Melbourne’s second lockdown will take a toll on mental health. We need to look out for the vulnerable



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Louise Stone, Australian National University

Metropolitan Melbourne and Mitchell Shire are beginning another six weeks of lockdown due to a spike in COVID-19 cases.

While this second round of lockdown may bring the case numbers under control, its effects on Victorians’ mental health could be significant.

Australians are already experiencing mental health fallout from COVID-19. A prolonged pandemic, and a second lockdown, might only make things worse.

COVID-19 and our mental health

Our mental health is affected by changes in our social circumstances, and no event in recent history has wrought havoc with our daily lives quite like COVID-19.

Parents of newborns have had reduced access to social support.

Many people have had to grieve alone after the death of a loved one.

People experiencing homelessness have received temporary housing, but may have difficulty readjusting to life without support again.

Nursing home residents have endured months of isolation.

Job losses and the economic consequences will mean the emergence of mental health problems in people who had previously enjoyed a life of privilege.




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While we don’t yet know the full extent of the mental health fallout from COVID-19, we are seeing an increase in mental disorders like depression and anxiety.

As Melbournians return to lockdown, the impact of loneliness, fear, anxiety and hopelessness is likely to increase further.

It could be harder the second time

A review of the literature around quarantine shows the mental health effects worsen with longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma.

The reality is we don’t know what the mental health effects of a second lockdown will be. But this second lockdown in Melbourne has all the features of a difficult quarantine situation, including enforced isolation from friends and relatives.

Another six weeks will likely bring frustration, anger and a sense of hopelessness, compounding the mental health effects we’ve felt up to this point.

Plus, any “novelty” we might have felt the first time has likely worn off.

This second lockdown also shows us COVID-19 is likely to be with us for a long time. Our hope for a quick resolution and return to normal is fading.

It won’t be the same for everyone

The effects of hardship, trauma and loss associated with lockdown and the pandemic more broadly are unlikely to be spread evenly across the population.

People who are socioeconomically disadvantaged, people who are unemployed, Aboriginal and Torres Strait islander people and those from culturally and linguistically diverse backgrounds already have poorer mental health and poorer access to services.

This week’s “hard lockdown” in the North Melbourne tower blocks is a stark reminder of the disproportionate effect this pandemic is having on vulnerable groups.

And unlike natural disasters that bring communities together, epidemics often foster suspicion and division. Sadly, scapegoating is emerging and we’re seeing multicultural groups targeted.

The longer the pandemic endures, the greater the division between those who have resources to access care and those who don’t is likely to become.




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If Australia really wants to tackle mental health after coronavirus, we must take action on homelessness


For young people, the sense of hopelessness and worry about the future is escalating.

Professor Susan Rossell from Swinburne University has been tracking the mental health of 18-25-year-olds over the past three months, and has noted a serious spike in mental illness. The mental health impacts of COVID-19 also seem to be more severe for women, and those with existing mental illness.

In the past month, this spike was particularly noticeable in Victoria, presumably due to increasing numbers of new cases.

Young people seem to be struggling during the pandemic.
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Mental health will change over time

In many ways, the trajectory of emotional responses to COVID-19 echoes the trajectory of chronic illness.

As a GP, I see people transition from their first episode of illness, where they hope everything will return to normal, to a more chronic course, where they gradually realise they need to adapt to a new and changing idea of what normal will become.




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This second wave in Victoria shows us we can’t just wait for things to return to normal. The implications COVID-19 has on our lives — and the associated mental health effects — will be ongoing.

Somewhat like a patient with chronic illness, we need to adapt to the idea that change is the “new normal”. This uncertainty makes life profoundly difficult for people beginning to plan for their future, like young people, and people who have few resources to weather change.

More than ever, we need to offer medical and psychosocial care to the vulnerable people in our community if we’re to prevent mental illness becoming more damaging than the virus itself.

On the other hand, there’s always hope the new normal will become more equal, more sustainable and more humane.




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Feeling hopeless? There are things you can do to create and maintain hope in a post-coronavirus world


If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.The Conversation

Louise Stone, General practitioner; Clinical Associate Professor, ANU Medical School, Australian National University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

If Australia really wants to tackle mental health after coronavirus, we must take action on homelessness



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Vaughan J Carr, UNSW and Anthony Jorm, University of Melbourne

The COVID-19 pandemic has opened fault lines in social, economic and health-care policy in Australia. One area in which all three converge is homelessness.

It’s almost impossible to practise self-isolation and good hygiene if you’re living on the streets or moving from place to place. This puts homeless people at higher risk of both catching the disease and transmitting it to others.

At the beginning of the pandemic, governments recognised this problem and responded by housing homeless people in hotels.

But we need to act now to ensure these people aren’t forced back onto the streets as the pandemic recedes.

This is particularly important given we’re worried about the mental health fallout of the pandemic. Evidence shows homelessness and mental illness are inextricably linked.




