Research released this week has tracked a marked increase in severe psychological stress among Australians during the COVID-19 pandemic.
Mental health experts argue flattening the curve of mental health-related deaths is just as important as flattening the curve of the coronavirus — however rhetoric surrounding COVID-19 deaths versus post-pandemic mental health deaths is starkly different.
COVID-19 modelling by Melbourne University’s Doherty Institute has been described by Prime Minister Scott Morrison as “a useful tool” to “inform Australian governments”, whereas mental health impact and suicide modelling by Sydney University’s Brain and Mind Centre has been called “unwarranted” by recently-appointed deputy chief medical officer for mental health Ruth Vine.
Those behind the mental health modelling have called the government’s approach dismissive — though others warn the rhetoric around suicide could be harmful.
An extra strain
Research from ANU found that between February and April the amount of 18 to 24 year olds experiencing severe psychological stress increased from 14% to 22.3%. For 25 to 34 year olds, the figure climbed from 11.5% to 18%.
Mental health hotlines have seen a spike in calls, with a four-fold increase in people contacting Beyond Blue.
Meanwhile, modelling from Sydney University has found there may be a 25 to 50% increase in suicide — up to 1500 additional deaths annually — disproportionately affecting young people.
But modelling by the same team also shows holistic intervention in mental health services could reduce this number by 8 to 10%.
Co-director of the Brain and Mind Centre Ian Hickie told Crikey the same commitment to the economy and the population’s physical health was not being applied to mental health.
“We have very strong dynamic statistical models, we have historical evidence,” he said. “Systems were heading in the wrong direction even before COVID-19.”
Inadequate investment
The federal government has announced $48.1 million in additional funding for the National Mental Health and Wellbeing Pandemic Response Plan.
$10.4 million of this is going toward a national “it’s okay to not be okay” awareness campaign, $7.3 million toward research and data collection, and $29.5 million toward reaching out to vulnerable groups.
But, Hickie argued, these grants do little to bolster mental health services on the ground. “What’s the point in making people aware they need help when just one in six people with depression get effective treatment?” he said.
“We need specialised care outside hospitals, we need aftercare, team-based supports, and IT-coordinated, digital support program care.”
Instead of investing in research and campaigns, Hickie argues the government should purchase private hospital services for mental health, as it did in preparation for COVID-19.
“Flattening the coronavirus curve was about not having the health system overwhelmed,” he said. “How is death from suicide different from death from COVID-19 if it has the same preceding factors?”
Language matters
Senior Research Fellow at Melbourne University’s School of Population and Global Health Dr Gregory Armstrong told Crikey some of the media coverage on mental health impacts had been concerning.
“Coverage has frequently used sensational terminology like epidemic, surge, tsunami, when we could simply be talking about our legitimate concerns regarding suicide rates,” he said.
Armstrong warned using sensationalist imagery heighten fears, but also risks normalising suicide. He said it was a particular risk if it is linked to a single cause people can identify with, such as unemployment.
“The coverage has often presented increases in suicides as somewhat inevitable, which strikes me as an unhelpful message to send to people in the community who may themselves be in distress. The outcomes here are far from predictable and suicide is never inevitable,” he said.
Professor Nicholas Procter, leader of the Mental Health and Suicide Prevention Research Group at the University of South Australia, told Crikey language matters when it comes to mental health.
“In suicide prevention, advocates say we have to be cautious around the use of language because it can be triggering to vulnerable groups who don’t have the same protective barriers others have,” he said.
Vulnerable groups, including people who have survived trauma or experience mental illness, can have two reactions to discussions of suicide, he said.
“You can have an unwanted contagion effect or a Papageno effect,” he said. In the contagion effect, a word or topic can act as a negative trigger, whereas with the Papageno effect, having dialogue out in the open can serve as a positive trigger, normalising the issue and prompting a person to get help.
The evidence around what causes which response is mixed, Procter said. “We don’t know for sure … it’s an important discussion we have to have and as we progress, we have to find a common ground and have experts come together.”
For anyone seeking help, Lifeline is on 13 11 14 and Beyond Blue is 1300 22 4636.
What pisses me of is that in talking about suicide nobody even talks about the group that has the highest rate of suicide, the over 85 yo men.
