Two psychologists have described the profound effects that COVID-19 has had not only on the mental health of Australians, but on the way that services are delivered and accessed nationally.

“COVID-19 has been a bit of a game changer for us”, Ms Tamara Cavenett, psychologist and president of the Australian Psychological Society, told HealthTimes. 

“We came from not really understanding telehealth and not working digitally. We were very used to pen and paper, and the old school way of consult rooms with one-to-one appointments. And in a space of a week, we jumped into the digital well and were completely out of our depth at first.”

“Around 94% of psychologists are now offering or have used telehealth, which is really fabulous. So, it's allowed us to offer services to people we wouldn't have before and that's probably been the biggest change for me.”

“I can now support mums who, for whatever reason, couldn't leave home before. I am able to see people on their lunch breaks at work, and people who are living at a distance and can’t travel.”

“Telehealth has really been a lifeline. So that's probably the single biggest challenge to our practice and it’s really, I guess, created an allowance for us to service people in a new way and more conveniently.”

Ms Cavenett said that while the pandemic had triggered a mental health emergency, it did not happen in isolation and trends were already on the increase.

“We’ve got to remember that the global pandemic was on the rise right after we had that horrific bushfire season, which I think a lot of people have forgotten.”

“With COVID-19 coming at the tail end of those bushfires, it’s never been clearer to Australians that mental health care is essential, but it's caused an increase in demand that we’ve not necessarily had to deal with before.”

“We know that a common consequence of these outbreaks is anxiety, panic symptoms, depression, a lot of anger and irritability.”

“A lot of the Melbourne people in particular have mentioned anger and confusion, and uncertainty, a lot of financial stress, and people putting off decisions that they might have otherwise made”, Ms Cavenett explained.

Ms Emily Upton, clinical psychologist and research officer for the National Drug and Alcohol Research Centre, UNSW Sydney, said that the pandemic had hit young Australians particularly hard.

“We’ve seen evidence for this in our recently published study, which used longitudinal data to track symptoms of anxiety and depression in young adults from around Australia before and during the lockdown last year, and found a significant increase over that time”, she told HealthTimes.

“What I’ve seen is that a lot of [young] people who may have had an underlying vulnerability to anxiety or depression – or pre-existing difficulties – have frequently had these exacerbated by the circumstances surrounding the pandemic.”

“For example, a greater sense of worry and anxiety around the uncertainty of the year; increased vulnerability to anxiety and depression due to social isolation and separation from loved ones and support systems; stress arising from difficulties creating boundaries around work/life balance and increased work demands due to working from home.”

“The switch to completing school work from home and the loss of routine, academic support, and social contact also seemed to have a big impact on adolescents last year, with many still experiencing mental health difficulties triggered during that time”, Ms Upton said.

Ms Cavenett agreed, adding that “the biggest thing that people are saying is that they basically were already feeling some of these things before COVID-19, and now it's even worse.”

“So, there’s been an increase in anxiety, depression, and post-traumatic stress since the pandemic began and it's worse for those who had a pre-existing mental health issue.”

“But it’s important to remember that we've also seen some of these psychological symptoms and distress in those without any history of mental illness. And that's probably somewhat due to unemployment or financial stress having made things worse.”

Both psychologists agreed that the pandemic had exposed problems in our mental health care system, but also new opportunities.

“It’s exposed holes that we already knew were there”, said Ms Cavenett.

“We’ve long since known that we were getting a rise in demand across the entire sector and that it was outstripping the supply of services – this has just ramped right up during the last year”, she explained.

“This was highlighted by the Victorian Royal Commission, and although it was only looking at Victoria, it could be echoed in most states. And they didn't mince words with their report.”

“They outlined a system that was operating in a crisis mode, where demand had long since overtaken the capacity of the system.”

Ms Upton echoed these sentiments, adding that “I think the increased demand we’ve seen for mental health care has shown that we need more affordable and accessible mental health services for Australians broadly, and for young people.”

“The provision of temporary additional Medicare items has meant people can access Medicare rebates for ten further sessions of psychological treatment per calendar year, as well as for telehealth treatment, which has been very sorely needed and meant many people have been able to continue to receive much-needed treatment”, she said.

“However, I think the long wait times for psychological treatment a lot of people are experiencing show that our existing systems are not meeting the demand.”

“There is a very high demand on free, community-based services with long wait times, so it would be great to see more funding directed into these community services rather than relying on the private sector to meet the demands for mental health care.”

Ms Upton added that COVID-19 has also placed a much-needed spotlight on mental health.

“In some ways, I think it’s great that mental health has been brought into everyday conversations.”

“I think we’ve seen a big reduction in stigma around seeking help for mental health; this normalisation and de-stigmatisation I think has helped many people feel more comfortable reaching out for support”, Ms Upton said.

“And the other plus is that it’s made the issue so much more obvious and harder to ignore”, Ms Cavenett added.

“The government has clearly done a record budget for mental health. and Victoria as a state has also matched that.”

“We’ve not yet seen that in other states. So, it will be very interesting to say how this ends up playing out in terms of whether or not everyone's going to start to work together to actually figure out what the gaps are in services and how to work on those connections, and that hasn't happened yet.”