Impacts on Australian Government-funded Mental Health service activity

Use of MBS subsidised mental health items

During the course of the COVID-19 pandemic the Australian Government has made a wide range of additions to the Medicare Benefits Schedule (MBS) to support medical professionals to provide care via telehealth – such as telephone and video conferencing – including for mental health services provided by GPs, psychiatrists, psychologists and allied health workers. Commencing 13 March 2020 and extending until 31 March 2021, temporary MBS telehealth items were made available to help reduce the risk of community transmission of COVID-19, and provide protection for patients and health care providers. In August 2020, the MBS Better Access initiative was expanded to provide 10 additional MBS-subsidised psychological therapy sessions for patients in areas subject to restrictions due to the COVID-19 pandemic. The Australian Government subsequently expanded access to the 10 additional sessions to all Australians in the 2020–21 Federal Budget, announced in October 2020.  

Between 16 March 2020 and 27 September 2020, 7.2 million MBS-subsidised mental health related services were delivered nationally ($791 million paid in benefits); 2.5 million of these services were delivered via telehealth (as opposed to face to face). In the last 4 weeks of September 2020 (31 August to 27 September 2020), the number of services delivered was 14.5% higher than for the same period in September 2019. Telehealth services reached their peak in the week ending 26 April 2020 when half (49.9%) of MBS mental health services were provided remotely. (Figure COVID.1).

Line graph showing the number of Medicare Benefits Schedule (MBS) mental health services delivered each week by mode of delivery, telehealth, face to face and total, from March to September 2020. Telehealth services increase from 6,866 in March to peak at 121,779 in April. It then decline to 71,369 in July and have remained relatively stable through to September. Face to face services decrease from 230,916 in March to a low of 99,859 in April. It then increase to peak at 194,538 in June and have remained relatively stable through to September. Total services have increased from 237,782 in March to 277,748 in September

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Pharmaceutical Benefits Scheme (PBS) prescriptions

In the 4 weeks to 27 September 2020, there was a 6.0% increase in mental health-related prescriptions dispensed under the PBS compared to the same period in 2019. Prescriptions for antidepressants increased by 7.6% in this period. A spike in PBS-subsidised prescriptions, including all mental health-related prescriptions, was observed in March 2020. This represented an 18.6% increase in the number of mental health-related prescriptions dispensed in the 4 weeks from 2 March to 29 March 2020 compared to the 4 March to 31 March in 2019 (Figure COVID.2).

Line graph showing the number of Pharmaceutical Benefits Scheme (PBS) mental health-related prescriptions dispensed by week between January 2019 and September 2020. Prescriptions dispensed per week in 2019 varied from 650,000 to 896,000. In 2020, a large increase in prescriptions dispensed occurred in March, increasing from 770,473 in the week beginning 17 February to peak at 1,013,765 in the week beginning 16 March before declining to 661,292 in April. The number of prescriptions has remained slightly higher than the number for the same time in 2019.

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Crisis support and digital health

A number of phone and online support organisations provide assistance to Australians experiencing mental health issues, including Beyond Blue, Lifeline, Kids Helpline, ReachOut and Mindspot. All Australian Government funded phone and online mental health services are listed on the Government’s gateway to digital mental health services, Head to Health. These services have reported substantial increases in demand for their services during the COVID-19 pandemic. In response, the Australian Government funded Beyond Blue to create a dedicated Coronavirus Mental Wellbeing Support Service to provide free 24/7 mental health support, particularly for people not already connected to the mental health system. Other support organisations have incorporated COVID-19 support into their day-to-day services.

In the 4 weeks from 31 August to 27 September 2020, almost 83,500 calls were made to Lifeline (a 15.6% increase from the same time in 2019), Kids Helpline received more than 32,000 contacts (14.3% increase from the same time in 2019) and more than 27,500 contacts were made to Beyond Blue (21.3% increase from the same time in 2019). Of the contacts made to Beyond Blue in September 2020, 17.5% were made to the Coronavirus Mental Wellbeing Support Service and 7.8% of contacts to Kids Helpline related to COVID-19 (Figure COVID.3).

