There is no health without mental health
In Australia’s reaction to COVID-19, our lives are being changed profoundly and our liberties curtailed, without consultation by federal, state and territory governments. Few have yet fully grasped the gravity of the effects on our wellbeing, nor what is still to come. Every day counts!
Focusing on saving lives and livelihoods isn’t wrong, but there is no truly good health without good mental health. Given that humans are social beings, for most people good mental health requires positive social interaction and hope.
Our mobility, work, education, recreation, exercise and, most importantly, our interaction with others is being restricted by authorities. We have to follow the regulations or we face being punished for disobeying them. Right now, it feels as if our careers, dreams and futures are vanishing in front of our eyes.
The reality of home confinements strikes hard too. Imposing one-size-fits-all lockdowns, policy-makers don’t seem to understand that not everyone is lucky enough to have houses with yards, or happy relationships. Families and groups living and working in gardenless flats 24/7 breeds increased interpersonal tensions as well as domestic violence. Over two million people in single-person households risk greater isolation, loneliness and depression, particularly the elderly, while shut off from family and friends. Significant international research links loneliness to serious mental and physical health risks.
Almost 10 percent of quarantined hospital staff reported depressive symptoms of high levels and a study says that more than 28 percent of parents in quarantine reported trauma-related mental health disorders.
Dr Eli Somer, a clinical psychologist and Professor Emeritus at University of Haifa says, “Home confinement restricts freedom of movement and, therefore, is similar in some ways to involuntary hospitalization or imprisonment”.
People with existing mental health challenges, and those living with them, are finding confinement and surveillance all the more traumatic. Economic hardship and no end-date of home confinements and free movement will exacerbate this.
Increasing unemployment is a mental health risk which leads to increased suicides through ‘deaths of despair’ similar to the 1930’s Depression. In the US, studies have estimated each one per cent increase in unemployment causes 58,000 deaths.
Both lives and livelihoods are being endangered by lockdown without being offered a definite sense of the future in return. Experts warn that the deaths caused by lockdown, loss of employment and mental illness are likely to be far higher than the virus itself, and will affect younger people much more than the virus itself, creating enormous inter-generational inequity. How do we create hope for their future?
Before our coronavirus pandemic, one in five Australian adults already had a chronic mental health condition, one in eight Australians (and one in four older adults) were on antidepressants and on average 8 Australian were committing suicide every day. These statistics were already terrible and defined Australia as the second worse mental health statistics in the World after Iceland. In addition to the untold personal and family suffering and community damage that mental illness causes, the costs to our economy are also enormous.
Professor Patrick McGorry recently said: “Societies that experience a crisis tend to see a roughly 20 per cent increase in new cases of mental illness. A massive economic downturn will cause society to fracture and even disintegrate. The consequences of an economic collapse will be much more severe and long-lasting”.
The key challenge faced by Australia’s mental health system in dealing with these accelerating levels of mental illness is the absence of effective treatments for many Australians and the absence of innovation in scalable treatments in the sector for nearly five decades.
Franklin Roosevelt famously said: “The only thing we have to fear is fear itself — nameless, unreasoning, unjustified terror which paralyses needed efforts to convert retreat into advance.”
Fear is the enemy of facts and reason. We are all getting caught up in the drama and terror of COVID-19 instead of focusing on known facts, especially about the real threat to the majority of our society whose risks of severe coronavirus consequences are relatively mild.
Instead of constant reporting of hospital overload, despair, loss and grief which creates an atmosphere of impending doom, why can’t we use more perspective based on dispassionate information that offers hope and comfort, not fear and terror?
Some expert epidemiologists are suggesting that the currently available data used to stir up fear is, in fact, fundamentally flawed. How many have been infected, and therefore true mortality rates, are unclear. As shown by the constantly revised forecasts from Imperial College professor Neil Ferguson — whose dire predictions panicked the British government into dumping its “herd immunity” strategy for total lockdown — modelling has been wildly unreliable. Furthermore, reporting doesn’t distinguish between those dying from coronavirus those dying with coronavirus alongside other illnesses. Italian authorities, for example, estimate 88 per cent of coronavirus-linked deaths in Italy had multiple co-morbidities, any of which may have been the actual cause of death.
Why not offer reassurance about excellent chances of survival, particularly for those under 70 without compromised immune systems? Why not advise Australians about ways to strengthen their immune systems using Vitamins C, D and Zinc and encourage fresh air, exercise, nutrition and sunshine? Let’s welcome evidence that the drug hydroxychloroquine and other treatments appear to help COVID-19 patients, and the other therapies that show promise too.
But, above all, we need to believe in a post-pandemic future, with resources to mitigate the mental health storm as we navigate sudden recession and massive social dislocation.
To create positive change, we will have to be innovative to broaden the tools and treatment options available to doctors and their patients including psychedelic-assisted psychotherapies. Psilocybin and MDMA assisted therapies have already been granted “Breakthrough Therapy Designation” in the United States by the FDA for treatment of mental illnesses including depression and post-traumatic stress disorder.
People need something concrete to look forward to, and Australia’s open-ended COVID-19 response, coupled with unnecessarily heavy-handed enforcement of restrictions by state governments, aren’t doing that.
As the infection curve appears to be flattening, now is the time for decision-makers to balance benefits and harms of prolonged and severe lockdowns. It may well be that Sweden has got it right; allowing society and businesses to keep going with some semblance of normality, with those most at risk urged to self-isolate. We should look closely at this, not dismiss it out of hand.
Let’s awaken our innate creativity and collective energy to find lateral solutions for this crisis and design a more productive and healthier future.
If restrictions on personal liberty and privacy aren’t eased sooner rather than later, the soul-destroying social and mental health consequences of close confinement could be catastrophic and will damage our nation more than any recession. The Prime Minister’s six-month timeframe simply is too long for too many.
This is not a case of lives versus the economy. The choice is between lives and lives.
Every day counts!