I know, like all issues affecting older people there is an acceptance that we are going to die soon anyrate so why get upset that old men top themselves, so it is easy for the government to cut funds from aged care so that some 16000 approved aged person die each year Waiting for care and that probably includes a most of the men’s suicides.
From my work over 25 year with the unemployed this is the main cause of suicide as the last of care is for aged people
Thanks for this comment frank. I never knew about this. Times are very different from the old institution days but now we have far too little in patient care for our most ill psychotics.
Suicide is quite a different thing to covid. The cause of covid is a virus every time. The cause of each suicide is its own sad series of events and afflictions.
I totally agree Frank,I wonder if you heard psychologist Sara Edeleman talking on ABC Nightline last night (1/6) about life without children & decisions people make wh affects them life long.She mentioned many people r advised by others to have children otherwise who will look after them when they are older.She mentioned studies into happiness @ diff life stages, with or without children & mentioned high depression rate in older single men. I knew about it as worked as a social worker.care manager in Community care packages at Prahran Mission ( alot of single older men on program then in area 1994-1998)& 12 yrs Eastern suburbs.Listening to Sara last night triggered same thought that older cohort of single men seem forgotten in suicide domain.I will never forget trying to engage a depressed man with severe depression & arrived for my 2nd visit to find him in situation of having taken his own life. Social connection so impt Thats why the demise of local village shopping hubs/pubs is very worrying as they are like the old Greek “agoras” where everyone single or coupled could connect & feel valued. We need to show our older people they are valued esp since longevity is increasing with better health interventions. The wait list for community aged packages appalling. As a care manager, I found many old single lonely men got as great a benefit from having someone having regular social contact with them as much as the direct practical help partic if they needed hospitalisation at any stage. My kids got used to me having clients pjs etc on our clothes line when one of my clients was admitted to hospital
Morrison the Moron like the Desiccated Coconut, Abbot and Furball , sees every issue through the lens of the economic impact on his fellow travellers, the business class.
Suicides have little impact on them as a group and so suicides are ignored.
Remember him saying if schools were closed to protect against Sars-Cov 2 transmission the kids wouldn’t go back this year. Well as usual he was completely wrong as was his incompetent government on the amount the “Job Keepers” allowance would cost.
He’s not said much about this as it was his equally incompetent mates in small business and their accountants who couldn’t fill out the ATO forms correctly. It wouldn’t do to point out their incompetence as they are his main constituency.
He’s ratcheting up for Work Choices III and will also be boning up on the “we have to pay back the Covid 19 debt” story where he will increase the GST rate and persecute the unemployed and under-employed as his government has done in the past.
“But modelling by the same team also shows holistic intervention in mental health services could reduce this number by 8 to 10%.”
As an aside, but not really an aside, according to the Daily Nexus is the mysterious deaths of many holistic healers in the US. At one point it was 11 dead in 11 days. Most by “suicide” but many others under absolute bizarre circumstances. According to another source it is 60 dead in the course of a year.
The word is too much competition with the pharmas and the growth of holistic healing as a bonafide alternative to modern western medicine.
Of course their opposition to vaccines, chemotherapy, radiology etc has nothing to do with it.
I’m sure the “holistic intervention mentioned for mental health is quite different from the “holistic healing” spoken of in the context of the USA news.
Why? Anything “holistic” in medicine is obviously not “traditional.” Since when is there a separation between the psychological and the physical when it comes to healing?…no context needed.
John, in the book of Revelation describes some of the unrepentant as those who commit murder, dabble in the magic arts and are involved in thievery.
The Greek word “pharmakon” (a spell-giving drug or potion) is a much better translation than magic arts. Obviously this is where we get the English translation of “pharmacy”.
According to John, who ever owns or controls these “pharmakons” is capable of murder. Murder, pharmakon and thieving all in the one sentence.
It must be a coincidence that Big Pharma is the central point of the industrial medical health complex. There is no financial return in healing you but there’s rivers of gold in treating you.
The last thing Big Pharma needs is some upstart holistic healer healing you.