Read more:
Homelessness and overcrowding expose us all to coronavirus. Here’s what we can do to stop the spread


Homelessness in Australia

The initiative to house the homeless in hotels has been targeted mostly at “rough sleepers”, of whom there are more than 8,000 in Australia.

But people who sleep on the streets make up only a tiny proportion of the Australians we consider to be homeless. Homeless people also include those living in unstable or substandard accommodation, for example.

In 2018-19 more than 290,000 Australians – roughly 1.2% of the population – accessed specialist homelessness services.

So this is only a temporary solution to a national emergency, and addresses only the tip of the iceberg.

Mental illness and beyond

At least one in three homeless people have a mental illness.

Homelessness is often a consequence of mental illness, especially of the more severe kinds that involve hallucinations, confusion, mood swings, depression and intense anxiety.

It’s also a consequence of family violence, which itself increases the risk of poor mental health in children and adults.

But homelessness can also be a cause of mental illness, through its associations with poverty, unemployment, emotional stress, food insecurity, discrimination, exploitation, loneliness and exposure to violence, crime and drugs.

It’s a vicious cycle. Mental illness can lead to homelessness, and homelessness can lead to mental illness.
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The pandemic has momentarily lifted the cover on homelessness as a widespread and, so far, intractable social, economic and health problem.

It’s not only a reservoir of private suffering for those driven to the social margins through unstable or inadequate accommodation.

Homelessness also has broad social impacts, including lost productivity, adverse effects on young people’s health, education and well-being, and increased consumption of mental health services and criminal justice resources, among others.




Read more:
When it’s easier to get meds than therapy: how poverty makes it hard to escape mental illness


Next steps

What will happen to the homeless people currently housed in hotels as the pandemic subsides?

As catastrophic an event as COVID-19 has been, it has created a unique opportunity to improve the long-neglected and critically poor state of social housing in Australia.

The Community Housing Industry Association recently put forward a strong economic argument under the Social Housing Acceleration and Renovation Program (SHARP) proposal for national investment in building 30,000 social housing units and upgrading existing housing.

Meanwhile, the Productivity Commission draft report on mental illness and the Australian Housing and Urban Research Institute (AHURI) have put forward robust recommendations concerning housing policy for people with mental illness.

The Productivity Commission and AHURI both advocate increased investment in low-cost, secure and good-quality accommodation, linked where necessary with suitable support services.

Many jurisdictions have excellent programs that help people with mental illness to live independently, such as the Housing and Accommodation Support Initiative in NSW. But these need to be scaled up dramatically.




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The need to house everyone has never been clearer. Here’s a 2-step strategy to get it done


Affordable social housing combined with government transfer payments (such as pensions, Centrelink and disability payments) sufficient to meet basic living costs would be a major boon to mental health in this country.

Both the Productivity Commission and AHURI highlight bridging the gaps in social housing could promote recovery from mental illness, enabling greater social participation and enhancing well-being. It’s likely this approach would also prevent many cases of mental illness before they take hold.

In the long term this would far exceed the benefits flowing from piecemeal handouts for clinical services, which is the present norm in addressing the mental health fallout of the COVID-19 pandemic.

Improving social housing in Australia would have a range of benefits.
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Home improvements or reducing homelessness?

Last week the Australian government announced HomeBuilder grants of A$25,000 for owner-occupiers for certain works on their homes. This funding will be going to people who already have homes and can afford substantial renovations.

There is a strong case for making similar investments in housing the homeless, which would substantially benefit the mental health of our most disadvantaged citizens.

Now is the time for a nationally coordinated effort by federal and state governments to institute economic, social and health policies to address the nexus between homelessness and mental health, and the poverty that feeds into both.




Read more:
Poor housing leaves its mark on our mental health for years to come


The Conversation


Vaughan J Carr, Professor of Psychiatry, University of New South Wales; Adjunct Professor, Monash University, UNSW and Anthony Jorm, Professor emeritus, University of Melbourne

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Women are drinking more during the pandemic, and it’s probably got a lot to do with their mental health



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Shalini Arunogiri, Monash University; Caroline Gurvich, Monash University, and Jayashri Kulkarni, Monash University

COVID-19 has significantly affected our collective mental health.

For many people, social disconnection, financial strain, increased obligations in the home and ongoing uncertainty have created distress – and with it, a need for new ways of coping.

One way people may choose to cope with stress is through the use of alcohol.

We’re now starting to understand the degree to which alcohol use has increased in Australia during COVID-19. While the data aren’t alarming so far, they suggest women are drinking at higher levels than usual during the pandemic, more so than men.

This trend is likely linked to the levels of stress and anxiety women are feeling at the moment – which, research suggests, are disproportionate to the distress men are experiencing.




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Alcohol consumption and COVID-19

Early reports of increased alcohol purchasing raised the alarm that we might see an increase in alcohol use across the population during lockdown.

However, recent data from the Australian Bureau of Statistics suggests overall, alcohol consumption remained relatively stable during April. Only 14% of Australians reported increased use of alcohol in the previous month.

