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32 SPOTLIGHT SERIES MENTAL HEALTH As seen in the April issue of Retail Pharmacy magazine. THE PANDEMIC’S SILENT IMPACT BWy Margaret Mielczarek. hile the Covid-19 pandemic has led to dramatic loss of life worldwide with an unprecedented impact on physical health and enormous strain placed on emergency departments and services, its silent impact has been on mental health, in Australia as well as overseas. With the rise in concerns within our community over mental health, how will services in this sector be affected? According to Professor Susan Rossell, NHMRC Senior Research Fellow and Professor of Cognitive Neuropsychiatry at Swinburne University of Technology in Melbourne, the ongoing mental health impacts from the pandemic are worrying. “Right at the beginning of the pandemic, as it started to emerge in January/February last year, I put together a national survey called Collate, and what we’ve been doing is ... monitoring the mental health status in the general population, once a month, every month,” she said. “We collected data on the first to the fourth of every month ... and we’ve been able to track people’s mental health ... We’ve been doing it with the general population and just getting them to tell us how they feel, using very standard measures that are accepted in the literature. “So, we were able to show during that first lockdown that for people in the general public, their depression, anxiety and stress levels were three times higher than in a typical year ... and for people with some pre-existing mental health conditions, they were actually four and a half times higher.” Professor Rossell says these results are “extremely concerning, because when you’re talking about levels that are four and a half times higher, what people are reporting is moderate to severe depression, anxiety and stress”. “Those moderate to severe levels would be akin to people wanting and needing mental health services,” she said, adding that “a huge increase in people needing mental health services” has been observed. “We know that in a typical year, up “Not only is Covid-19 having an impact on emergency departments, but now the next step is ... having a huge impact on mental health services.” to around 20 per cent of the general population will need some kind of support from mental health services,” she continued. “But what our data \\\\\\\[suggests\\\\\\\] ... we were finding between 40 and 50 per cent of the general population \\\\\\\[were\\\\\\\] needing mental health support.” While data for January and February 2021 showed a “small decrease” in numbers seeking help from mental health services, Professor Rossell points out that the number is “still really up”. “Remember: they went from three times to four and half times in September,” she said. “They’re only back down to three times \\\\\\\[now\\\\\\\]. So, it’s still an increase ... I think that number has gone from maybe 50 per cent of the general population needing mental health services to maybe 40 per cent. So, it’s still up.” “This will have a huge impact, obviously, on clinics and services that are available. So, not only is Covid-19 having an impact on emergency departments, but now the next step is ... having a huge impact on mental health services.” Signs of mental struggle Two of the signs that pharmacists and pharmacy can look out for among their customers in terms of possible mental health problems are a “very withdrawn” state and that of “being very agitated”, according to Professor Rossell. “I’d say these are the two big things \\\\\\\[to look out for\\\\\\\],” she said, adding that another “red flag” – a consequence of the “isolating factor”, perhaps – would be if some regular customers suddenly were not visiting a store any more. A further sign of a mental health struggle may be changes in symptoms associated with a previously diagnosed mental health condition, such as in behaviour associated with obsessive- compulsive disorder (OCD). Professor Rossell points to “reasonable reports in the literature” of increased OCD-type symptoms prompted by a more intense focus on cleanliness. “If someone’s taking that to an extreme level and not getting on with their everyday duties because they’re washing their hands too much or cleaning their house too much, that would certainly be of concern,” she said. According to the Department of Health, “the impacts of the Covid-19 RETAIL PHARMACY ASSISTANTS • APR 2021