Coronavirus  (COVID-19) and Mental Health

In the last several months, many Australians have been impacted by anxiety, fear and panic about
Coronavirus.

During an immediate pandemic, many people will experience high
levels of anxiety and worry, however, for most, anxiety will decline over time as the virus is contained.
There will be a significant minority who will be affected by long-term anxiety as a result. Health care
workers, people placed in quarantine, and individuals with life-threatening cases of COVID-19 are at
increased risk of long-term mental health problems.
The following summary provides the best available evidence and literature in terms of what can be
anticipated in the existing pandemic, after a large-scale outbreak and specific evidence-based mental
health interventions that are needed in the short and long term.

What are the negative psychological consequences of COVID-19

Common consequences of disease outbreaks include anxiety and panic, depression, anger, confusion
and uncertainty, and financial stress, with estimates of between 25% to 33% of the community
experiencing high levels of worry and anxiety during similar pandemics

[1]. People with pre-existing
anxiety disorders, existing health anxiety (those who worry excessively about having or contracting
illnesses), and other mental health disorders (e.g., depression, and post-traumatic stress) are at risk
of experiencing higher anxiety levels during the COVID-19 outbreak, and may require more support
or access to mental health treatment during this period. This means we will likely see higher rates of
accessing mental health treatments and supports, although given concerns about attending in person,
many people may be looking to get support in different ways.

Populations groups of increased risk

• As noted above, people with pre-existing anxiety disorders and mental health problems are at
increased risk of experiencing significant anxiety and distress during a disease outbreak.

• Health care workers (including nurses, doctors and auxiliary staff) have been found to have high
levels of anxiety during previous pandemics. Overseas experiences of COVID-19 suggest that if
the healthcare system is overwhelmed then healthcare staff are likely to have to make decisions on
rationing of critical care support. While this is not unusual, the scale and extent of this is likely to
be unprecedented. Overseas medical staff have reported high levels of distress through watching
patients die who could have, under usual circumstances, been saved. This type of moral injury is likely
to have long term consequences on the mental health and morale of staff involved.

• Being placed in quarantine is an unpleasant experience and can have long-term negative
psychological effects. A recent review found the potential psychological effects of quarantine
include depression, PTSD symptoms, confusion, anger, boredom and loneliness. The review found
that as many as a quarter of patients in quarantine had trauma-related mental health problems, with
evidence that these symptoms could last for a number of years. Longer duration of quarantine, fears
of infection (getting sick themselves, or infecting others), having inadequate supplies, inadequate
information, experiencing financial loss, and stigma are associated with poorer outcomes following
quarantine.

• Unemployed and casualised workforce are at increased risk of poorer mental health during times of
economic instability and during pandemics [2]. High job insecurity is associated with stress, financial
strain, poorer health and increased rates of depression and anxiety.

Offer practical support

Fear or anxiety about Coronavirus should not necessarily be regarded as pathological or in
need of professional intervention. For those who are in a heightened state of anxiety or worry, it will
typically reduce once the pandemic is resolved, and the majority will not require clinical treatment.
Practical non-psychological health is likely to be the most effective way of reducing the mental health
burden.
People who are unemployed or those with high job insecurity (casual workforce, small business owners)
will be placed under financial strain due to the impact of COVID-19. There are currently 3.3 million
Australians who do not receive sick leave entitlements; these individuals are likely to have
increased stress levels due to the need to take forced unpaid leave, and because their financial security
is being placed under threat. Job insecurity and the perception of job insecurity [3] have been shown to
increase effects of poor mental health, and a three-fold increase in rates of anxiety and depression [4].
Practical support and financial resources for those who are under financial strain or whose jobs are at
risk due to COVID-19 is an essential part of helping to reduce the mental health burden of the current
situation.
Provide good quality information

Community fear and panic can be fueled by rumors, myths and misinformation, sensationalised and
alarmist media coverage, and confusing information and messaging and advice from experts and the
government. Studies of prior pandemics show that media portrayals of respiratory illnesses are often
threat-based and sensational, rather than accurate, factual, or informative about the symptoms of the
virus, and how it can be prevented [6]. To counteract the spread of information (and associated anxiety),
most people will need:
a. Access to free, trustworthy, high quality, and accurate information about COVID-19 from a
centralised and trusted source.
b. Accurate information about the signs, symptoms, risk factors, about how to effectively prevent or
control the disease will give the community a sense of control, and reduce confusion and uncertainty
that contributes to anxiety. Having a single website that members of the public can access both
information and evidence-based interventions.
c. Provide accurate information which makes the distinction between physical distancing and social
distancing, in failing to delineate, this has the potential of having negative longer-term impacts
for societal social inclusion. Encourage people to remain socially engaged as this is critical for
community connectedness and well being.

Offer technology enabled mental health services
An increased focus on technology enabled mental health is critical due to the fears of illness, and
potential for a significant proportion of the community being placed in isolation or quarantine.

• Technology-enabled mental health services such as mobile apps, telehealth, and online treatment
provide an efficient and practical means of delivering treatment to anxious individuals and
communities. These services provide an accessible mechanism for people in the community to seek
support, advice and practical strategies to manage anxiety, without having to attend in-person
sessions. Studies show that online treatments can improve the most common types of anxiety and

• Attending in-person therapy sessions may be too anxiety provoking for those who fear contracting
COVID-19, or impossible for those in quarantine or self-isolation. This means those with existing
mental health problems risk disturbances to their ongoing care – this increases the risk of relapse
and worsening symptoms. The recent additions of new telepsychiatry Medicare items will assist with
this but could go further.

Speak to your GP if you are not feeling like yourself.

There are also numbers you can call and are 24/7 and confidential 

Beyond Blue 1300 224 636 or http://beyondblue.org.au

Headspace 1300 737 616 http://headspace.org.au