NEWS: COVID-19 & youth mental health (1)

NEWS: COVID-19 & anxiety disorders (2)

Suicide rate has not changed

Commentary

• Much has been written about the impact of the COVID-19 pandemic and societal responses to this, such as lockdowns and school closures on mental health.
• Typically young and urban middle class people are highlighted as being at particular risk in contemporary media (1, 2)
• A rise in psychological distress and the prevalence of anxiety and depression has been documented in cross-sectional surveys (3)
• Clearly, this amounts to substantial morbidity and distress for the many affected.
• However a rise in self-harm or suicide has not yet been seen, as highlighted in the middle panel. (6)
• Perhaps, this focus on near term and urban impacts may inadvertantly detract from other concerning and sustained secular trends in vulnerable populations, as this report will explore.

Commentary

• Self-harm and completed suicide are not borne equally throughout Australia.
• The chloropleth graphs on the left show that in each case the incidence is lowest in the capital cities and increases with remoteness. (4, 5, 6, 7, 8)
• The graphs on in the right panel show that these burdens are borne disproportionately by men, particularly of First Nations extraction, and those who are in the poorest and most remote parts of the country. (6, 8, 9, 10, 11, 12)
• There has been an alarming increase in suicide among First Nations men over the last 10 years, from an already high baseline incidence.
• Poorer regions have substantially higher rates of suicide, which have also risen sharply for the poorest quintile over the last 20 years.

Commentary

• The mental health workforce is unevenly distributed, with the highest densities of psychiatrists, psychologists and mental health nurses in the major cities and the lowest in remote areas. (4, 5, 8)
• The graphs on the right show that the poorest, most remote regions and those with the highest proportions of First Nations people also have the fewest mental health professionals. (8, 9, 10, 11, 12)
• In each case, workforce supply is almost the inverse of the need demonstrated on the previous page.

Conclusions

• There is a clear social gradient to the burden of self-harm and suicide in Australia, with higher rates in poorer, more remote areas and among indigenous Australians.
• For some, such as indigenous men and those in low socioeconomic regions, there have been concerning increases in suicide over the last two decades.
• However, the distribution of mental health professionals does not reflect this need, with larger, more affluent cities enjoying much greater access to their expertise.