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RUBY:

From Schwartz Media I’m Ruby Jones, this is 7am.

State and federal governments have promised billions in new spending to fix Australia’s mental health crisis - a crisis exacerbated by the pandemic.

But despite the pledges, experts are identifying that young people in particular are still struggling to access urgent care and support.

Today, contributor to The Saturday Paper Santilla Chingaipe, on why this could be our one chance to fix the country’s mental health care system.

And a warning, this episode contains discussion of self-harm and suicide.

It’s Tuesday, September 14.

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RUBY:

Santilla, throughout this pandemic, there has been a lot of debate about what the toll will be or has been on people's mental health, on the one hand, it does seem obvious that lockdowns and border closures and economic uncertainty will have a negative impact on people's mental health. But on the other hand, the data and all of this is a bit mixed, is that right?

SANTILLA:

Absolutely. And for me, it was a very curious one. You know, someone that's living in Victoria, you know, sustained lockdowns have had an impact not just on my mental health, but on the mental health of people around me. And it's a conversation that keeps coming up.

Archival tape -- Reporter 1:

“There are now serious concerns about the impact the pandemic and lockdowns are having on our mental health…”

Archival tape -- Reporter 2:

“What does this tell us about the massive impact of these restrictions and lockdowns that they're having on our young Australians?”

SANTILLA:

And I was curious to sort of get a sense of what was really going on. Are we seeing the rates of suicide going up? Is this being linked to lockdowns? And that's essentially where I started. And what I found was that it's a little bit more complicated than some of the headlines have made it seem.

RUBY:

OK, so let's talk about that. What did you actually find out about what's going on?

SANTILLA:

What I found, Ruby, was that suicide rates have been going up. And this is a trend that we were seeing prior to the pandemic. However, and this is where the important distinction needs to be made, the link to suicides and the pandemic are not as clear as they're being made out to be and this sense that suicides have increased because of the pandemic at the moment, the data does not show that increase and that link.

There was research that was carried out in Victoria led by a psychiatrist called Dr Justin Dwyer from St Vincent's and together with the coroner's court and the Mersey Hospital and Monash University. So they looked at the data pre pandemic and they also looked at the rates of suicide during the pandemic and during the pandemic. They were looking for specific things. So they read police accounts, they read family testimony, and they were looking for key themes, things like JobKeeper, Coronavirus, any of those mentions that were coming up. So what Dr. Dwyer's study found was, was that there wasn't an increase in suicide rates, but it did note that there was an increase in people coming through the hospital system who clearly were all being affected by the pandemic in all sorts of ways.

RUBY:

Right. So there isn't evidence that there has been an increase in suicides as a result of the pandemic. But we are seeing more people come through the hospital system as a result of deteriorating mental health at this time.

SANTILLA:

That's right. During the pandemic, we have seen an increase in the number of people that are presenting to emergency departments with suicide ideation, suicide attempts. And this is also worrying, I think an interim report from the Victorian Agency for Health and Information points to an increase in the number of young people who've presented to hospitals with self-harm and suicidal ideation. And the statistic there is that for young people aged up to 17 years old, 157 young people a week presented to the emergency departments and that's a marked increase from 83 in the same period last year and 91 in 2019.

RUBY:

And it sounds like from everything that you've been saying, that it is young people who find this the hardest. Do we know specifically why that is?

SANTILLA:

So I spoke to Patrick McGorry, who's the executive director of Orygen and the professor of Youth Mental Health at the University of Melbourne.

Archival tape -- Patrick McGorry:

“You look at the support systems around young people, whether it's teachers or parents, universities, all of those institutions and scaffolding, as we call it, scaffolding around young people, as it has been under tremendous strain and stress as well.”

SANTILLA:

They essentially pointed out and, you know, this is not going to be surprising news to anyone listening, that young people have had their lives disrupted in so many ways. And a lot of those social connections have also been impacted.

Archival tape -- Patrick McGorry:

“So basically young people are unsupported or less well supported and their lives have been sort of place in turmoil and their futures are very clouded. And there hasn't been a clear, optimistic, hopeful recovery plan presented to them as an antidote.”

SANTILLA:

The uncertainty about their future, the disruption in their schooling and education, if they're employed. You know, most young people are in precarious jobs and we know that a lot of those sectors have been tremendously impacted by the pandemic.

And so those sort of support systems around young people are essentially non-existent at the moment. And that is adding to a lot of the distress that young people are feeling and the fact that there hasn't been a sort of hopeful message from political leaders as well in terms of how we will come out of this and where young people will be. So that's been sort of one of the things that a lot of these experts have sort of pointed to as why young people are feeling this specifically harder than than other parts of the population.

RUBY:

We'll be back in a moment.

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RUBY:

Santilla, experts have been talking about the impact the pandemic has been having on our mental health but we’ve also seen politicians chime in as well. They have their own motivations for doing that though, don’t they?

Archival tape -- Josh Frydenberg:

“Patrick McGorry, who knows a lot more about this than either you or I. Former Australian of the Year and noted psychiatrist has talked about the shadow pandemic that's occurring in our midst.”

SANTILLA:

Josh Frydenberg, a fortnight ago, he essentially pointed to Professor McGorry’s assessment of what he calls a shadow pandemic.

