Concerns are growing that people needing mental health support are not reaching out for help amid the COVID-19 Omicron wave, as hospital presentation rates fall.

A similar effect was observed at the start of the pandemic two years ago, NSW chief psychiatrist Murray Wright said on Tuesday.

"We have seen some concerning signals that people with serious mental health issues might be avoiding seeking acute care, or attending our emergency departments," Dr Wright told reporters.

"I understand why some people might feel that they're helping the system by staying away and delaying their access to care.

"Delaying or avoiding care for someone who needs mental health can derail recovery."

Since the beginning of the Omicron outbreak, fewer people in suicidal distress or suffering an acute mental health episode have presented to emergency departments when compared to a year ago, Dr Wright said in a statement.

This is cause for concern as the people of NSW are "feeling the cumulative affects of the COVID-19 pandemic".

The first confirmed cases of the Omicron strain were detected in NSW on November 25.

"Please do not delay asking for care because it can dramatically delay the recovery process," Dr Wright said, adding services remain available to all people, even those infected with COVID-19.

People needing assistance should contact their local emergency department, call triple zero or the Mental Health Line, he added.

The waves of the pandemic have brought new challenges, fears and dangers and the process of adjusting to these changes is "emotionally and mentally draining", Dr Wright said.

Mental health should be an ongoing topic of constructive conversation.

"It's so important once someone admits they're struggling with stress and anxiety to validate their concerns," he said.

Things like the return-to-school next week, with multiple changes for teachers and students, are "genuinely stressful".

The NSW plan for reopening schools includes twice weekly rapid tests for students and teachers, and mask mandates for all teachers and high school students.

NSW Premier Dominic Perrottet says the return to school is "essential", not just for students' academic progress but for their social lives and mental health.

Parents who are concerned about the changes, especially those with underlying health conditions, should work with their school, the premier added.

Demand for help from Beyond Blue has settled since a peak in August 2020, although people continue to post about "significant levels of distress" on their online forums, CEO Georgie Harman said.

"The Beyond Blue Support Service is always available - you're never a burden for seeking support for your mental health and wellbeing," Ms Harman said.

"Beyond Blue looks forward to seeing details of the National Mental Health and Suicide Agreement when it's released because this is where the fundamental system change starts."

While many feel hospitals are under pressure and they should delay their care, people who need help should seek it out, a spokesperson for Lifeline Australia said.

The organisation continues to see volumes of calls higher than they were pre-pandemic, following on from 2021, when the non-profit organisation recorded its largest call volume in history.

This included 48 of the 50 busiest days in Lifeline's 59 year history.

"The last two years have been extremely stressful times for all Australians, in facing both a once-in-a-century pandemic and a series of natural disasters," the spokesperson said.

"With the ongoing mental health impacts of the pandemic likely to continue for years to come Lifeline is here for all Australians in need 24/7."

Lifeline 13 11 14

beyondblue 1300 22 4636

Kids Helpline 1800 55 1800 (for people aged 5 to 25)