But women are over-represented in this group. Some 18% of women reported increased alcohol use in the previous month, compared with only 10.8% of men.

14% of Australians reported they were drinking more than usual during April.
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Similarly, preliminary results from our COVID-19 mental health survey of 1,200 Australians in April found a significantly higher proportion of women had increased their alcohol intake: 31.8%, versus 22.5% of men.

Why are we seeing this disparity between women and men? The answers may lie in what we know about why women drink, and in the disproportionate burden of stress women are facing as a result of COVID-19.

Women tend to drink for different reasons to men

In Australia in 2016, 14% of men and 7% of women drank alcohol to risky levels.

Although fewer women than men drink alcohol regularly, alcohol consumption among women has increased in the past decade, particularly in middle-aged and older women. This mirrors international trends that suggest women may be catching up to men in terms of their alcohol consumption.




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Overall, Australia has observed a reduction in risky drinking across the population, with increasing numbers of young people choosing not to drink.

In contrast, women in their 50s are the only subset of the Australian population with rising rates of alcohol use. In 2016, data showed for the first time, they were more likely to drink at risky levels than younger women.

Drinking has become more normalised among women in this middle-to-older age group, potentially contributing to the rise in alcohol use. Alcohol has become a commonly accepted coping mechanism for distress, with women feeling comfortable to say “I just had a bad day. I needed to have a drink”.

This highlights a theme that frequently underpins problematic alcohol use in women: what’s termed a “coping motive”. Many studies have found more women drink alcohol to cope – with difficult emotions or stressful circumstances – as compared to men, who more often drink alcohol in social settings or as a reward.




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Women’s alcohol consumption catching up to men: why this matters


Women seem to be struggling more during the pandemic

With this in mind, it’s unsurprising we’re seeing increased alcohol consumption among women during COVID-19. International data show women have been more likely to experience symptoms of stress, anxiety and depression during the pandemic.

Meanwhile, Australian data show loneliness has been more of a problem for women (28%) than men (16%) during this past month under lockdown.

Caregiver load has also been a source of stress, with women almost three times more likely than men to be looking after children full-time on their own during COVID-19.

Many women have had to work from home while looking after their children.
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While we don’t have enough evidence yet to tell us conclusively whether family violence incidents have increased during the pandemic, this may add to the mental health burden for some women during COVID-19.

Further, younger female workers are disproportionately affected by the economic crisis in the wake of COVID-19. The fact women make up a majority of the casual workforce makes them highly vulnerable at this time.




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Together, it seems COVID-19 is having a different mental health impact on women compared to men. And this is likely to be intertwined with their increased drinking during the coronavirus pandemic.

Whether we’ll see higher rates of problem alcohol use or dependence in women after the pandemic remains unclear. However, we know women who drink at unsafe levels experience complications more quickly, and enter treatment later, with perceived stigma a barrier to help-seeking.

It’s vital we draw our attention to these gender-specific differences in mental health and alcohol consumption as we formulate our mental health pandemic plan.

If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.The Conversation

Shalini Arunogiri, Addiction Psychiatrist, Senior Lecturer, Monash University; Caroline Gurvich, Senior Research Fellow and Clinical Neuropsychologist, Monash University, and Jayashri Kulkarni, Professor of Psychiatry, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

What are the characteristics of strong mental health?



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Simon Rosenbaum, UNSW and Jill Newby, UNSW

Amid the coronavirus pandemic we are being warned of a “second wave” of mental health problems that threatens to overrun an already weakened mental health service.

As we emerge from this crisis, while some people may need specialist help with treating mental illness, everybody can benefit from strategies to improve mental health.

This is because mental health is more than just the absence of mental illness. Positive mental health is a combination of feeling good and functioning well.




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Mental illness vs mental health: what’s the difference?

Mental health and mental illness are not simply two sides of the same coin. Mental health, just like physical health, exists on a spectrum from poor to optimal.

With physical health, some days we naturally feel stronger and more energetic than others. Similarly, some days our mental health is worse than others, and that too is a natural part of being human. We may feel tired, grumpy, sad, angry, anxious, depressed, stressed, or even happy at any point in time. These are all normal human emotions, and aren’t on their own a sign of mental illness.

Someone living with a mental illness can be experiencing optimal mental health at any point in time, while someone else can feel sad or low even in the absence of a mental illness.

Differentiating between poor mental health and symptoms of a mental illness is not always clear-cut. When poor mental health has a sustained negative impact on someone’s ability to work, have meaningful relationships, and fulfil day-to-day tasks, it could be a sign of mental illness requiring treatment.

Mental health and mental illness are not the same thing. You can have poor mental health in the absence of a mental illness.
Supplied, adapted from Keyes 2002.

What does positive mental health look like?

Mental health is more than just the absence of mental illness.

