There’s no doubt COVID-19 is causing unprecedented levels of mental ill-health and distress across the Australian community. We don’t know how long the immediate health and economic crisis is going to last, but for many people the mental health effects of 2020 will linger long after there’s a vaccine.

A quarter of all Australians are experiencing symptoms of depression and anxiety. There has been a 30 percent spike in people asking for help through Beyond Blue’s digital support services and projections of a 35 percent increase (University of Sydney, PDF 3.68MB) in mental health presentations to Emergency Departments in regions facing severe economic downturn. Supporting mental health now through early intervention and prevention is a critical shift that could make a lasting difference on the other side of the current crisis. It’s one of the ways we can ensure our community doesn’t just survive the challenging events of this year, but rebounds with the tools for better mental health and wellbeing.

The effects of COVID-19 on mental health

The Black Dog Institute has emphasised that people placed in quarantine and those who have experienced life-threatening cases of COVID-19 – or cared for loved ones who have – are particularly at risk of developing or exacerbating mental health problems. Health care workers and other people on the frontline of Australia’s emergency response also face increased risk (PDF 195KB) to their longer-term wellbeing. Assertive outreach for these Australians now could help prevent residual distress for years ahead. This calls for new thinking, as many of these Australians will never have engaged with the mental health system before.

Taking help to where it's needed

That’s why it is important to make mental health supports available at the services that people are using. Pop-up services are used in a number of other parts of the health system to support early identification and intervention for life-threatening illnesses like breast cancer, while diabetes screening is widely available in chemists across Australia. This is the kind of approach we need for mental health – creating opportunities for people to check-in about what they’re going through, get a referral or just talk to someone as part of maintaining their wellbeing.

Sustaining this kind of early-intervention effort at scale would be challenging but it can help in the months ahead while the direct disruptions of COVID-19 continue. It is also important to strengthen capacity for communities and families to support each other longer-term.

Boosting mental health literacy

Research by Relationships Australia has found around 75 percent of men and 70 percent of women say they can only sometimes recognise when others around them, like partners or family members, are struggling with their mental health. So there would be real value in scaling up in the number of people who’ve completed mental health first aid and suicide gatekeeper training programs like safeTALK – giving them the knowledge to spot friends and family who are struggling and the confidence to intervene.

This is an area where governments could invest to strengthen the community-level supports available in every home and workplace. Businesses and other organisations could also take the lead by supporting staff to undertake training so they can better support their colleagues. Strengthening mental health literacy across the community and giving people the practical skills to take action when a friend or loved one needs help is an effective way to make support more available, whenever and wherever that need arises.

Developing workplace early intervention and prevention supports for health care and frontline workers is another important priority. The stressful, fast-paced and sometimes traumatic nature of their work creates particular risks to their wellbeing. In the past few years, KPMG Australia has worked with a range of first responder and frontline agencies to design workplace-based early intervention mental health supports. Some of the factors that drive successful outreach include making mental health check-ins regular and routine by putting these alongside testing or check-ups for physical health. This can help to reduce stigma around seeking help by framing mental health supports as ‘just another’ way of managing workers’ overall health and wellbeing.

Empowering peers

Giving workplace peers dedicated training in identifying and supporting at-risk colleagues is also an important way to reach frontline workers who may not feel like they can spare the time to seek help, or are worried about the professional consequences of doing so. Queensland Ambulance Service’s Priority One unit is a great example of a peer-based early intervention approach which empowers workers to look out for each other when someone is struggling. At a time when hospitals and other frontline agencies are racing to meet the second-wave surge of demand, this might seem like something that’s a nice idea for a quieter time. But protecting the mental health of people who take care of others must be a top priority.

In our recent articles on the topic of connecting COVID-related mental health supports to longer term reform, we have identified a range of promising non-clinical, peer and community-led mental health approaches which can bolster existing services and break down barriers to Australians seeking help. These supports, working in tandem with assertive outreach and community capacity-building, can help build a mental health system that takes the right help to where people are, when they first need it.

Flipping the focus of Australia’s mental health system from managing acute crisis to early intervention and prevention is a reform that is often discussed, but has so far been slow to take hold. Like the shift to mass remote working and all-digital service delivery, perhaps the COVID-19 crisis can provide the push needed to drive this important reform.