FRAN KELLY:
Well today is undoubtedly a good day for Melbournians, who'll be able to enjoy the simple pleasures of dining out and window shopping after 112 days in lockdown. But there's growing concern about the toll this has taken on the mental health of Victorians. The Prime Minister warning yesterday the impacts will be felt for years to come.
[Excerpt]
SCOTT MORRISON:
There are so many Victorians who will carry the scars of this lockdown, many, Mr Speaker, for years to come. That is the advice we've received from Christine Morgan, my National Suicide Prevention Adviser, Mr Speaker, and the Deputy Chief Medical Officer, Mr Speaker, Ruth Vine, who is focussed on mental health.
[End of Excerpt]
FRAN KELLY:
That’s the Prime Minister Scott Morrison in the Parliament yesterday. Well demand for counselling services in Victoria has surged in recent weeks. Beyondblue has recorded a 67 per cent increase in calls during the four weeks to October 4th, compared to the same period last year. Meanwhile, Kids Helpline has had a 61 per cent increase. As we just heard the Prime Minister say, Dr Ruth Vine is the Deputy Chief Medical Officer for Mental Health and she joins us this morning from Melbourne. Ruth Vine, welcome to RN Breakfast.
RUTH VINE:
Good morning, Fran.
FRAN KELLY:
Ruth Vine, can you help us understand the scarring from this pandemic that the Prime Minister was talking about there? How have Victorians, in particular in terms of their mental health, been scarred by this prolonged lockdown?
RUTH VINE:
Fran, I think right back at the beginning of this, it was recognised that the social changes, the employment changes would have a potentially very negative impact on people's ability to cope, particularly for those who may already have vulnerabilities or those in particular circumstances. And as you've highlighted, there was certainly an increased demand for services during this time, and I think that will be ongoing. And some of the improvements and increases in services were particularly directed to Victoria. So, for instance, the additional primary care setting of mental health clinics, the Head to Health clinics were an immediate response to recognition of people's increased distress. But I think it's also very important to realise that people do receive support and in fact, that support is effective. And so although the Prime Minister mentioned scarring, I think we also know, from follow up from other major events like the Black Saturday bushfires or others, that while those impacts can last for months or even years, they do diminish and people do need to use their families, to use their communities, and use more formal supports to get right back into their life. So I wouldn't want it to be thought that those scars are irreversible or won't fade with time, if you like.
FRAN KELLY:
Yeah, for some, of course, that's not necessarily the case. I mean, the Treasurer, Josh Frydenberg, also a Melbournian, spoke in the parliament yesterday too, clearly angry at the price that his city has had to pay to curb the virus spread. He spoke of hearing of people taking their own lives and self-harming. Do we know that this has indeed increased or incurred at a greater rate during the lockdown?
RUTH VINE:
Firstly, in relation to suicide – and I'm deeply saddened to hear that he had a friend or an acquaintance that did die by suicide, but in relation to suicide, we haven't seen an increase, which is not really good news because Australia and Victoria do have way too many people who decide to die by suicide, approximately 600 in a year, so that is an ongoing effort to try and understand people's distress and get in before the distress reaches that level. In relation to self-harm, I think it is true that emergency departments have seen increased rates of people presenting in distress, and particularly in younger people that's been with self-harm. And interestingly, again, in younger people, we've seen increased rates of presentation with eating disorders, which while you wouldn't necessarily categorise immediately as self-harm, it certainly is a form of trying to find a relief from distress or control in a different way. So...
FRAN KELLY:
[Interrupts] Can I just interrupt you there, Ruth, because the Victorian Health Minister actually put a statistic on that this week. I think he said the number of teenagers presenting to emergency departments for suicidal ideation and self-harm had risen by 25 to 30 per cent over three months to September, which is, if correct, a very significant increase. Can you confirm that statistic? And is there analysis being done yet on what is driving that increase? What is behind it? Or is it simply obvious the stresses of the lockdown?
RUTH VINE:
So, look, my understanding is that those numbers are correct. I sit in, Fran, on the weekly meeting with the mental health providers in Victoria, and certainly that pressure on increased demand on emergency departments and in particular in younger people has been discussed. But the understanding of it, I think it's multifactorial. I mean, clearly, COVID sits behind this. But the impact of COVID has been to disrupt school, to disrupt families, to disrupt social engagement and connection, and I think all of those play a role. I do think there's been a bit of a collective sigh of relief in this week and recently as people have gone back to school and had greater freedom of movement. But I also think that for some, returning will create anxiety. So I know there's been increased mental health supports into schools, and certainly, the federal government’s increased funding to some of those particular helplines that you've mentioned, like Kids Helpline, but also eating disorders helplines in order to try and make sure that if people do reach out, there's someone there at the end of the phone or end of the chat line are getting good, sensible, empathic responses and advice.
