FRAN KELLY:
Mental health support services across the country are at breaking point. Prolonged lockdowns have triggered unprecedented demand, with Lifeline last week receiving more than 3300 calls on a single day as the highly- highest daily call rate in its history. Now, in their sixth lockdown, Victorians are amongst those suffering the most. One in three Victorians continue to experience high levels of psychological distress. In response, the Federal Government says it will fund 10 pop up clinics in Greater Sydney while extending funding for 12 clinics currently operating in Victoria.
Dr Ruth Vine is the national Deputy Chief Medical Officer for Mental Health. She joins us from Melbourne, a city still in lockdown, Ruth Vine, welcome back to Breakfast.
RUTH VINE:
Thank you, Fran. Good morning.
FRAN KELLY:
We're seeing between 2 and 300 cases, COVID cases across the country on most days at the moment. But we are seeing thousands of requests for mental health help every day, 3300 in one day to Lifeline alone. So, we're on alert for the virus. But are we doing enough to stem the mental health pandemic unleashed?
RUTH VINE:
It - Fran, it's certainly - I mean, this has to be one of the most significant mental health crises we face. And - I think it's interesting, isn't it? And in some ways we're learning to do things. You know, we are getting vaccinated, we are better at tracing, we are better at scanning ourselves in. But there's also this cumulative effect, I think, of uncertainty and insecurity. And it's manifest by people feeling distressed, anxious, depressed, and presenting, as you said, both to helplines and to emergency departments. And one of the most worrying factors has been the very significant rise in young people presenting to emergency departments, you know, up to something like 30 per cent or more compared with two years ago.
So, I think all governments have tried to address this by increasing the capability and capacity. And you mentioned Lifeline, but - Lifeline, Beyond Blue, ReachOut helpline have all been able to increase their capability. But we've also seen, I think, waiting lists and difficulty in accessing other services like Headspace and some of the better access services. And that's where these pop-up clinics, I think, have been really terrific in - it's actually almost a year to the day that we announced the Victorian ones, that was, I think, August 14th, and we managed to get them up in a matter of four weeks. So …
FRAN KELLY:
[Interrupts] Okay. I want to come back to the pop-up clinics because I want you to tell us - describe what people can access there. But before we do that, I'm just trying to get a handle on, you know, Sydney's in its six-week mark of this lockdown, Victoria's in its sixth lockdown. We know the cost of that, the toll it's taken on people. What considerations are taken into account when stay at home restrictions are in force for so long? Do you, as the Mental Health Chief Medical Officer, have input into lockdown decisions? How is it factored into when we go into or come out of lockdowns? What part does that play?
RUTH VINE:
Look, the first answer that is no. Lockdown decisions are made really on the basis of the public health officer and in discussions with the government of the day, of course. But I think what my role is and where I keep being informed is the- when they're occurring- where you get a weekly placemat of demand and where those demands are occurring and what age range. And that sort of helps in form, I think, the sort of packages that have been successively rolled out over the last 12 months or more. And I mean, there was a New South Wales package announced just, when was it? Mid-July, to increase, to bolster the ability of helplines to respond. And then, of course, we've just had the one announced on Sunday around the pop-up clinics.
FRAN KELLY:
With the pop-up clinics. There was …
RUTH VINE:
[Talks over] So, I - sorry.
FRAN KELLY:
There was a study published last week in the Journal of Psychiatric Research, which surveyed more than 1000 Victorians during September last year. It found 33.4 per cent reported symptoms of anxiety or depression, 9.5 per cent reported seriously considering suicide in the past 30 days, which are staggering statistics. There's a limit to what people can handle. So how do we, how do we balance this and help these people?
RUTH VINE:
The first thing I think is to not lose sight of the common sense things and to keep reminding people of the importance of staying connected, of keeping structure in their day, of reaching out to those they know are isolated or lonely or have particular risks like, you know, older people living alone or people living with disabilities. So, I think it's really important to not lose sight of those, you know, common sense, normal ways of trying to keep ourselves buoyant and keep ourselves hopeful for the future. I think it's also really important to make sure that people are aware of when to reach out and where they can reach out.
And so, things like the Beyond Blue COVID line that is available 24 hours a day and- or as you've mentioned, Lifeline. That sort of communication and keeping people engaged is really important. I also think it's really important to- when we're looking at the research, some of the research, some of the surveys are, they seek out people to respond and others are population based. And so, there's been quite a lot of different research. And all of them show increased numbers, Fran, I'm not arguing with that. But I also think we should not overly catastrophise when we know we're doing lots of things and we are making progress. And we are, and we do see a light at the end of the tunnel.
