Emergency medicine specialist Dr Simon Judkins recently called for climate action to help address the mental health burden and distress that many young people are experiencing.
It’s also critical to address young people’s concerns around COVID vaccine misinformation and hesitancy through pragmatic and equitable pandemic responses, writes Dr Sarah Simons, an Emergency Department registrar in Melbourne.
Her article comes as the NSW Government announces a Pfizer vaccination program will be launched for Year 12 students in the eight local government areas of concern with doses being redirected from regional NSW. The LGAs are: Fairfield, Canterbury-Bankstown, Liverpool, Parramatta, Georges River, Cumberland, Campbelltown and Blacktown.
Sarah Simons writes:
Early on in this pandemic, there was a recurring sentiment that tackling COVID would be a long-haul effort, a “marathon, not a sprint”. Seventeen months on, many of us are still in the midst of lockdowns and the infection remains a persistent and urgent threat.
The marathon analogy has crumbled; even a marathon has an expected and fixed finish line at 42km. With millions of Australians in necessary lockdowns with no endpoint in imminent reach whilst our peers overseas are cautiously unlocking, it’s even harder this time.
The morbidity and mortality of this pandemic extends far beyond those infected with the virus itself and the fumbled vaccination rollout has further fuelled the tidal wave of mental illness that will be the Australian legacy of COVID-19.
Suicidality and crisis presentations amongst young people age 5-25 years old have skyrocketed in Victoria by 184 percent in the last six months with similar spikes in New South Wales and Queensland. This is manifesting as increasing numbers of cases of anxiety and panic attacks, assaults and family violence, alcohol dependence, drug overdoses and suicide attempts in our Emergency Departments on a daily basis.
Our hospitals are filling with young people at crisis point, many of whom have barely ever discussed their mental health before, like teenagers and young men, let alone sought professional help.
Data released recently by the Australian Institute of Health and Welfare (AIHW) for 2019-20 shows that people aged 18–24 years old already had the highest rate of mental health-related presentations to Emergency Departments, even prior to the most recent round of lockdowns and the Delta variant outbreak.
Harmful messaging
Confusing messaging and risk analogies about COVID vaccines has proven to be at the abject expense of young Australians’ mental health. People in their teens, twenties and thirties have spent several months of their formative years cautiously social distancing and masking up in a large part to protect their older loved ones at the expense of their own health and wellbeing, but have found themselves confused and ignored when it comes to getting vaccinated.
Human beings are “anticipation machines”; being able to plan for the future is a huge protective factor for mental wellbeing and impossible until vaccination rates dramatically improve. Instead, ill-informed concerns, confusing risk assessments and conflating terminology about vaccination side effects are feeding vaccine hesitancy, uncertainty and anxiety amongst this age group in particular.
Accurate and engaging public health information needed to help people of all ages and socio-economic status make informed, empowered decisions about the vaccine and ameliorate risk has been sorely lacking in Australia and misinformation has been allowed to propagate.
It is especially galling to walk past numerous lamp posts plastered with anti-vax sentiment and false claims on the way to work in a Melbourne hospital battered by COVID cases and deaths last year.
Though some anti-vaccination sentiment has since abated with the Delta outbreak, the Australian Government’s choice of coronavirus advert features a panicked and breathless young, slim, Caucasian woman who, as an aside, is epidemiologically far less likely to die or get very sick compared to her ethnically minoritised and older counterparts.
What we need
The recurrent presence of anti-vax posters and this fearmongering, blinkered advert only amplifies the absence of the clear, engaging and diverse public health campaign that should have been carpeting buses and billboards months ago instead, like the optimistic French adverts with the right idea and a Gallic sense of humour or Australia’s own iconic “Slip, Slop, Slap” sun safety campaign in the 1980s.
Fortunately, finally, last week’s wonderful offerings from the Melbourne Symphony Orchestra and the Victorian Council of Social Service have the right idea, but the Federal Government’s choice of fear as a motivation technique is useless – it cannot provoke people into getting immunised when it simply isn’t possible because there aren’t enough vaccines available and so anxiety and distrust of the government further propagates and drives mental ill health.
Australia is by no means the only country to deal with a large influx of COVID-related mental illness and though it feels difficult to see the end of the tunnel when Delta and poor vaccination rates keep pushing the light further away, those struggling should know that they’re not alone and this won’t be forever.
The Delta variant is an imminent threat but, with resources we already have, time, adherence to hard lockdowns and increased vaccination efforts, it is absolutely possible to curb the spread of the infection.
Pragmatic perspective is important, too; the vast majority of people are innately good, kind and sensible.
For every news story of someone breaching COVID rules or endangering others, there are millions of Australians staying at home and trying to get vaccinated, mask-wearing neighbours depositing packages on the doorsteps of isolating friends and relentless healthcare teams working all hours in order to prevent someone else getting really sick or another heartbroken family holding a Zoom funeral and trying to nudge us a small step closer to normality instead.
Australia is a powerful, wealthy country with public healthcare and the means to end this pandemic with vaccines. Though the Australian health system will feel the weight of pandemic related mental health issues for the foreseeable future, we have cause for cautious optimism with a pragmatic and equitable approach.
However, whilst the vast majority of the general population remain unvaccinated, an imminently worsening and avoidable mental health crisis amongst young people is an urgent concern and one that must be anticipated in coming years.
Dr Sarah Simons is an Emergency Department registrar working in a busy inner city public hospital in Melbourne. She is British trained with postgraduate study in global public health at UCL and an academic interest in the determinants of health, incorporating social justice perspectives and advocacy into emergency clinical practice for socially vulnerable people.
Follow on Twitter: @SarahNSimons
See our previous coverage of youth health.
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