Thank you Amber and Crikey for being the only media outlet prepared to scrutinise the issue of Professor Ian Hickie of the Brain and Mind Institute releasing alarming predictions about the rate of increase of suicides post Covid. From early May he appeared on many ABC programs,& SBS and was interviewed by the Australian newspaper , syndicated to regional areas, covered by Australian Doctor newsletter and the Guardian newspaper online to announce modelling done by the Institute of which he is Co-Director. With certainty & authority in his presentation, he predicted, as you say in your article, the best case scenario of 25 % increase in suicide, worst case 50 % with disproportionately youth being affected. He painted the picture that this outcome was going to inevitable with the potential to scare the living daylights ie heighten anxiety further in the community at a time when uncertainty and anxiety was already widespread. A number of my ex social work colleagues and friends also felt the same way using terms like “normalising “suicide .
He basically linked the increase in suicide rate due to unemployment rates. He told Stephanie Dalzell of ABC on May 14, that if the Govt introduced certain measures recommended by his team to improve mental health services & unemployment was only 15 %, ,the post pandemic suicide rate could be “halved”. However by the time of your interview with him in late May he had moderated his predictions of reduction in rate to 8-10%. Now I donot have the research qualifications or the high profile and standing in the mental health field of Prof Hickie but firstly this shows inconsistency but I also find it hard to accept how anyone can claim to prevent 50 % of predicted suicide deaths on the basis of modelling on proposed initiatives that havenot yet been introduced.
How can you measure such a dramatic outcome of interventions that have not been introduced.? Furthermore it is acknowledged globally that prediction of suicide is very difficult (see work of Matthew F Nock at Harvard University)
Drawing parallels with Covid modelling seems questionable. Covid is an identifiable virus.Suicide is a much under explored area, a very individual event and whilst a lot is known about the multitude of factors that can contribute to someone taking their own life, there are lots of uncertainties regrettably. The modelling used for Covid was based on overseas experience used quickly without factoring in contextual factors applying to Australia eg our remote location. low density living, low population, unknown of behavioural compliance of public to imposed restrictions. It seems since publication of your article Prof Hickie is now defining his modelling by “place based” which he failed to clarify in so many media appearances. It has emerged that the modelling used for his predictions came from areas of Australia ( northern NSW&coastal areas)where there are already higher rates of suicide.
It is concerning that at a time when “we are all in this together” that leading mental health professionals like Prof Hickie were quick to express criticism of newly appointed Dr Ruth Vine , Deputy Mental Health officer singling out one word “unwarranted” in her response to a question about Prof Hickie’s numerous sustained media interviews about his modelling and his alarming predictions. I watched Dr Vine’s response and for the record she said “Suicide is multifactored and hard to predict. when any modelling is done you have to know what assumptions are built in to that modelling and what particular groups are vulnerable . I think that making statements about likely to be an increase is unwarranted” . It was my interpretation that Dr Vine was trying to be more measured and allay heightened fears of a epidemic /surge of suicides. My take was that she thought it was”unwarranted” for figures like a 25- 50 % increase in suicide rate to be in the public arena repetitiously via the media without knowing more about the details of the modelling. The fact that Prof Hickie has now qualified his modelling as being “place based” and shared more information about the areas of Australia investigated there is more information for the public available.My research in to interviews with experts in suicide prevention both in the United Kingdom and the United States during Covid have shown that they think it is too early to make predictions re suicide rate trajectory and use words like “uncertain”
The issue of careful media coverage of suicide and suicide prevention is recognised by the fact that Mindframe government funded agency exists which has written and on line education for journalists communication professionals and so on . It is recognised that public awareness of the complex issue of suicide is important and no longer the taboo subject it once was but as both Mr Gregory Armstrong and Professor Nicholas Proctor commented that the way the issue is covered can have harmful impacts.
Thank you once again Amber for your excellent and insightful coverage of some of the many Australians who every day push on through with their serious emotional & mental pain. It is so impt the public donot see mental health as the “too hard basket” I know as a former community care case manager I used to advocate strongly for individuals with mental health disability to be as eligible for our programs as people with neurological/physical disabilities. A huge barrier was always this view that mental illness is not a chronic disease but “episodic” I know this “comment” is very long but I am an attention to detail person, committed to transparency and advocacy
& be fearless not intimidated by people in positions of power . I have a 30 yr social work career, and considerable long lived insight in the mental health field.