This blog is part of a series relating to the economic impacts of the COVID-19, novel coronavirus outbreak of 2020.
While the full effect of coronavirus on the economic and physical wellbeing of the global population is yet to be fully realised, many are bracing for another area of impact as the pandemic continues to grow: mental health.
The rapidly evolving national and global situation, widespread media coverage of the pandemic and the uncertain timeline of a return to normalcy have increased individual and collective feelings of anxiety and depression. As stricter social distancing and isolation measures are enforced, many Australians are confined to their homes and unable to spend time with friends and family. While these techniques are necessary for helping to slow the spread of coronavirus, they can have adverse affects on mental health. New research indicates that self-isolation and quarantine negatively impact psychological wellness by contributing to feelings of fear around contracting coronavirus, a loss of personal freedoms, boredom and separation from loved ones. These issues are present in people with no history of mental illness, who are not accustomed to feelings of anxiety and depression, and heightened in individuals with pre-existing mental health conditions. Additionally, as we have previously discussed, many individuals are facing loss of work or unemployment. Lack of work and depression have a symbiotic, cyclical relationship: having little or no work leads to increased depression and depression significantly hinders many from finding a new job, which increases financial hardships, which negatively impacts mental health. A study conducted after the Global Financial Crisis of 2008 found that one in five suicides globally were linked to unemployment. Suicide and mental health are thus economic issues and must be treated as such.
As anxiety and uncertainty become the new normal, many more people are seeking assistance for their mental health needs. Beyond Blue, a not-for-profit organisation that provides help for people experiencing depression, anxiety and suicidal thoughts, have reported a significant increase in contacts since the outbreak of COVID-19, with one in four inquiries explicitly related to the virus. Their online discussion thread titled ‘Coping during the Coronavirus outbreak’ receives about 2000 hits each day – seven times that of a similar resource established during the recent bushfire crisis.
“We expect that there will be more demand for mental health support as the health, social and economic consequences of COVID-19 play out, and we would encourage everyone to reach out early”, noted Beyond Blue CEO Georgie Harman.
To meet this increase in mental health care needs, the Federal Government recently expanded its bulk-billed Telehealth services, which provide mental health care services via videoconference. Prior to this expansion, Telehealth services were only available to people living in Modified Monash Model areas 4-7, namely remote locations and towns of under 15,000 people; now, they are available to individuals who tested positive for COVID-19, those in mandatory isolation, and at-risk groups, including people over 70 years old, immunocompromised people and pregnant women. Before the outbreak of coronavirus, however, the Australian mental healthcare system was barely adequate to begin with. In order to receive any subsidised help, an individual must meet with a health professional to set up a mental health treatment plan; if deemed eligible, they are offered merely ten subsidised sessions each year – less than one session per month. Individuals, many only meet with certain registered mental health professionals, and must pay the difference in cost between the professional’s rate and the amount covered by Medicare. Being required to physically attend doctor’s appointments, discuss in detail one’s mental state and traumatic experiences, constantly have their plan reviewed and pay out of pocket for additional fees or appointments are all barriers to accessing adequate mental health services. Furthermore, the Commonwealth’s refusal to be proactive in digitising healthcare for the entire public leaves many individuals seeking help elsewhere.
As coronavirus continues to spread, many people are cancelling their routine psychologist appointments as they can no longer afford the sessions. While the Commonwealth expanded Telehealth rebates to the aforementioned vulnerable groups, they have not afforded these rebates to members of the general public who usually receive Medicare rebates for in-person appointments and are now seeking online or over-the-phone sessions. Across NSW, many private healthcare practitioners have warned NSW Health Minister Greg Hunt that “the mental health of existing and new patients will be compromised, lives will be lost, and hospitals and community services will be rapidly overwhelmed” if Telehealth rebates are not extended to all online or over-the-phone sessions. The Indigo Project, a private psychology practice in Surry Hills, NSW, has moved online and is absorbing the additional costs so their clients can continue to have sessions. Mary Hoang, the head psychologist, said the organisation is expecting to lose about $60,000 every month this continues, which is clearly unfeasible for any small business to maintain. “It’s almost like we have to choose between our physical health and our mental health,” said Hoang.
The effects of COVID-19 on mental health are already being seen across the globe. In the UK, a teenager recently committed suicide due to fears of the “mental health impacts” of coronavirus. However, many people are stepping up to the plate to help others facing mental health issues during the pandemic. In New York, over 6,000 mental health professionals have committed to volunteering their services for those in need. New York residents can phone a hotline to make appointments with professionals that will be held online or over the phone at no charge. Similar initiatives are underway in Los Angeles and Louisiana, with free hotlines available for people who need to speak with a counsellor. As the pandemic grows, we can only hope that more governments, organisations and individuals rally together to establish efforts that help all members of the public access the mental health services they need to make it through this crisis.
In any year, it has been estimated that one in five Australians experiences mental ill-health. This is in normal times without the heightened health, financial and social concerns that currently exist in Australia. The costs to the Australia economy of mental ill-health and suicide has been conservatively estimated by the Australian Productivity Commission’s report in October 2019 as between $43 to $51 billion per year. In addition, to this are costs to the value of $130 billion in diminished health and reduced life expectancy for the individuals with these conditions. The economic impact of CoVID-19 on mental ill-health needs to be recognised and aptly underwritten.