Positive mental health and well-being is a combination of feeling good and functioning well. Important components include:

  • experiencing positive emotions: happiness, joy, pride, satisfaction, and love

  • having positive relationships: people you care for, and who care for you

  • feeling engaged with life

  • meaning and purpose: feeling your life is valuable and worthwhile

  • a sense of accomplishment: doing things that give you a sense of achievement or competence

  • emotional stability: feeling calm and able to manage emotions

  • resilience: the ability to cope with the stresses of daily life

  • optimism: feeling positive about your life and future

  • self-esteem: feeling positive about yourself

  • vitality: feeling energetic.

How can I cultivate my mental health?

Your mental health is shaped by social, economic, genetic and environmental conditions. To improve mental health within society at large, we need to address the social determinants of poor mental health, including poverty, economic insecurity, unemployment, low education, social disadvantage, homelessness and social isolation.

Positive mental health involves being able to cope with the challenges of daily life.
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On an individual level, there are steps you can take to optimise your mental health. The first step is identifying your existing support networks and the coping strategies that you’ve used in the past.

There are also small things you can do to improve your mental health and help you to cope in tough times, such as:

  • helping others

  • finding a type of exercise or physical activity you enjoy (like yoga)

  • getting good sleep

  • eating healthy food

  • connecting with others, building and maintaining positive relationships

  • learning strategies to manage stress

  • having realistic expectations (no one is happy and positive all the time)

  • learning ways to relax (such as meditation)

  • counteracting negative or overcritical thinking

  • doing things you enjoy and that give you a sense of accomplishment.

How do I know if I need extra support?

Regardless of whether you are experiencing a mental illness, everyone has the right to optimal mental health. The suggestions above can help everyone improve their mental health and well-being, and help is available if you’re not sure how to get started.

However, when distress or poor mental health is interfering with our daily life, work, study or relationships, these suggestions may not be enough by themselves and additional, individualised treatment may be needed.

If the answer to RUOK? is no, or you or your loved ones need help, reaching out to your local GP is an important step. If you are eligible, your GP can refer you for free or low-cost sessions with a psychologist, exercise physiologist, dietitian, or other allied health or medical support services.


This article is supported by the Judith Neilson Institute for Journalism and Ideas.The Conversation

Simon Rosenbaum, Associate professor & Scientia Fellow, UNSW and Jill Newby, Associate Professor and MRFF Career Development Fellow, UNSW

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Coronavirus lockdown made many of us anxious. But for some people, returning to ‘normal’ might be scarier



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Amy Dawel, Australian National University; Eryn Newman, Australian National University, and Sonia McCallum, Australian National University

Many Australians have welcomed the gradual easing of coronavirus restrictions. We can now catch up with friends and family in small numbers, and get out and about a little more than we’ve been able to for a couple of months.

All being well, restrictions will continue to be lifted in the weeks and months to come, allowing us slowly to return to some kind of “normal”.

This is good news for the economy and employment, and will hopefully help ease the high levels of distress and mental health problems our community has been experiencing during the pandemic.

For some people, however, the idea of reconnecting with the outside world may provoke other anxieties.




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Social distancing and mental health

We surveyed a representative sample of Australian adults at the end of March, about a week after restaurants and cafes first closed, and with gatherings restricted to two people.

Even at this early stage, it was clear levels of depression and anxiety were much higher than usual in the community.

Surprisingly, exposure to the coronavirus itself had minimal impact on people’s mental health. We found the social and financial disruption caused by the restrictions had a much more marked effect.




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Many people in our survey reported the restrictions also benefited them in some way. Around two-thirds of people listed at least one positive impact coronavirus has had on them, such as spending more time with family.

For many people, lockdown has been an opportunity to enjoy more time with family.
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Another positive thing we’ve seen is communities coming together in new ways. For instance, teddy bears have appeared in windows for neighbourhood children to find, with We’re Going On a Bear Hunt Australia connecting more than 20,000 followers on Facebook.

More than half of our survey respondents were hopeful “society will have improved in one or more ways” after the pandemic.

Adjusting to the ‘new normal’

Our findings show adverse events can affect mental health and well-being in unanticipated and mixed ways.

Because we haven’t experienced anything like the coronavirus pandemic in recent history, we simply don’t know how our community will readjust as restrictions ease.

Some people may feel particularly anxious about reconnecting. For example, people with social anxiety might experience heightened anxiety about the prospect of socialising again.

One of the main evidence-based treatments for social anxiety is exposure therapy. When social exposure is reduced, as has been the case over the last couple of months, social anxiety may flare up, making returning to social gatherings particularly daunting.




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Meanwhile, people who fear germs, such as some people with obsessive compulsive disorder (OCD), might worry about re-entering public spaces.

Even people who don’t normally have these tendencies might share similar worries. Our survey found around half of Australians were at least moderately concerned about becoming infected with COVID-19.

People who experienced psychological conditions before the pandemic may be able to draw on skills they’ve learned through therapy to help them re-engage. But people without any prior experience of anxiety or depression could struggle more because they have never had to manage these conditions before.

