The mental health pandemic

Mental health experts in Australia are predicting the impact of COVID-19 will greatly influence suicide risk. Recent modelling by the Brain and Mind Research Institute suggests suicides could increase by up to 50 per cent. We are already seeing emerging signs of this trend through an increase in demand for mental health support. Calls to Lifeline are up by 25 per cent on last year, while Beyond Blue has seen a 40 per cent leap in contact, since before the pandemic.

This is closely linked to the economic consequences of COVID-19 resulting in increasing uncertainty and unemployment. The potential increase in suicide has highlighted the fragility of mental health in Australia and the types of issues that affect already-vulnerable groups. Those with insecure employment, young people, people with pre-existing mental health issues, our indigenous populations and rural and remote communities with limited access to services, are likely to be most impacted.

Although the modeling bears new concerns of a different kind of pandemic, there is nothing new in these pre-existing vulnerabilities to suicide.

There has been no significant or sustained reduction in the suicide rate for the past decade, even though there have been ongoing efforts to boost the effectiveness of suicide prevention. Prior to COVID-19, suicide was the leading cause of premature death in Australia’s young adults: one-third for Australians aged 15 to 24, according to the recently released draft report from the Productivity Commission into Mental Health. This will undoubtedly worsen, given the economic consequences of COVID-19 will continue to increase the unemployment rate for young adults.

The Australian Government has responded accordingly, with the recent appointment of our first Deputy Chief Medical Officer for Mental Health. This will address systemic issues surrounding our mental health, while hopefully integrating a somewhat fragmented delivery of services.

A biopsychosocial approach

In the meantime, we need to be more proactive in our response. We need to discuss suicide, its consequences and how we approach it from a health, social and economic front. Scholars in this field are calling for a need to create ‘safe places’ in medical facilities, businesses, schools and our homes, so those who feel suicidal or have attempted suicide can tell their story.

If we continue in how we approach suicide, we won't succeed at flattening the newly labelled ‘suicide curve’. Again and again, we turn to medical approaches that address suicide solely as a consequence of illness, rather than a consequence of distress. By reducing suicide to an illness, we limit our approaches exclusively to medical protocols, which aren’t always effective.

To understand a person’s experience within a medical setting requires a system that looks at physical and mental health, as well as recognition of related cultural, economic and community factors.

Practical solutions

In practical terms, this means there needs to be a mix of preventative procedures, intervening measures and recovery interventions, with responsibilities appropriately shared across the different support services (i.e. GP, psychiatry, allied health, counselling services, peer support networks). These should include:

Preventative measures

• Limiting the exposure to distressing events and experiences by incorporating a psychosocial risk approach.

• Creating psychologically-safe environments where individuals can express their thoughts and feelings to those they feel most comfortable talking to – peer support.

• Education surrounding psychological literacy, which focuses on a range of feelings and factors that can influence suicide.

Intervention measures

• Appropriate access to mental health professionals who can address suicide.

• Escalation of support services to psychiatry and GP access if required.

• Care coordination across services to ensure continuity of care.

Recovery measures

• Post-suicide support services in a variety of settings, including peer support and lived experience.

• Appropriate access to bereavement and grief services for those affected by suicide, to prevent further harm.

Workplace health and safety (WHS) obligations

Organisations that address mental health and suicide in their workplace are likely to improve the wellbeing of their employees and subsequent productivity. While doing so, they will also be meeting their legal and WHS obligations that incorporate mental health and suicide into the pre-existing WHS legislation we must all adhere to. Only by working together can we turn the tide in preventing the next pandemic. Each organisation is unique, with varying risks including bullying and harassment, exposure to potentially traumatic events and isolating work environments, to name a few. To seriously address suicide, organisations need to address these causal factors.

If you or someone you know is thinking about suicide, get help immediately. Call Lifeline on 13 11 14, or 000 if life is in danger.

The views expressed in this article are the views of the author, not Ernst & Young. This article provides general information, does not constitute advice and should not be relied on as such. Professional advice should be sought prior to any action being taken in reliance on any of the information. Liability limited by a scheme approved under Professional Standards Legislation.