Line graph showing the number of contacts made per week to Lifeline, Kids Helpline and Beyond Blue between August 2019 and September 2020. Contacts to Lifeline gradually increased from 17,319 in October 2019 to peak at 21,399 in April 2020. It then declined to a low of 19,025 in July before rising to peak again at 21,954 in September. Contacts to Kids Helpline remain relatively stable until February 2020, at 6,836. It then peaked at 11,001 in April before declining to a low of 7,085 in July. Contacts increased again to 9,045 in August. Contacts to Beyond Blue have gradually increased from 3,735 in December 2019 to 6,536 in 2020. Between 31 August and 27 September 2020, all services reported an increase in contacts from the same time period in 2019, with Lifeline reporting a 15.6% increase, Kids Helpline 14.3% and Beyond Blue 21.3%.

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Following initial significant spikes in traffic, websites provided by ReachOut and Head to Health have seen their activity drop from their peak of visitors in March/April 2020, although their average number of daily users has remained higher than before March. ReachOut reported an average of over 11,000 website users a day in the 4 weeks to 27 September 2020, an increase of 24.7% from the same time in 2019, while Head to Health received an average of around 2,700 users a day, an increase of 150.2% in activity from the previous year (Figure COVID.4).

Line graph showing the average number of daily users by week of use of ReachOut and Head to Health websites between November 2019 and September 2020. ReachOut users increased from an average of 4,320 per day in 2019 to peak at 13,380 in March 2020. User numbers have fluctuated since, to a low of 6,517 in June, increasing to a second peak of 12,277 in early September before declining again to 8,968 in mid-September. Head to Health uses increased from an average of 718 per day in 20 January 2020 to peak at 9,309 in March. User numbers have fluctuated since but overall have declined to 2,220 in mid-September.

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Key research messages

Since April 2020, a number of surveys have been conducted by the Australian Bureau of Statistics (ABS) and several Australian universities to investigate the impact of the COVID-19 pandemic on Australians. For more detailed information on these surveys refer to the AIHW Suicide & self-harm monitoring page.

The Household Impacts of COVID-19, conducted monthly by the ABS, collects information on the impact of COVID-19 across a range of key areas, including psychological distress. The Household Impacts of COVID-19 Survey found that young people and women often reported higher levels of concern due to COVID-19, with 28.0% of females experiencing loneliness during April/May, compared to 15.7% of males (ABS 2020a). In July 2020, 19.3% of females surveyed had used a mental health support service since March 2020 compared to 9.5% of males (ABS 2020b).

The Australian National University COVID-19 impact monitoring survey asked Australians about their experience of loneliness between January and August 2020 and found that 45.8% of Australian adults felt lonely some of the time during April, 36.1% in May and 40.5% in August (Biddle et al 2020).

The University of Melbourne’s Melbourne Institute has been running a weekly Taking the Pulse of the Nation survey since April 2020. In the initial survey, 20.0% of Australians reported feeling depressed and anxious 'most of the time'. Since April, the number of people saying they felt depressed or anxious most of the time has varied between 15.1 and 19.7% (COVID.5). For employed parents, if the youngest child was aged 5 to 11, they reported higher levels of mental distress, nearly quadruple from 7% since April to 27% in July (Broadway et al. 2020).

Line chart showing the percentage of people who report feeling depressed or anxious ‘most of the time’ per week, between April and August 2020. 20% of people reported feeling depressed or anxious ‘most of the time’ in April 2020. The rate has fluctuated since and is at 15% as of the week beginning 17 August 2020.

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References

ABS (Australian Bureau of Statistics) 2020a. Household Impacts of COVID-19 Survey, 29 Apr - 4 May. May 2020. Cat. No. 4940.0. Canberra: ABS.

ABS 2020b. Household Impacts of COVID-19 Survey, 6 - 10 July. July 2020. Cat. No. 4940.0. Canberra: ABS.

Biddle, N, Edwards, B, Gray, M & Sollis, K. 2020. Tracking outcomes during the COVID-19 pandemic. Viewed14 October 2020.

Broadway, B, Mendez, S & Moschion, J 2020. Behind closed doors: the surge in mental distress of parents. Viewed 28 October 2020