Tips for people who are feeling anxious

Whether you have previously experienced anxiety or not, there are several strategies you can use to manage your worries around re-engaging.

One effective psychological approach to managing anxiety is cognitive behavioural therapy (CBT).

CBT involves learning about how your thoughts affect your mood, and developing strategies to manage problematic thinking patterns. Importantly, CBT can be effectively delivered online.

CBT might also include developing a social or germ “exposure hierarchy”. For instance, working up from seeing a few people briefly to longer interactions, with more people. There are some critical ingredients that make exposure therapy work though, so it’s important to get advice from a psychologist or follow an evidence-based online program.

If you’re feeling anxious about coming out of your isolation bubble, you’re probably not the only one.
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Mindfulness, regular exercise and getting enough sleep can also help manage anxiety.

If you or someone you know is feeling distressed, it may also be helpful to contact relevant support services in your area – many of which now have telehealth options.

These may include your GP or a psychologist, or community services like Lifeline, SANE Australia, or Beyond Blue.

Things are likely to change over time

The public health measures implemented to mitigate coronavirus risk have worked to stop the spread of the virus, but they’ve also disrupted the way we live.

There’s much speculation on what the future will look like, resulting in the “new normal” terminology. A key concern as we continue to navigate this new normal is our collective mental health.

Japan experienced a 20% decrease in suicides in April 2020 relative to April 2019. Yet predictive modelling raises concerns about suicide rates potentially rising after the pandemic recedes.




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But it’s important to remember no model can perfectly predict the complex impacts of this unprecedented pandemic.

We’ll need ongoing data collection to assess how community mental health is faring over the coming months. And we’ll need to use this data to implement evidence-based mental health strategies and policies as and when they’re needed.The Conversation

Amy Dawel, Lecturer, Australian National University; Eryn Newman, Lecturer, Australian National University, and Sonia McCallum, Postdoctoral Fellow, Australian National University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

7 ways to manage your #coronaphobia



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Jill Newby, UNSW and Aliza Werner-Seidler, UNSW

As we’re slowly moving out of lockdown, many Australians will be feeling anxious about going outside, away from the safety of home, and returning to normal life.

For most people, these coronavirus fears will be temporary.

But for some, being overly afraid of the coronavirus can have serious implications. People might avoid seeking medical care, isolate themselves from others unnecessarily, or be debilitated with fear.

Others have taken to social media under the hashtags #coronaphobia and #coronaparanoia to share their anxieties, some with humour.

If you’re anxious, you’re not alone. Our survey of more than 5,000 Australian adults during the peak of the COVID-19 pandemic found one in four were very or extremely worried about contracting COVID-19; about half were worried about their loved ones contracting it.

But how do you know if your fears of coronavirus are out of control? And what can you do about it?




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Here are some signs

Your anxiety may be out of control if you notice:

  • your fears are out of proportion to the actual danger (for instance, you’re young with no underlying health issues but wear a mask and gloves to the park for your daily exercise where it’s easy to social distance)

  • the fear and anxiety is intense and persistent (lasting weeks to months)

  • it’s hard to stop worrying about coronavirus

  • you’re actively avoiding situations (for instance, places, people, activities) even when they’re safe

  • you’re spending a lot of your time monitoring your body for signs and symptoms, or searching the internet about the virus

  • you’ve become overly obsessive about cleaning, washing, and decontaminating.

None of these experiences alone are a problem. But when they occur together, are persistent, and negatively impact your life, it’s time to do something about it.

Are you cleaning the same place over and over?
Shutterstock



Read more:
If Dr Google’s making you sick with worry, there’s help


These seven tips can help:

1. reassure yourself, it’ll get better: for most people, the anxiety will get better as the threat of COVID-19 passes. If anxiety doesn’t go away, it can be treated

2. change your ‘information diet’: spending time reading alarming tales of the horrors of COVID-19 will probably increase anxiety, not reduce it. Instead, try spending time focusing on positive information, stories or activities that take your mind off your fears

3. think logically about the risk: coronavirus has led to tragedy for many families, and we acknowledge the risk and consequences of contracting coronavirus differs from person to person. However, keep in mind over 90% of people infected with coronavirus in Australia have already recovered. The number of cases is also still extremely low, with 7,072 confirmed cases to date out of about 25 million people

4. reduce the focus on your body: when we pay too much attention to our bodies, it can make us notice things we wouldn’t normally notice, which then makes us more anxious. Take your mind off your body by focusing on other things, such as positive, enjoyable activities

5. take things slowly, at your own pace: it’s OK to slowly ease back into doing things you used to do. Take a step-by-step approach, doing one activity at a time, so you feel safe, while slowly building up your confidence

6. channel your anxiety into action: it can help to focus on what’s under your control. Taking active steps to look after your mental health, by sleeping well, exercising, doing fun or relaxing activities, and staying socially connected can make an enormous difference to your mental health

7. get help from professionals, not Dr Google: try an evidence-based online program for health anxiety, seek advice from your GP, or a psychologist who specialises in anxiety.

