NEWSREADER:
The mental health impact of the pandemic and especially the Victorian lockdown is one of the great challenges for the medical community and profession. Ruth Vine, is the Deputy Chief Health Officer for mental health. She spoke to Patricia Karvelas.
PATRICIA KARVELAS:
Dr Vine, welcome.
RUTH VINE:
Thank you very much, thanks for having me.
PATRICIA KARVELAS:
As the rules change and we enter Stage 4 in Victoria, who are you worried about?
RUTH VINE:
Well, the list might be quite long, actually, but I think firstly the news, of course, was relatively - it was sort of expected, but sort of unexpected in its detail, and I think that will have taken some people by surprise. Clearly we are at the moment in a particular stage and phase in relation to our aged-care sector and so perhaps once of the prompts for these changes were, of course, the rise in infections in the aged-care sector, which had a massive impact not just on the residents but also the families and indeed the staff who worked with them. That's one of the groups that I think we need to be looking out for now and related to that, of course, are health care workers. I know health service providers are working very hard to support their staff to check on their mental health and wellbeing to make sure that they are getting the supports they need both at work and when they are not at work. But, Patricia, one could also say that young people are going to be very disturbed and again distressed by the yet again changes to their education and the current uncertainty. I think we are at the beginning of a six-week phase. Of We are probably all getting our heads around what these any restrictions mean for us, and I'm sure there will be heightened levels of questioning and some frustration and some anxiety around that. But I could probably have a long list, if you wanted me to do that.
PATRICIA KARVELAS:
Well, on that, a state of disaster has been declared in Victoria. It's pretty serious language for a very serious situation. What impact dos that sort of language have on our mental health when we are told we are in what is a disastrous situation?
RUTH VINE:
Well, very, very understandably, it has been impact on the questioning of ourselves, our questioning of our community, we question our leaders and I think that thirst for certainty, that thirst for knowing as much as we can about what's happening, why it's happening, for how long will it happen, I think that is one of our sort of major foci, to try to manage that level of anxiety, and for those experiencing mental illness, or already experiencing anxiety, that will exacerbate, and also knowing that services are available, knowing what services are available and knowing how to reach those services.
PATRICIA KARVELAS:
Modelling released by the Brain & Mind Centre in May predicted suicide rates could rise by 750-1500 deaths a year unless a dedicated mental health response is put in place. That's greater than the number of deaths even from the virus. What is being done to lower that alarming prediction?
RUTH VINE:
Well, you're quite right that it was modelling and modelling is based on particular assumptions, things that will both escalate and things that will mitigate, and indeed the same institute released another report just at the end of last week, I think, end of July, also looking at the impact particularly in this report of unemployment and disrupted education, but they highlighted that having employment support was a very important thing to have in place to mitigate that rise. So I think what's important about modelling is that it raises the questions and raises our awareness of the sorts of things we need to be looking at. It also highlights, as you've just commented, that there needs to be a mental health system, and I think all governments are investing in mental health at the moment. All governments have invested in increased both front line services but also digital services and of course there has been that real change in access to Tele-health and just very recently - I think it was today or yesterday, the announcement of increased MBS-funded psychology sessions, so the modelling is useful, but it needs to be taken in the context of looking at the assumptions on which it is based and the mitigating factors that have been put in place.
PATRICIA KARVELAS:
There are high levels of stress and distress, even before you get to clinical issues like anxiety and depression. So how do people navigate those things? What's your analysis of how widespread and real those issues now are in the community and the kind of difficulties they are presenting for people?
RUTH VINE:
Firstly, I think they are widespread, I think we have seen in a number of surveys very significant increases in, as you say, particularly levels of anxiety and uncertainty about the future. It is - it's frustrating because those levels were starting to go down and I'm pretty sure that if Victorians and particularly Melburnians were asked in these next few weeks what their concerns were, we would again see that escalation. It makes the social messaging very important, so the little things that we can do - control what you can in your day, structure your day, give yourself routine, give yourself small rewards, set achievable goals, talk to people, talk to your family, I think there is an understandable escalation in concern, but I think we, and this is you as well as me, have a responsibility to give people strategies to lessen that and to understand their anxiety.
PATRICIA KARVELAS:
The Australian Government, as you mentioned, is going to give these 10 additional Medicare subsidised therapy sessions. I want to get your view on whether people are expected to take them up as an option, and do therapists have the capacity to take on those extra patients or boost sessions?
RUTH VINE:
This is an excellent question because, of course, can you increase the availability of sessions in a way more easily than you can increase the number of psychologists there to deliver those sessions and it does highlight the importance of also having a workforce strategy and looking at who is doing this. What we know is that many people don't need 10 sessions. Many people actually use two, three or four sessions, but for people whose illness is exacerbated by this current situation, who already have a relationship with their psychologist and for whom that longer-term care has real meaning and benefit, then the availability of those extra sessions funded through Medicare, I think, is very important, but I do sit that alongside saying we also need to consider the mental health workforce and who will need those sessions and whether we also need to be looking at other types of treatments and availability of clinical services within the state-funded sector as well.
PATRICIA KARVELAS:
Given we are in this unprecedented situation now, more announcements have been made this afternoon, as you know, in relation to businesses that will be shut down, that has obviously an impact on people interacting with those businesses as well as the people running them, what are the long-term mental health effects of the current crisis, specifically in Victoria, but there is also a national toll as well? And how much bigger does the mental health response need to be? Is there a sense of urgency about actually increasing the way we are responding to this?
RUTH VINE:
Well, I think - firstly, I think the response here, of courses not just a health response, and I do think, and this is what was emphasised in the Mind & Brain Institute modelling that the social and economic al remedies, if you like, need to be just as highlighted, so, Patricia, I think one of the reasons for my appointment was a recognition there be a long-tail with mental health impacts from this pandemic and that the rolling nature of that is not just this immediate anxiety about health and infection and availability of health service to address that, but much more, the impact is has on a family, on career trajectories, on, as you said, businesses. So, the answer is, yes, it will go on for a long time, yes, it will probably change in its presentation over time. You would know that we have a royal commission into mental health in Victoria as a reflection that we desperately need better and improved and more services. And I think one benefit, if you like, from the pandemic has been a real expansion in the very nature of treatment provision, and we need to keep looking at that and considering how Tele-health can be used, can be expanded and can be used effectively.
PATRICIA KARVELAS:
Thank you so much for joining us.
RUTH VINE:
My pleasure, thank you.
Contact
