Professor Patrick McGorry is an Irish-born, Australian psychiatrist known worldwide for his development and scaling up of early intervention, youth mental health services, mental health innovation, advocacy and reform. He is executive director of Orygen, Professor of Youth Mental Health at the University of Melbourne, and founding editor of the journal “Early Intervention in Psychiatry”.
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Despite much advocacy to increase the funds available to manage what Professor McGorry refers to as the “shadow pandemic”, there are too many examples of resources being taken from mental health care which is already underfunded, to support the management of patients with COVID-19. Even prior to the pandemic, “approximately 7% of the health budget in Australia is allocated to mental health, yet mental health conditions contribute close to 20% of the burden if we include all conditions that are mental health related” according to Professor McGorry. “The pandemic has added an additional 30% of demand, yet this demand cannot gain access to care and far too many consumers are turned away because there is simply no room for them.”
Professor McGorry explained that the only place many find they can go to is the emergency department. Lack of beds, ambulances queuing outside emergency departments, and psychiatrists/psychologists closing their books because they have too many patients have become the norm. “Every day, mental health professionals must make “Sophie’s choices” regarding which patient they must discharge or turn away in order to care for another. There is no other specialty that must do that, turn their patients away in such numbers. It causes “moral injury” for mental health professionals.” Professor McGorry said. Some of this is to do with lack of resources, and some is to do with reduced capacity due to the pandemic, but undoubtedly this is also due to the stigma that has always been pointed toward psychiatry, its patients, and professionals, including by our general health colleagues within the health care system.
“Effects of the virus and worsening mental health add a significant burden, but now there is some predictive modelling that reveals the ill effects of the pandemic in all areas of health and wellbeing will be felt for years to come,” - Professor McGorry
Professor McGorry recounted a story of a sister and brother, one with leukaemia and one with schizophrenia. Both were treated within the same hospital for their disorders, yet the sister experienced tremendous care, warmth, positive regard and even support with her mental health. The brother’s experience was completely different, and even though he was the one with the serious mental illness, he was offered a much lower standard of psychological and psychiatric support.
Living in the time of a pandemic
Chief Health Officers during this time are little more than “Chief COVID-19 Officers” - they have really only been able to focus on the management of the pandemic. Another reality of living in the time of a pandemic becomes clear, and that is that public health more broadly deteriorates. “Effects of the virus and worsening mental health add a significant burden, but now there is some predictive modelling that reveals the ill effects of the pandemic in all areas of health and wellbeing will be felt for years to come,” Professor McGorry said. Not only is mental health the “Shadow Pandemic” but issues like delays in diagnosing and treating cancers are occurring because people were in lockdown or could not get medical appointments.
Although there is much work to be done, a positive which has emerged from the challenges of the pandemic, and which was also highlighted by the Royal Commission into the Victorian Mental Health system, is a culture and an expectation for change. Reform is underway in Victoria and we must insist that this spreads to other jurisdictions and Federally.