Thursday, 12 November 2020                                     HOUSE OF ASSEMBLY                                                                          Page 3305/3306/3307



The Hon. G.G. BROCK (Frome) (11:01): I move:

That this house establish a select committee to inquire into and report upon the impact of the COVID-19 pandemic on the mental health of South Australians, with particular regard to

(a) the impacts of social isolation on mental health and wellbeing;

(b) the stress and anxiety caused by the sense of uncertainty and disruption to daily life;

(c) particular impacts on vulnerable and disadvantaged South Australians, including implications for models of care and social support;

(d) particular impacts of job losses, business closures and economic recession on mental health and wellbeing;

(e) mental health presentations in the context of the pandemic and implications for policy, programs and service delivery;

(f) rates of suicide, self-harm and substance abuse in the context of the pandemic, and implications for policy, programs and service delivery;

(g) measures taken, or that ought to be taken, to help South Australians to proactively manage mental wellbeing in the context of the pandemic;

(h) policy and program responses taken, or that ought to be taken, to address mental health and wellbeing challenges in the context of the pandemic;

(i) the efficacy of the government and community responses to date; and

(j) any other relevant manner.

Mr Speaker, 2020 has been a year like few others.  The sudden onset of a global pandemic and the impact of the lockdowns, travel bans and other measures to tackle it have had impacts on daily life that few of us will forget in the years to come. We do not yet know what the endgame will be. This virus, which the Chief Public Health Officer has repeatedly described as ‘highly transmittable’, seems set to be with us for some time to come.

We are earnestly hoping for a vaccine and we all know that, even with the best efforts, there is always going to be an element of luck in every medical breakthrough. We cannot be certain when or if a vaccine will become available. I am informed, for example, that following the 1919-20 flu pandemic—the deadliest pandemic in recorded human history in terms of absolute numbers—it took another quarter of a century for the first seasonal flu vaccine to become available.

After millions of deaths over 1919 and 1920, later waves were less virulent and subsided into the regular seasonal flu because of acquired immunity long before a vaccine came to the market. Indeed, it is perhaps easy to forget that the world has lived with pandemic-scale diseases such as cholera, influenza and the plague for centuries without the benefit of vaccine.  Even today, HIV remains a pandemic-scale disease across the globe.

Humanity has lived through pandemics before and will find a way to live through this one. As with previous pandemics, or indeed others that remain current, the key to our response will be adaption. Already, we have seen dramatic changes to public administration and the delivery of programs to the community. Barriers that once seemed insurmountable have fallen and ideological objections have been set aside.

The federal budget and state budget both exemplify this trend, but it is clear that on 1,001 fronts there will be more changes to come. It is incumbent upon us all as public policymakers, legislators and elected representatives to embrace these opportunities as they emerge, to seek to chart a new course for the delivery of public policy and services for our community in the face of this extraordinary crisis.

I turn to the substance of the motion that I bring to the house today.  Australia has responded far better than many nations to the impacts of the COVID-19 pandemic. Although it was touch and go at some stages, by and large, governments have acted in a timely fashion to arrest the spread of the disease and to mitigate the immediate impacts of public health measures, such as social distancing, travel restrictions and business controls, on the economic life of the community. This is not to deny that there are things that we could have done better, of course, nor that there are legitimate differences in opinion as to how things should be done in future.

We all have done well and that should be well recognised; however, one of the areas that has perhaps received less attention has been the impact on mental health. Fear, worry and stress are normal responses to perceived or real threats and at times when we are faced with uncertainty or the unknown, so it is normal and understandable that people are experiencing fear in the context of the COVID-19 pandemic.

Added to the fear of contracting the virus in a pandemic such as COVID-19 are the significant changes to our daily lives as our movements are restricted in support of efforts to contain and slow down the spread of this virus. Faced with the new realities of working from home, unemployment and underemployment, business shutdowns, homeschooling of children and lack of physical contact with other family members, friends and colleagues, it is important that we look after our mental health as well as our physical health. As we adapt to this crisis, we must also adapt to this impact.