Here’s what you can do to ease your anxiety about the coronavirus (Australian Academy of Science)

How about children?

Most children will be pleased to get back into their familiar routine and to re-engage with their peers and friends.

Australian research conducted with adolescents at the height of the pandemic found young people were most worried the impact of the restrictions on their education and friendships (more so than the health risk).

However, for some children, the transition back to preschool or school will be more stressful.

For younger kids, some initial separation anxiety from the family members they have been spending a lot of time with is to be expected and will typically resolve quickly.




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A small proportion of children may be excessively worried about leaving the safety of home and in these cases, these tips may help:

1. have an honest and open discussion with your child: ask your child to share exactly what they are worried about. Address their concerns rationally and devise a plan with them about how they can start to face their fears in a manageable way

2. model brave behaviour: children pick up on our anxiety and fears, but also on our behaviour. Model brave behaviours to demonstrate that it is now OK to go outside, and it is safe. You can start with a walk in the park on the weekend together and then transition to attending school. Importantly, if you are feeling overly anxious about the relaxation in restrictions, it is important to address your own anxiety first, before attempting to address your child’s

3. get professional help: if your child remains overly anxious about going outside and this doesn’t resolve over a few weeks, seek professional support. The best place to start is with a GP or psychologist who specialises in anxiety.


Coronavirus mental health resources are available online. Help for adults is also available from THIS WAY UP, myCompass and
MindSpot. Help for kids and adolescents is available from BRAVE-Online, ReachOut, Kids Helpline and headspace.
The Conversation

Jill Newby, Associate Professor and MRFF Career Development Fellow, UNSW and Aliza Werner-Seidler, UNSW Scientia Fellow, Senior Research Fellow in Mental Health & Clinical Psychologist, UNSW

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The government will spend $48 million to safeguard mental health. Extending JobKeeper would safeguard it even more


Anthony Jorm, University of Melbourne

Federal health minister Greg Hunt has unveiled a A$48.1 million COVID-19 mental health plan, featuring A$7.3 million for research and data collection, A$29.5 million for outreach to vulnerable people, and A$11.3 million for communication and other outreach programs.

This is on top of the A$1.1 billion Medicare package to tackle mental health and domestic violence, announced in March, which included funding for telehealth mental health services by GPs and mental health practitioners.

Is the funding needed?

Mental health experts have warned of a “second curve” of mental ill-health in the wake of the COVID-19 epidemic. This will result from widespread anxiety and depression, both about the disease itself and the knock-on social and economic effects of the lockdown.




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We need to flatten the ‘other’ coronavirus curve, our looming mental health crisis


Modelling has predicted that suicides could increase by 25-50% per year for up to five years, if urgent action is not taken.

It is hard to rely on any prediction with confidence, given this situation is unprecedented. Recent research from the Australian Bureau of Statistics indicates that the mental health effects of the pandemic are not dramatic so far. The graph below shows data from a national survey of symptoms carried out in April 2020, compared with earlier national survey data collected in 2017-18.


Author provided

There has been a significant increase in feeling “restless or fidgety” and a trend towards more people feeling “nervous”. This probably reflects the confinement of the lockdown and anxiety about infection. Increases in anxiety are not necessarily a bad thing, as they motivate people to protect themselves against infection. Fortunately, the more serious symptoms of depression did not increase; in fact, there has been a signficant decrease in the number of people who report feeling “depressed”.

Similarly, early data indicate there has not been an increase in suicides in Australia, and Japan has actually reported a decline in suicides. This seems paradoxical, given the surge in unemployment and financial uncertainty.

Yet it has long been recognised that suicides can decrease during times of war if there is a greater sense of purpose and social cohesion. Whether our national response to the COVID-19 pandemic will also produce these protective effects is unclear, but the potential is there and should be encouraged.

While the early effects on mental ill-health have not been dire, it is very early days, and the predicted adverse consequences of the pandemic and lockdown may yet be seen. Given the uncertainties, the government’s planned investment in gathering better data seems wise.

Will it make a difference?

The biggest slice of the government’s new and previous funding packages will go towards extra Medicare services. But although this seems an obvious response, past experience indicates it is unlikely to have a major impact.

Over the past two decades Australia has had hugely increased the provision of mental health services, but there has been no detectable improvement in the mental health of the population. One likely reason is that the extra services are not of sufficient quality to make a difference, with people not getting enough treatment, or services not being targeted to those most in need.




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What seems more likely to have a beneficial effect is the funding put into the JobKeeper and JobSeeker schemes. The evidence is clear that mental ill-health is associated with job loss and low income. These schemes are keeping people in employment and providing incomes, which means they are directly tackling key risk factors for mental ill-health.