Archival tape -- Josh Frydenberg:

“And while we need to do everything, Paul, to try to reduce the chance that someone gets Covid because it is a serious illness, at the same time, we've got to balance that with other health concerns, other health priorities, but protecting people's wellbeing and their mental health.”

SANTILLA:

So Professor McGorry and a bunch of other researchers did some modelling last year, which essentially sort of predicted that there would be a 30 per cent increase of suicides amongst young people that were above the normal level if the mental health wasn't adequately addressed. And a lot of that data has sort of been used to push for and argue for reopening and the sense that the sustained lockdowns are impacting the mental health of young people. And therefore, you know, states, territories should stick to the national plan that the national cabinet has committed to.

Archival tape -- Josh Frydenberg:

“But if we don't learn to live with the virus, then the cost to the economy of these lockdowns. But more concerningly the cost to people's wellbeing and particularly our younger people.”

SANTILLA:

But what's also been interesting was I spoke to an academic at the University of Melbourne and they did some research that also found that people that are living in areas that have had eased restrictions or haven't even been in lockdown are also feeling the effects of mental health and so it’s not a fair and accurate picture to just look at the lockdowns and sort of argue that this is having a devastating impact on Australians.

RUBY:

Right so the Federal Treasurer is pointing to this mental health crisis, but is his government actually doing anything about it? Are they investing in the system to fix it?

SANTILLA:

Yes. You know, at all levels of government, we have seen commitments. In Victoria, there was a mental health royal commission and the Victorian government pledged resources to addressing mental health.

Equally, we've seen similar measures in New South Wales and the federal government around the budget also announced it probably described it as a historic mental health investment. It was $2.3 billion to mental health and suicide prevention.

And by and large, people in the sector have welcomed this. They say it's a good start, but more needs to be done. And the argument that I heard from a lot of the experts, including Professor Patrick McGorry, was that there is an urgency to this mental health crisis and this money needs to get out there and it needs to start addressing what they see are the critical areas. And one of the ones which kept coming up over and over again was the workforce.

Archival tape -- Patrick McGorry:

“After six of them here in Victoria, the parents are actually exhausted. But certainly the mental health workers and the mental health system, they're basically, you know, dwindling and burning out.”

SANTILLA:

They argue that we need to mobilise a workforce. We need to be training psychiatrists, psychologists, GPs, that can and know how to deal with mental health.

Archival tape -- Patrick McGorry:

“The big thing that's needed now in Victoria, at least, and probably in most parts of Australia, is a workforce. We need to mobilise an emergency workforce, just like they did with Covid, we need that now for mental health.”

SANTILLA:

Professor McGorry talked about young people that are presenting to hospital and they might have very, very serious symptoms of mental health. And yet you're likely to be turned away. And if you present with, you know, other health issues, you're likely to be treated right then and there. And so this disparity is what they're saying needs to be urgently addressed because if we don't deal with it. We will start seeing more and more people lose their lives, and that's obviously where we don't want to end up.

And so I think when we're talking about this, it's sort of really recognising that while the data at the moment does not explicitly show an increase, what a lot of these experts also talked about was that they we might be in a bit of a lag. You know, this might be a bit of a holding pattern that it might be when we come out of this pandemic that we start seeing just how devastating the consequences have been on people's mental health, which is why a lot needs to be done now. And here's hoping that governments take a lot of what's being said quite seriously.

RUBY:

And as you're saying, Santi, at the moment, we're sort of in the, I suppose, acute phase of all of this. We're still in the pandemic. We're still dealing with lockdowns and border closures. So can you tell me any more about what might come later on? What might the long term health problems be as a result of this 18 months to two years of stress that people have gone through? And is anything being done to think about those long term needs?

SANTILLA:

You know, I asked this question of every expert that I spoke to, and they all did not want to hypothesise, because the simple answer is no one knows what this is going to look like once we get out of it.

So it's very difficult to hypothesise about what toll it's going to have on people's mental health. But what is clear, though, is that the trend in terms of the impact or the decline, rather, in people's mental health is something that we've been seeing year on year on year. And prior to the pandemic, it wasn't prioritised by governments. It wasn't treated with a sense of urgency.

And so the pandemic has essentially presented an opportunity for governments to prioritise the mental health of all Australians and to ensure that it is adequately, you know, resourced and invested in because it also presents an opportunity to turn things around.

A lot of the experts that I spoke to talked about how if governments meet this moment and see it as a moment of opportunity, we could end up having one of the best healthcare systems in the world if we prioritise mental health. But it does require urgent action. And I don't think that can be stressed enough.

RUBY:

Santilla, thank you so much for your time and for your work on this.

SANTILLA:

Thanks Ruby.

RUBY:

If this episode has raised any issues for you, you can call Lifeline on 13 11 14.

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Also in the news today...

On Monday Victoria recorded 473 new cases of Covid-19, a record for the current outbreak. Less than half of the new cases are linked.

There are now 157 people in Victorian hospitals with COVID-19, with 38 people in intensive care.

And in New South Wales, Premier Gladys Berejiklian has warned there will be different rules for vaccinated and unvaccinated people once the state’s lockdown restrictions ease.

Her comments came as the state eased restrictions for outdoor gatherings this week.

I’m Ruby Jones, this is 7am. See you tomorrow.

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