The COVID-19 pandemic has created a tsunami of health, social and economic consequences. There is increased understanding that health includes both mental and physical health, with recognition of the trauma and distress people are experiencing now from the impacts of the COVID-19 restrictions. Many are experiencing individual and collective grief from loss of employment, loss of connection, loss of loved ones, loss of autonomy. There is another possibility after such significant events though: post traumatic growth (PTG). This is where, through challenges, we can thrive. However, our current approach of band-aiding mental health risks is nowhere near enough to help us collectively thrive.
Many will be familiar with the risks of post-traumatic stress after experiencing individual or collective traumas. However, through these same events, some will experience positive psychological growth and elevated mental wellbeing. Post-traumatic growth can be enhanced by many individual and experiential features. Focusing on building psychological coping skills, relational supports, strategies to manage adversity (such as financial literacy support, housing support, real and timely access to support services) could all help us to thrive.
There has been growing mental health awareness in Australia over the last twenty years. Yet awareness is not enough.
The mental health system is comprised of underfunded and often disconnected services. Waitlists for publicly funded and bulk-billed services are unacceptable. Crisis services and supports for individuals and their families are insufficient. Community-based services to support individuals in a social model of care are at best a patchwork effort. These services are under-resourced and not integrated with the dominant crisis model of mental health service delivery. And prevention and early intervention is almost non-existent.
The announcement of the Morrison governments additional $48.1m to support Australians against the mental health impacts of COVID-19 does not address the problems within the existing system. Nor does it make provision for the already seen increased demands – let alone that which is surely still to come as economic impacts hit hard. While Job Keeper, Job Seeker and other economic supports are welcome, they will at some point cease and then the true economic impacts will start to be felt. This safety net that is giving some hope of riding out the storm will leave a gaping hole when removed.
Economic responses have been swift. As time passes some of these measures will be discredited under closer inspection.
Such is the nature of a pandemic response. The rapidity of response required carries innate risk that not all decisions will hold up in retrospect but are probably able to be forgiven as good enough given the circumstances in which they were made. This will not be the case in the mental health sector given that the risks around mental health system inadequacy is not new. The pandemic will exacerbate and expose these inadequacies but the pandemic is not the dominant cause. We have had decades of neglect and funding inadequacy, and now another band-aid solution will cost lives.
This new funding announcement has included some recognition of the needs of particular groups with high risks such as aged care, carers and Aboriginal Australians. There is also an outline of the need to increase service linkage and coordination. These are welcome initiatives. And yet they will not plug the gaping hole already existing in these areas. Part of the newly released response is to have targeted communications and awareness raising campaigns. Another campaign that tells us of the importance of mental wellbeing and that “we are all in this together” will be of no comfort to those who have experienced trying to traverse a system for themselves or loved ones that is itself sick.
Inadequacy of funding is a significant problem, the competitive nature of funding of mental health services has often exacerbated this problem.
There has been a need to brand services and professionals in a way that highlights their offerings and expands personal egos. There are so many diverse needs when it comes to supporting mental wellbeing, and therefore diversity of services enables individuals to seek the services that best meet their needs. However, when a system is so grossly underfunded there is a risk that services get involved in fierce competition for these funds and the focus for building their own domain, can take over the actual work getting done.
Now is the time for action. Not more promises. But coordinated, comprehensive person-centred, community-based, preventative and early intervention action. We have the knowledge and skills in this country to do this. And maybe with the impetus of a pandemic we can get past the at times divisive ego-laden approaches and come together to see not just how we as a country can survive (economically, socially and healthily) but, how we can all thrive.
By Tasha Broomhall