FRAN KELLY:
Sure. My own experience from this lockdown in Sydney, which is now into its seventh week, I think, is that it is- I'm less motivated to reach out and do all those things you just mentioned. Others I speak to are the same. In Victoria, of course, in their sixth lockdown. Are you experiencing that? And is there something more we should be doing in terms of sort of outreach and messaging, reminding people or making platforms for people to do that? Because the more it happens, the less motivated you are. It's easier just to sink into, you know, inside.
RUTH VINE:
That's right. I think you're right, people do have a certain weariness, as I said, a sort of cumulative…
FRAN KELLY:
[Talks over] Yeah.
RUTH VINE:
…impact of being unable to plan for things, or when you do plan for things it goes awry yet again, you know, that sort of difficulty of even planning the next week or month or term. But I, again, I would say that there are lots of things out there. I was just looking at some of the ReachOut websites which have got a whole series of things of what to do when you're lonely and chat rooms and other sorts of forums. And I think it's a really hard one for parents at the moment because they need to keep reassuring their kids that they will get through their school and others are feeling the same way and that things will eventually come right. But- so I understand, Fran, your, sort of, sense of exhaustion at times, but I would also say to keep sort of saying, I am going to keep my daily routine, and I am going to get some exercise, and I am going to do something that I can achieve and enjoy today, is a really important thing to keep doing.
FRAN KELLY:
Oh, sure. I'm not really talking about myself, I'm just using that to illustrate. I think there's a lot of people who are finding it hard and the tail of this is long. As Professor Ian Hickie from the Brain and Mind Centre says, the psychological injury may well persist even though the cause is gone away. We've got these, for the immediate, we have this new funding for ten pop-up clinics in Greater Sydney. They've already been working in Victoria, as you said, and the Government said that since their opening in Victoria, they've answered 11,000 calls for help. What kind of help is available for people at these pop-up clinics?
RUTH VINE:
So I think the beauty of the pop-up clinics is they're free, they have a, sort of, staffing contingents that's usually multidisciplinary, so maybe a mental health nurse, a psychologist, someone with OT experience, some lived experience, or care support workers. The reason they can be popped up so quickly is that they're established in pre-existing primary care platforms. So, in Victoria, we had a range. Some were in community health centres, some were in general practices, you know, a range of different sort of environments. And they're agnostic, so they will take people of, or look after people of any age, they'll provide assessment where referral to other services make sense, they'll support that. But they'll also provide immediate treatment and support within those clinics, and support referrals to GPs, psychologists, and psychiatrists when needed. But I think the other thing that's been really important in Victoria is there was a, sort of, single 1-800 number that allowed people to access a fairly senior clinician who would take them through what they were experiencing, and think about what might be needed. And I think what we found was, of those 11,000 calls, probably about 5000, a bit more than 5000, did need to come into the clinics and receive some more direct support or treatment. But a lot of people actually got a really positive outcome from that, sort of, initial assessment and, sort of, clinical exploration of what they were experiencing.
FRAN KELLY:
You mentioned earlier, and a lot of people have pointed this out, that, you know, resources are very stretched. It's hard to- there's a long waiting list, particularly in regional Australia, for psychologist services for instance, for some of the Headspaces. I know this is really not, you know, phone Dr Ruth time here, but let me give you this example. Someone's written in and saying, my daughter went through Year 12 last year in lockdown. She's depressed, anxious, she's self-harming. As a single mother with no private health insurance, the minimal support we've been able to access has not helped her. I am desperate and do not know where to turn. What would you tell this mother?
RUTH VINE:
So the- and isn't it terrible when you hear that and you think that a person has experienced something during 2020 and now, sort of, still struggling in 2021.
FRAN KELLY:
[Interrupts] She's desperate.
RUTH VINE:
But- so, what I would say is, do explore the things that are around you. There is Headspace. About 30 per cent of the MBS mental health items at the moment are being provided by telehealth or video health, which has really improved access to some of our regional and rural services. And depending on where this mother is, I would say, look to the HeadtoHelp clinics in Victoria if that's where you are, or, you know, try out these new ones in New South Wales. And always, you know, talk to your general practitioner. Explore what's available both online and by more speedy referral to what's around via face to face or video.
FRAN KELLY:
Ruth Vine, thank you very much for joining us.
RUTH VINE:
Thank you. Thanks for having me, Fran.
FRAN KELLY:
Dr Ruth Vine is the national Deputy Chief Medical Officer for Mental Health.
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