If this preventive benefit is to be maintained, it will be necessary to extend these schemes beyond the planned six months. Now that would be a real investment in the nation’s mental health.The Conversation

Anthony Jorm, Professor emeritus, University of Melbourne

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Miss hugs? Touch forms bonds and boosts immune systems. Here’s how to cope without it during coronavirus



Claudio Furlan/Lapresse/Sipa USA

Michaela Pascoe, Victoria University; Alexandra Parker, Victoria University; Glen Hosking, Victoria University, and Sarah Dash, Victoria University

Don’t shake hands, don’t high-five, and definitely don’t hug.

We’ve been bombarded with these messages during the pandemic as a way to slow the spread of COVID-19, meaning we may not have hugged our friends and family in months.

This might be really hard for a lot of us, particularly if we live alone. This is because positive physical touch can make us feel good. It boosts levels of hormones and neurotransmitters that promote mental well-being, is involved in bonding, and can help reduce stress.

So how can we cope with a lack of touch?


Wes Mountain/The Conversation, CC BY-ND

Touch helps us bond

In humans, the hormone oxytocin is released during hugging, touching, and orgasm. Oxytocin also acts as a neuropeptide, which are small molecules used in brain communication.

It is involved in social recognition and bonding, such as between parents and children. It may also be involved in generosity and the formation of trust between people.

Touch also helps reduce anxiety. When premature babies are held by their mothers, both infants and mothers show a decrease in cortisol, a hormone involved in the stress response.

Positive touch can release oxytocin, which is involved in human bonding.
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Touch promotes mental well-being

In adults with advanced cancer, massages or simple touch can reduce pain and improve mood. Massage therapy has been shown to increase levels of dopamine, a neurotransmitter (one of the body’s chemical messengers) involved in satisfaction, motivation, and pleasure. Dopamine is even released when we anticipate pleasurable activities such as eating and sex.




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Disruptions to normal dopamine levels are linked to a range of mental illnesses, including schizophrenia, depression and addiction.

Serotonin is another neurotransmitter that promotes feelings of well-being and happiness. Positive touch boosts the release of serotonin, which corresponds with reductions in cortisol.

Serotonin is also important for immune system function, and touch has been found to improve our immune system response.

Symptoms of depression and suicidal behaviour are associated with disruptions in normal serotonin levels.

But what about a lack of touch?

Due to social distancing measures during the COVID-19 pandemic, we should be vigilant about the possible effects of a lack of physical touch, on mental health.

It is not ethical to experimentally deprive people of touch. Several studies have explored the impacts of naturally occurring reduced physical touch.

For example, living in institutional care and receiving reduced positive touch from caregivers is associated with cognitive and developmental delays in children. These delays can persist for many years after adoption.




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Less physical touch has also been linked with a higher likelihood of aggressive behaviour. One study observed preschool children in playgrounds with their parents and peers, in both the US and France, and found that parents from the US touched their children less than French parents. It also found the children from the US displayed more aggressive behaviour towards their parents and peers, compared to preschoolers in France.

Another study observed adolescents from the US and France interacting with their peers. The American kids showed more aggressive verbal and physical behaviour than French adolescents, who engaged in more physical touch, although there may also be other factors that contribute to different levels of aggression in young people from different cultures.

Maintain touch where we can

We can maintain touch with the people we live with even if we are not getting our usual level of physical contact elsewhere. Making time for a hug with family members can even help with promoting positive mood during conflict. Hugging is associated with smaller decreases in positive emotions and can lessen the impact of negative emotions in times of conflict.

In children, positive touch is correlated with more self-control, happiness, and pro-social skills, which are behaviours intended to benefit others. People who received more affection in childhood behave more pro-socially in adulthood and also have more secure attachments, meaning they display more positive views of themselves, others, and relationships.

Pets can help

Petting animals can increase levels of oxytocin and decrease cortisol, so you can still get your fill of touch by interacting with your pets. Pets can reduce stress, anxiety, depression
and improve overall health.

In paediatric hospital settings, pet therapy results in improvements in mood. In adults, companion animals can decrease mental distress in people experiencing social exclusion.

Cuddling with pets is therapeutic and may help ease the mental health effects of social distancing.
Shutterstock



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What if I live alone?

If you live alone, and you don’t have any pets, don’t despair. There are many ways to promote mental health and well-being even in the absence of a good hug.

The American College of Lifestyle Medicine highlights six areas for us to invest in to promote or improve our mental health: sleep, nutrition, social connectedness, exercise, stress management, and avoiding risky substance use. Stress management techniques that use breathing or relaxation may be a way to nurture your body when touch and hugs aren’t available.

Staying in touch with friends and loved ones can increase oxytocin and reduce stress by providing the social support we all need during physical distancing.


This article is supported by the Judith Neilson Institute for Journalism and Ideas.The Conversation

Michaela Pascoe, Postdoctoral Research Fellow in Mental Health, Victoria University; Alexandra Parker, Professor of Physical Activity and Mental Health, Victoria University; Glen Hosking, Senior Lecturer in Psychology, Victoria University, and Sarah Dash, Postdoctoral research fellow, Victoria University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Coronavirus has boosted telehealth care in mental health, so let’s keep it up


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Ian Hickie, University of Sydney and Stephen Duckett, Grattan Institute

Australia’s health system has embraced telehealth during the coronavirus pandemic, with patients getting care online, by video or by phone. But what happens to this post-pandemic is uncertain.