FRAN KELLY:
Just in terms of suicide and I don't want to overstate this. As you say, the numbers so far there's been no rise, which is great. But the presentations with that ideation to emergency in young people have risen. Given that, should there have been more funding in the budget targeted towards suicide prevention strategies? Because I think we've spoken to Ian Hickie on this program before, who one of the things he thought was missed in the budget was funding for, you know, prevention of suicide by increasing follow ups after. Do we need more of that?
RUTH VINE:
Look, we're living in interesting times, Fran. I'm in Victoria. We've got the Victorian Mental Health Royal Commission, the Productivity Commission. We're awaiting the government response to that. Both of those, I'm sure, will talk about the need for a broader range of mental health service support. So, if you like, we sort of think about universal, which is communication and awareness raising, and then the more selected, which might be those particular supporting helplines or particular services and then absolutely targeted, which is what you're talking about, so people who may have presented following an attempted suicide or thinking of suicide and getting greater support.
Now, there has actually been a lot of investment in that. So two particular programs come to mind. The HOPE program in Melbourne, which is being expanded across Victoria, I think, and likewise a program called The Way Back. So I do think, incrementally, we are getting better and better at putting those services. But what is, in my view, still lacking is the better integration between those services. And that needs more than just funding. It needs really good cross government work and really good employment strategies to get that integration happening.
FRAN KELLY:
And is there enough urgency about all this? I mean, I note that a national children's mental health and wellbeing strategy is currently being developed. I think there's a draft expected to be handed to the Government by the end of the year. The Australian is reporting today the Victorian Government hasn't commissioned any modelling on the mental health impact of the prolonged lockdowns. Is there enough urgency around this? Should that national children’s mental health and wellbeing be being strategy, given that children in Victoria have effectively missed six months of face to face learning, should we be rolling out this support now?
RUTH VINE:
There is an irony there, Fran, because there is an urgency. But of course, COVID itself has delayed many things. It just has forced different ways of working and different forms of consultation. And I think, for instance, the Victorian royal commission was to report in October, but now that's been pushed back to February. So, look, I think there is an urgency, but I don't think urgency should replace consideration and consultation and really trying to get it right.
FRAN KELLY:
Okay. Well, then let me ask you this, I suppose it's the primary question as Deputy Chief Medical Officer for Mental Health for Australia, but you're also a Melbournian. What is your biggest concern and your most urgent priority in this job you've taken on?
RUTH VINE:
Well, it's certainly been very urgent and a priority to get these services out during this time. And I would again go back to the Head to Health clinics. They were stood up in a matter of four weeks. It was amazing. But I think they also brought home the importance of increasing and establishing and supporting our health workforce and our mental health workforce. So I'd have to say that getting the right workforce remains a priority. It's not a new one, but it's absolutely critical. And the second, Fran, would be, I think, to really, really undertake mental health service reform. So we've got many great bits of our service, but it is fragmented. It's often duplicative and it really does need better coordination.
FRAN KELLY:
And as Melbournians move out of their homes today, many of them going to the shops, maybe meeting someone at a cafe, going to a restaurant, even for dinner. I mean, as you look on as a Deputy Chief Medical Officer for Mental Health, do you think this will be an immediate fillip for people's mental wellbeing? And do you have any advice for people who have done it so hard through lockdown?
RUTH VINE:
Well, I do and I have to give myself this advice, which is, yes, you have this sense of relief and sense that hey, hey, hey, maybe things are getting back to normal, but, you know, don't rush too fast. Don't stop being vigilant. Measure that moving out and don't think that some people aren't going to find that hard and that there's still many difficult questions to answer. But Fran, for myself, I just can't wait to get back to the beach.
FRAN KELLY:
Ruth Vine, thank you very much for joining us.
RUTH VINE:
Thank you.
FRAN KELLY:
Dr Ruth Vine is the Deputy Chief Medical Officer for Mental Health, and I'm with her on the beach – it can do great things for your state of mind, that's for sure.
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