1.2 Mental health impact of national disasters and emergencies

General practice is the frontline for mental health services, as with physical health services.

GPs are essential in supporting individuals and communities before, during and in the aftermath of natural disasters and emergencies, such as the 2019–20 Australian bushfires and the COVID-19 pandemic.

In times of natural disaster and emergencies, the mental health impact on people and communities is significant. RACGP member feedback highlights that a higher percentage of patients experience mental health issues following disasters, which is often raised in consultations where mental health is not the primary presenting problem.

The mental health impact on communities is often protracted over time – in the context of COVID-19, this has been referred to as a ‘fourth wave’ comprising trauma, mental illness, post-traumatic stress, economic injury, burnout and more.⁹

One study found that five years after the 2009 Black Saturday fires in Victoria, 22% of people in high-impact communities were still reporting symptoms of mental health disorders at approximately twice the rate evident in low-impact communities.¹⁰

Modelling suggests that Australia could see a 13.7% increase in suicide deaths over the next five years, due to high rates of unemployment and reduced community connectedness. The modelling also highlights the likelihood of increased mental health-related emergency department (ED) presentations and self-harm hospitalisations during that time period.¹¹

1.2.1 Mental health impact on patients

For the fourth year running, psychological issues are reported as the most common presentation in general practice (Figure 1).

The mental health of young Australians in particular has been impacted by COVID-19. Between February 2017 and April 2020, the proportion of people aged 18–34 experiencing severe psychological distress has increased much more than for older participants (Figure 3).

The impact of COVID-19 on mental health disproportionately affects younger Australians, as well as females.¹² Between 3 April and 3 May 2020, during the Australia-wide lockdown, the psychological impact of the pandemic was reported as moderate to severe in 35% of females compared to 19% of males for depression symptoms, and in 21% of females compared to 9% of males for anxiety symptoms.¹³

Prior to the COVID-19 pandemic, suicide rates among Aboriginal and Torres Strait Islander peoples were double those of other Australians, due to a history of intergenerational trauma, economic inequity and inadequate access to culturally appropriate health services. The pandemic is therefore likely to disproportionately affect the mental wellbeing of this group.⁹

The proportion of young Australians experiencing poor mental health has increased — Measure: Participant responses to the question ‘How often in the last four weeks have you felt: ‘nervous’; ‘hopeless’; ‘restless or fidgety’; ‘so depressed that nothing could cheer you up’; ‘that everything was an effort’; or ‘worthless’
Base: Total respondents, n = 1745
Data sources: Life in Australia^TM February 2017 and ANU poll April 2020, in: Biddle N, Edwards B, Gray M, Sollis K. Initial impacts of COVID-19 on mental health in Australia. Canberra: ANU Centre for Social Research and Methods, Australian National University, 2020.

1.2.2 Mental health impact on GPs

The emotional and psychological impacts of disasters on healthcare workers is known to change with time, as emerging events elicit different responses and coping mechanisms.¹⁵

In May 2020, one in two GPs (52%) reported at least one negative impact to their wellbeing during the COVID-19 pandemic. The most commonly reported impact was to work–life balance (33%), although more than one in four (27%) reported a deterioration in their mental health state (Figure 4).

GPs aged <45 years are more likely to report a deterioration in their mental health than GPs aged ≥45 years (33% versus 23%). Female GPs are more likely to report a deterioration in their work–life balance than male GPs (35% versus 29%).⁵

One in three GPs rank their own wellbeing as one of the top three challenges that impacts their ability to provide care to patients during the COVID-19 pandemic (Figure 8, section 1.4.2).

52%

of GPs reported at least one negative impact to their wellbeing during the COVID-19 pandemic⁵

Impact of COVID-19 on GPs' wellbeing — ^*Due to rounding, figures do not add up to 100%
Measure: GP responses to the question ‘Have you experienced any negative impact on your own wellbeing as a result of COVID-19?’ (select all that apply)
Base: Responses to survey question, n = 1782
Source: EY Sweeney, RACGP GP Survey, May 2020.

5. EY Sweeney. RACGP GP Survey, May 2020. Melbourne: EY Sweeney, 2020.
9. Dudgeon P, Derry KL, Wright M. A national COVID-19 pandemic issues paper on mental health and wellbeing for Aboriginal and Torres Strait Islander peoples. Transforming Indigenous Mental Health and Wellbeing Grant. Perth: Poche Centre for Indigenous Health, University of Western Australia, 2020.
10. Gibbs L, Bryant R, Harms L, et al. Beyond bushfires: Community resilience and recovery – Final report. Melbourne: University of Melbourne, 2016.
11. Atkinson JA, Skinner A, Lawson K, Song Y, Hickie I. Road to recovery: Restoring Australia’s mental wealth. Sydney: Brain and Mind Centre, University of Sydney, 2020.
12. Headspace. New research: Young Australians fearful and uncertain for their future. 15 June 2020 [Accessed 15 August 2020].
13. Kulkarni J. Expert: COVID-19 mental health and suicide modelling. Monash Alfred Psychiatry research centre. 19 May 2020 [Accessed 15 August 2020].
14. Dudgeon P, Milroy J, Calma T, et al. Solutions that work: What the evidence and our people tell us. Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project Report. Perth: School of Indigenous Studies, University of Western Australia, 2016.
15. Stuchbery M. Minding healthcare workers: Psychological responses of healthcare workers during the COVID pandemic. Melbourne: Victorian Comprehensive Cancer Centre, 2020.

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1.2 Mental health impact of national disasters and emergencies

1.2.1 Mental health impact on patients

Figure 3. The proportion of young Australians experiencing poor mental health has increased

1.2.2 Mental health impact on GPs

Figure 4. Impact of COVID-19 on GPs' wellbeing*