(NEW) Population mental health: Challenges during the pandemic

The COVID-19 pandemic has presented multiple challenges for the Australian healthcare system. In this Presidential Symposium at RANZCP Congress 2022 chaired by Associate Professor Vinay Lakra, aspects of population mental health during the pandemic were discussed by Associate Professor Jeffrey Looi, Professor Tarun Bastiampillai and Professor Steve Kisley.

Public and private specialised mental health services have held a vital role during the COVID-19 pandemic. Demand for public specialised mental health services has remained steady and sustainable during the pandemic to date, while an increase in demand has been seen in private sector specialised mental health services.

Public and private specialised services have played complementary roles in meeting population mental health needs to date during the COVID-19 pandemic.

Another population health issue relevant to the pandemic is suicide. In the early days of the pandemic, suicide rates were predicted to be likely to rise.1 Despite a worldwide increase in rates of anxiety and depression during the pandemic, suicide rates remained stable or declined in higher income countries during the early stages of the COVID-19 pandemic.2

The decline of the suicide rate during the COVID-19 pandemic is reminiscent of the situation in the United States during the early 20th century Spanish flu pandemic.3

In 2022, Australia is experiencing high rates of COVID-19 infection and slow uptake of booster vaccines.4,5 This situation is affected by vaccine hesitancy, which exists on a continuum from outright refusal to milder hesitancy towards vaccination.6

Reasons for vaccine hesitancy can include complacency, fear of side effects, and lack of clarity regarding eligibility for vaccines.6

Conspiracy theories can also contribute to vaccine hesitancy. These exist on a spectrum from healthy scepticism to firm belief in conspiracy theories, through to persecutory delusions.7 Conspiracy theories may be distinguished from delusions by considering factors including the nature of the belief, level of preoccupation, and whether the threat perceived is thought to relate to the individual or the whole of society.7

People with severe mental illness may be at greater risk of breakthrough infection after COVID-19 vaccination,8 so vaccination is crucial for this population.

Strategies to reduce vaccine hesitancy in those with severe mental illness include discussing reasons for hesitancy with the patient, using motivational interviewing,9 providing flexible opportunities for vaccination and using linguistically and culturally appropriate approaches. Combatting vaccine hesitancy can help to improve the wellbeing of this vulnerable population.

Our correspondent’s highlights from the RANZCP 2022 symposium are meant as a fair representation of the scientific content presented. The views and opinions expressed on this page do not necessarily reflect those of Lundbeck.

AU-HLU-0039. May 2022

References

  1. Bastiampillai, T et al., Molecular Psychiatry 2020; 25:3445–7.
  2. Pirkis, J et al., Lancet Psychiatry 2021; 8:579-588.
  3. Bastiampillai, T, et al., Prim Care Companion CNS Disord. 2021;23(6)
  4. Coronavirus (COVID-19) case numbers and statistics. Available here
  5. Who wants to get boosted? COVID-19 vaccine uptake in Australia in January 2022. Available here
  6. MacDonald N. Vaccine 2015; 14; 33:4161-4.
  7. Starcevic, V et al., Australasian Psychiatry 2021; 29:535-539.
  8. Nishimi, K et al., JAMA Network Open 2022 ;5:e227287.
  9. Kisely, S et al. International Journal of Mental Health Nursing 2017; 26:41-48.