Mental health crisis as self-harm presentations surge during lockdown

“Jobs will be lost, businesses will close, debt will increase and the mental health of our community – particularly among kids – will suffer.”

NSW Health’s fortnightly internal report on mental health service demand and care, dated August 17 and obtained by The Sun-Herald, shows demand for services has risen among all age groups since the pandemic began, but the impact is most severe for children and teenagers.

People aged 0 to 17 already suffered a decline in mental health in 2020 compared with 2019, and in 2021 there is a further decline.

In the year to July 29, 8489 people under the age of 18 were rushed to hospital for self-harm and suicidal ideation, equating to more than 40 a day. That was a 31 per cent rise on the same time in 2020 and up 47 per cent compared with 2019. Across all age groups visits to emergency departments for self-harm and suicidal ideation were up 13 per cent compared with last year.

Emergency department mental health presentations for 0- to 17-year-olds – a separate category which can include psychotic episodes – were up 26 per cent compared with 2020, compared with a 6 per cent increase for the general population.

Acute mental health admissions for children and young people for the year to July 22 were up 43 per cent on 2020, compared with a 2 per cent rise for the general population.

The Australian on Saturday reported on a similar crisis in Victoria, where figures to the end of May show an average of 156 teens a week were rushed to hospital after self-harming and suffering suicidal ideation, an 88 per cent increase on last year.

NSW Chief Psychiatrist Murray Wright said young people are feeling the effects of lockdown the most.

NSW Chief Psychiatrist Murray Wright said young people are feeling the effects of lockdown the most.Credit:Nick Moir

Dr Wright said self-harm among adolescents had been increasing in the western world for the past decade, so the impact of the pandemic came on top of the long-term trend.

The NSW Ombudsman last week delivered its Biannual Report of the Deaths of Children in NSW, which found suicide was the leading cause of death for people aged 15 to 17 in 2018 and 2019, and had increased significantly for all children aged 10 to 17 since 2005.

Among all age groups, 444 people died by suicide in the first half of this year, compared with 428 before the pandemic, with most of the rise in regional NSW.

The NSW budget in June allocated $109.5 million to enhance child and adolescent mental health services in every local health district over the past four years.

On Sunday Minister for Mental Health Bronnie Taylor will also announce an additional $8 million in grants for suicide prevention targeting specific communities, including LGBTQ+ people, older people, people who have previously attempted suicide in regional communities, men and young people. A similar grant to prevent Indigenous suicide is pending.

Calls to crisis lines for 0- to 18-year-olds are 13 per cent higher this year compared with before the pandemic, though down 9 per cent on 2020. Mental health services on the Medicare Benefits Schedule for 0- to 17-year-olds were up 20 per cent on 2020, while new community clients for this age group were up 24 per cent year-on-year.

Dr Wright said this showed young people and their families were accessing mental health assistance earlier, which was “a good thing because we’ve spent decades trying to destigmatise mental health and telling people ‘don’t suffer in silence, please ask for help’.”

Christine Morgan, National Suicide Prevention Adviser and chief executive of the National Mental Health Commission, said there were long waiting lists for mental health services across Australia and there was a need to equip parents to help because they were akin to “frontline workers”.

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“They’re in the homes with the young people, they can see it, and by engaging in these conversations, they can often help to de-escalate some of the anxiety,” she said.

Ms Morgan was concerned about a rise in young people expressing a sense of loss of hope in the future. She acknowledged parents with children and teenagers at home during lockdown had a tough job but said they should try their best to help children maintain engagement with education and friends and stay physically active, and encourage them to think about what they had to look forward to.

The Mental Health Commission along with other peak mental health bodies is starting a social media campaign called #ChatStarters to try to start conversations that go deeper than asking people if they are OK.

Dr Wright said it was important to talk about solutions because “a sense of helplessness” could create further harm. He welcomed the announcement of vaccines for 12- to 15-year-olds because this would not only protect them physically from COVID-19 but would also give them a mental health boost by letting them control their response to the pandemic.

Dr Wright said that when advocating for mental health among his colleagues, he promoted the need to increase social cohesion rather than targeting specific measures. He said he was comfortable with the fact it was a balancing act with the public health measures to fight the pandemic.

For emergencies call 000. Other helplines: Lifeline 13 11 14; Kids Helpline 1800 55 1800; NSW Mental Health Line 1800 011 511.

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