve has predominantly been successful from an Australian context, but the mental health impact of the pandemic will be significant, and frontline services are unprepared to deal with it and chronically under-resourced.

They are not able to deal even with current demand, let alone growing demand for mental health services. Some have called on the government to increase funding to frontline services the way it has with mainstream health care to allow for growth in mental health care programs. This could allow them to better ensure that the mental health of Australians is being given the same consideration as their physical health.

While flattening the curve has been fundamental to fight the current pandemic, there will also a need to mind the gap. That gap, which is the growing difference between demand for mental health care and access to that care, was already great before COVID-19, and experts are making the case that the pandemic will have serious mental health consequences, including a growth in suicide.

Any post-pandemic health strategy considered by Australia’s governments must consider frontline services and mental health. The government must respond to the increased need for mental health services, as well as other mainstream professional services. After all, Australia is trying to walk away from the pandemic as healthy as possible, and for that, the need for healthy minds couldn’t be more important.