Open Access
Psychological medicine

Improving mental health and reducing suicide risk: how GPs can help during the COVID-19 pandemic

WEI-MAY SU, LOUISE STONE, GRANT BLASHKI
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© JPC-PROD/stock.adobe.com models used for illustrative purposes only
© JPC-PROD/stock.adobe.com models used for illustrative purposes only

Abstract

A potential 25% increase in suicides per annum has been predicted in Australia as a result of the distress associated with the COVID-19 pandemic. This article looks at how GPs can support the mental health of their patients while also taking care of their own wellbeing during this crisis.

Recently, the Australian Medical Association, Brain and Mind Centre, and Orygen, Centre for Youth Mental Health issued a joint statement that the COVID-19 pandemic was likely to lead to increased rates of suicide and mental illness.1 According to their modelling, they predict that there may be a 25% increase in suicides, and 30% of these may be among young people. They estimate an additional 750 to 1500 people per annum will be lost to suicide in addition to the 3000 lives lost per annum before the COVID-19 pandemic. In 2018, there were 3046 suicides in Australia, and suicide is the most likely cause of death in young people.2 Economic downturn may worsen this figure and, if the economic situation persists past 12 months, the increased risk is predicted to continue for up to five years. This difficult period comes just after the ecological disaster of mega-bushfires in Australia. Of course, Australian communities are resilient and supportive during crises and it is unclear precisely how these contemporary challenges will impact on suicide rates.3,4 Nevertheless, as the first point of call for many people in times of distress, it raises the question: how can GPs best prepare to manage this increased risk?

Impacts of COVID-19 on community mental wellbeing

The precise population mental health impacts of COVID-19 are still largely unknown, though we do know that there has been a surge of around 30% in the mental health support services such as Beyond Blue.5 Apart from the well-known risk factors for suicidal behaviour, the pandemic adds another layer of risks and stresses on people’s mental health. Because of the recency of the COVID-19 pandemic, many of the practice principles described in our paper are inferred from the general suicide prevention research rather than COVID-19-specific studies, which are yet to be undertaken.

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GPs function at the nexus between clinical medicine and the community, and it is useful to take a step back and look at the various phases of societal responses to a community crisis.6 There may be an apparent lessening of distress in the initial phase as people focus on what needs to be done and there is a sense of solidarity in the community pulling together. A later disillusionment phase is influenced by their perception of injustice in resource allocation. For some, this sense of inequality can persist and result in long-term sequelae. With this in mind, the GP can be particularly vigilant to patient crises during high-risk times as well as to changing levels of mental distress in the different phases of a patient’s response to a natural disaster.

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© JPC-PROD/stock.adobe.com models used for illustrative purposes only
© JPC-PROD/stock.adobe.com models used for illustrative purposes only
Dr Su is Academic Lead (GP) at the Health Education and Training Institute Higher Education, Sydney; and Adjunct Clinical Senior Lecturer in the School of Medicine, The University of Notre Dame Australia, Sydney, NSW. Associate Professor Stone is Clinical Associate Professor, Academic Unit of General Practice, ANU Medical School, Australian National University, Canberra, ACT. Associate Professor Blashki is Associate Professor at the Nossal Institute for Global Health, The University of Melbourne, Melbourne, Vic.