It is important to acknowledge that the way we have conversations about mental health and the services for mental health are continuing to evolve. We have come a long way since I was a youngster, but there remains an active public policy debate about how mental health should be addressed as part of our healthcare system. It is good that we continue to have these discussions, and they are even more important now. I do not profess to be an expert, although I have had my own experiences with mental health that have shaped my values and interest in this important area of public policy; however, even a cursory review reveals there is much more to unpack.

Some have described the mental health impacts of the pandemic as a hidden epidemic or even a third wave, and the underlying data paints a picture that should be concern for all of us.

According to The Lancet, one of the world’s premier medical journals, in its November editorial there is now mounting evidence that the COVID-19 pandemic is having a monumental impact with ‘effects on the mental health and wellbeing of populations worldwide’.

From studies into more recent pandemics, such as Ebola and SARS, we know mental health impacts can include widespread panic and anxiety, depression resulting from the deaths of friends, family or colleagues, and stigmatisation and social exclusion of survivors. One meta-analysis has found depressed mood, anxiety, impaired memory and insomnia were present in up to 42 per cent of cases of precursor coronavirus pandemics, SARS and Middle East respiratory syndrome (MERS), and that these symptoms continue beyond recovery.

We should also recognise the mental health impacts of the pandemic on our frontline workers who, with increased workload and trauma, are more susceptible to stress, burnout, depression and post-traumatic stress disorder. In the longer term, we can only speculate what the impacts could be. We know, for example, that non-pharmaceutical interventions, although essential, have led to physical isolation particularly of at-risk groups, disruptions to services and widespread job losses. Disruptions to services disproportionately impact at-risk groups, such as people with pre-existing mental health conditions or on lower incomes.

Recently, to mark World Mental Health Day on 10 October, the World Health Organization released the results of a survey of the impact of COVID-19 on mental health, neurological and substance use services in 130 countries around the world. Conducted from June to August 2020, the survey finds the pandemic has disrupted or halted critical mental health services in 93 per cent of countries worldwide. Reasons for disruption were various and included redeployment of health workers to COVID-19 responses, use of mental health or treatment facilities for COVID-19 quarantine or simply not enough funding to start with.

When we look beyond our borders, it is perhaps tempting to discount the impacts of the pandemic on the mental health of South Australians. We have, after all, experienced nothing like what Victorians have just emerged from: a lockdown that must have seemed endless. The stresses and anxieties COVID-19 has created here in South Australia can seem to pale by comparison, but it is clear, even without direct lockdowns, that the mental health impacts of this pandemic are significant and beyond the prior experience of almost all of us. We may not have been exposed to the same levels of disruption as many in other places around the world, but that does not mean there are none. An article on 10 October in the Sunday Mail reported:

  • psychiatric consultations have increased by 5,000 in March to June and wait times for services have ballooned;
  • there was a 20 per cent increase in mental health presentations to the RAH over the last four months;
  • antidepressant prescriptions have already increased since March compared to 2019;
  • ambulance call-outs for mental health in September increased by 23 per cent compared to last year;
  • weekly calls from country South Australians to mental health emergency triage services have increased by 20 per cent compared to last year;
  • calls to drug and alcohol information services peaked in July, 26 per cent higher than last year;
  • average mental health visit times at metropolitan emergency departments rose to 12 hours in July—90 minutes longer than the same time last year; and
  • Lifeline call rates were up 12.5 per cent in September—one of the highest in the world.

These are just some of the indicators and should be enough to give pause to all of us here. It is important to acknowledge that governments have been responding with extra resources being made available, but, of course, this is for a system which is chronically underfunded, and, in any event, this is not just about funding. Like so many other matters this pandemic has touched, it is clear that we need to be open-minded enough to find new and better approaches to deliver outcomes.

What can we do to ensure that all our citizens can continue to enjoy the pleasures of social interaction at a time of social distancing? What can we do to keep people connected to each other and the community in which they live? What can we do to ensure that vulnerable individuals are really heard and seen before a tragic event unfolds? How can we help build good mental health habits that improve resilience for all at-risk groups? What do we need to do differently in delivering acute services? How can we intervene earlier to prevent escalation of mental health problems?

This inquiry, if the house is open-minded to support it, is an opportunity to explore and, I hope, find answers to these and other questions. I commend this motion to the house and I would hope that we can get the support to have this select committee established to understand how we can move forward. Again, I commend the motion to the house.