Unfortunately, the pandemic’s spatial isolation converted quickly into social isolation, and this created stress and anxiety for many. All of this means that after the pandemic, there will be a surge in demand for mental health services.




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This extra demand will put still more pressure on an already overloaded mental health system.

Digital help is on hand

It’s crucial that public and private mental health services adopt new technologies now to help meet this future demand.

Compelled by the massive health services dislocation accompanying the COVID-19 pandemic, Medicare this year finally moved to support for the most basic form of telehealth, supporting both telephone and video consultations.

That’s 144 years since Alexander Graham Bell produced the first working telephone in 1876. Let’s hope it doesn’t take quite as long for our general health care system, and particularly our mental health system, to incorporate the power of 21st-century digital technologies.




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Australians are fortunate to have already benefited from many innovations in digital mental health care, such as moodgym, eHeadspace and Project Synergy, all offering online support to people in need.

This has been led by partnerships between major universities, non-government organisations and industry.

ReachOut was the world’s first online service when it launched in Australia in 1996 to reduce youth suicide.

Slow uptake of telehealth services

But telehealth systems have not been widely deployed or accessed. Of the 2.4 million visits to psychiatrists in 2018-19, only 66,000 involved telehealth.

Clearly too many Australians who seek mental health care do not gain the potential benefits of what’s available in telehealth innovation.

This failure is not unique to Australia. Pre-COVID-19, the World Economic Forum highlighted the massive gap in mental health service provision between developed and developing countries. It’s calling for rapid deployment of smarter, digitally enhanced health services.

The World Health Organization and every other major health body is warning of the urgent need to expand mental health services in response to the economic and social dislocation caused by the pandemic.

The cruel lesson of past economic recessions is that for people hit hardest, mental health deteriorates rapidly. Without a swift and targeted response, suicide attempts and death by suicide will increase.

A boost to the system

To prevent this in Australia, we need widespread social and welfare investments and a better mental health system.

Pre-COVID-19, the Productivity Commission in its draft report on Australian mental health care highlighted a lack of sustained investment (relative to the social and economic costs of poor mental health), poor coordination and a fundamental lack of responsiveness to the needs of those most affected.

It also called for more prevention and early intervention measures, particularly for children and young adults.

Australia has two separate mental health systems. State-based systems are highly focused on emergency departments and acute and compulsory care. These benefit principally the smaller number of people with very severe and persisting illnesses.

Private hospitals provide additional hospital beds to people with private health insurance, but also support day programs that cost a lot but provide limited value.

The upshot is that Australia has a missing middle – big service gaps for the people most in need of care.

We need more specialised but outpatient care and multidisciplinary care for those in need. That means GPs, psychiatrists, psychologists, nurses and other skilled health workers, working in coordinated team structures. These services are desperately needed in outer urban, regional and rural communities.

A digital future, now!

A digitally enhanced, 21st century-style mental health service may be the answer.

Smart digital systems, such as smartphone apps and other technologies, can help to assess quickly the level of need and direct people to the best available clinics.

They can help our highly talented mental health professionals provide better care. They also bring the world of other tools, peer support and enhanced social connections to the client, no matter where they are located.

Access to online forms of cognitive-behavioural therapy, such as those offered by Mindspot, THIS WAY UP and other evidence-based psychological interventions can be delivered to meet demand.

These innovations can bring real expertise to the lounge room of those in rural and regional areas who typically live most distant from quality face-to-face care.

In one of our research trials, a child and adolescent psychiatrist operating in Bogota, Colombia, was able to provide same-day specialised assessments to young people in Broken Hill, New South Wales.

Mental health services in Australia have already been radically transformed during the pandemic. Video-style consultations are now central to the work of mental health professionals.

Psychologists and psychiatrists all around the country are reaching out to their clients online. Many clients find it much more convenient and far less costly than attending regular clinics.

Time to act

The digital future is not just about making small changes. A digitally enhanced future for mental health involves a fundamental rethinking of models of care.




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Online or helpline-supported screening tools should be used to guide people along the best, evidence-based treatment path for them.

Primary health networks – the regional health authorities funded by the commonwealth to coordinate primary care – should ensure the services they commission are using digital technology appropriately and tracking the provision of care.

These new forms of digitally enabled care will make the whole mental health system more efficient, freeing up resources to help the backlog of Australians who need more intensive clinical care.

Australia’s governments must seize the opportunity that COVID-19 has created. Digital systems must now be viewed as essential health infrastructure, so that the most disadvantaged Australians move to the front of the queue.The Conversation

Ian Hickie, Professor of Psychiatry, University of Sydney and Stephen Duckett, Director, Health Program, Grattan Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.