Right now our country, our government, and our health system are in the grip of dealing with a pandemic. For a healthy community it provides many challenges – but for those who need to urgently access the health system for non-COVID-19 treatments it’s proving to be very problematic in many areas of Australia. Some of the hardest hit people are those living with mental health issues.
Former Deputy Commissioner of NSW Mental Health Commission, and general manager of inclusion for Flourish Australia, Fay Jackson, believes that the current health crisis shows clearly that the public mental health system is not working. It wasn’t working effectively before COVID-19 and it certainly isn’t now, she says.
The issue for people experiencing a mental health crisis is that, by far, the most common entry point to the system is when people are triaged and assessed at Accident and Emergency (A&E). The impact of COVID-19 on A&E is causing many people to be turned away, and they are not receiving the support they need, or timely, compassionate, healing treatment.
‘I am receiving phone calls from different areas of several states across Australia, saying that when people are in severe psychological distress, and are feeling suicidal, or have engaged in serious self harm, they are frequently being turned away’, says Fay. ‘This is probably for a variety of reasons, but is not new since the COVID-19 crisis began. People experiencing this level of distress have usually experienced severe trauma in their lives and being turned away can add to the traumatic experience.
‘With the COVID-19 crisis, the situation is changing daily, even hourly. So if anyone is having difficulties with mental health, my advice is to make a safety plan to try to avoid an emergency situation. If A&E is needed in an acute crisis, my advice would be to ring ahead. A plan can decrease risk and trauma. It’s hard to consider what to do when you are in the middle of a mental health crisis.’
The current health pandemic is putting more pressure on people living with mental illness
‘A lot of people are feeling more vulnerable and frightened’ says Fay. ‘Many people aren’t getting the types of support they were getting before social distancing, isolation, shutdowns on gatherings and social interactions started. Some people’s support previously included support to go shopping, and social engagements with friends, family or staff from not-for-profit mental health services. This has significantly decreased. Most supports are now only offered by phone or video calls. For some people that is very difficult.’
Flourish Australia has a philosophy and model of valuing lived experience of mental illness, and offering peer support as part of recovery. Peer support workers carefully, and purposefully, use their lived experience to bring hope and encouragement to people’s lives and situations. They remind the people they support about their resilience and attributes, rather than following old models that focus on symptoms and deficits.
According to Fay Jackson, ‘Many of us with mental health issues, apart from [the distress of] COVID-19 itself, have been through many of the elements that people are going through in this crisis right now. We have often been isolated from our friends, family and community. We have been unable to get employment, afford rent or mortgages and [have been] fearful of going shopping. Many of us have been forced, against our will, to be locked in psych wards, unable to enjoy freedom or choice and living under community treatment orders.
‘When you are in a time of psychosis, or deep depression, you usually don’t feel you can connect in the way you might have done usually. Those of us who have lived with long-term deep anxiety, paranoia and lack of sleep have experienced what many people are now experiencing for the first time. But we have often developed coping skills and resilience that aren’t recognised. We are survivors, and we draw on what we have learned to support others. We may not feel strong or resilient, we may feel fragile and weak, but feelings and thoughts aren’t facts. The fact is, if you are alive today you have been through tough experiences and you are a survivor. I encourage people to support others who haven’t learned to recognise their resiliency skills to discover them. People with lived experience of mental health issues have an incredible amount of support, advice and resilience to share, if people care to recognise it and listen to it.’
Someone is suicidal, or threatening self harm, what should you/they do?
‘Hopefully you are able to put some things in place before the crisis’ says Fay, ‘Utilising such things as the Beyond Now Safety Plan App, or just writing out things you can do to help yourself through these times. A plan for if things reach crisis point is important too, but that’s not always possible. You can call Lifeline 131114, the Mental Health Access Line on 1800 011 511. The Sane Australia online forums also provide some great peer support and carer support. Sane Australia is on www.sane.org, but try to do all these things to avoid a crisis taking place.’
And of course, phone ahead to an emergency room for advice
The Morrison government has announced increased funding to go towards support services to address the needs of people with mental health issues who are experiencing increased difficulty accessing help. Fay says, ‘Many more peer workers, and carer and family support workers, would be a great addition to the current mental health systems. But we all need to recognise our resiliency skills and to support others who are re-experiencing, or experiencing psychological distress for the first time. We all have things we can say, even if it is only over the phone, that can help people through this hard time. Let’s do this’.