Public and private mental healthcare for the population mental health effects of COVID-19 measures

To the Editor

With the current qualified success of Australia’s COVID-19 pandemic public health measures, attention turns to the current and longer term population mental health impacts of the pandemic. The range of impacts are upon a number of groups: those with pre-existing mental illness, those distressed by the pandemic events including media coverage and those distressed by the measures, especially enforced social distancing that has caused unemployment and isolation. Public and private mental health services need to be prepared and involved in providing care now.

A nationwide survey in China during the COVID-19 pandemic found increased rates of panic disorder, anxiety and depression (Qiu et al., 2020). A total of 29% of respondents experienced mild to moderate distress, and 5% of respondents experienced severe psychological distress. Similar impacts are emerging in Australia, in advance of formal research data, with reports of increased acuity of psychiatric presentations to emergency departments and in general hospitals. This has also been the case across the broader community too – of note, Lifeline reported its busiest ever day on Good Friday.

There is an urgent need to enhance public mental healthcare during the COVID-19 crisis. Mental healthcare needs to have sustained surge capacity in a system that is at a ‘tipping point’ during normal times (Allison and Bastiampillai, 2015). Public mental healthcare (hospital, acute and community sectors) must have enhanced resourcing and staffing to provide care for the increased mental healthcare demands of the COVID-19 public health crisis (https://ama.com.au/media/managing-mental-health-we-emerge-covid-19-threat). Acute hospital, rehabilitation and long-term bed capacity must be expanded and commensurately staffed to address bed-block from increased emergency department mental health presentations. Community mental health services must also be expanded and commensurately staffed to provide comprehensive care. Rapid development of metropolitan and rural outreach telehealth resources for mental health consultations is needed in public mental healthcare.

Private sector mental healthcare has continued to provide care, including a rapid transition to telepsychiatry services in metropolitan areas to maintain continuity of care for existing patients (Looi and Pring, 2020), as well as ongoing complex care and hospital services. Public mental healthcare must partner with private mental healthcare providing complementary capabilities to enhance surge capacity.

Australia needs to rapidly resource public–private mental healthcare and partnerships to provide surge capacity and care for existing and new patients during the COVID-19 pandemic.