A profound impact

CONTENT WARNING: This article discusses topics and language that may be sensitive to some readers. If you or anyone you know has or is experiencing crisis or needs help and support, please visit beyondblue.org.au or lifeline.org.au. If your life or the life of others are in danger, please call 000.

Shayne Elliott: Beyond Blue is a very well-known organisation, but I doubt people truly understand the scope and exactly what Beyond Blue does. Georgie could you give a bit of background into the organisation?  

Georgie Harman: We are Australia's most well known and most visited mental health organisation, with a sharp focus on the most common mental health conditions in Australia; depression and anxiety. We also focus on suicide prevention.

Millions of Australian’s come to us every year, whether they are well and want to stay that way or they're acutely unwell or in suicidal distress and are looking for support to recover. In some cases, they have gotten better and want to give back - they want to connect with our community and become an ambassador or a speaker. We're here for everybody.

Most people know us for our work tackling stigma and discrimination, but we've moved far past that. It's still a core part of our work however we've moved from just simply raising awareness to behaviour change; how we educate people, so they make good choices about their mental health and recovery.  

We have a 24-hour support service, which is predominately funded by donations from companies such as ANZ, philanthropy and the community. But we also run a bunch of other services that people may not realise. For example, we have a service that works with people in the community after they've attempted suicide. We have a very early intervention service called New Access, which uses coaches – it's about lower intensity coaching, which is cognitive behavioural therapy based.

We also do policy advocacy and have workplace mental health programs. We've got a major national initiative which is Commonwealth funded called Be You, that's in about –two thirds of all schools around Australia and about a third of all early learning services.

We are in schools, early learning services, workplaces, communities and sporting clubs. We help people to equip themselves and know where to get support if they need it.

Shayne Elliott: In our line of business and work, two things we saw broadly as a result of COVID-19 were acceleration of pre-existing trends (i.e. digitisation) and the emergence of new behaviours and stressors. What was the impact of COVID-19 on the broader mental health of the community?

Georgie Harman: The impact of COVID-19 has been profound and still is, to be honest. The reasons people are coming to us have changed as the pandemic's changed.

In the beginning, it was really heightened health anxiety. What is this virus? Am I going to catch it? Am I going to die or is my family going to get sick?

It then moved into high stress around jobs and unemployment.

We then started to see a real focus on family stress and unfortunately, family violence.

And now it's moved into this space where it's just pure exhaustion. People are just exhausted.

The three most common reasons of presentations to us are number one by a country mile - anxiety, then depression, and generalised worry.

And then we move into the financial stress and family stress areas. Everybody's been affected to some degree, but some groups are doing it much tougher than others. People with existing mental health conditions, young people, small business owners, women, people in insecure or casualised work or with no work, multicultural communities, Aboriginal Torres Strait Islander communities and LGBTIQ+ communities.

So those are the groups we're really focussing on, and we're seeing a greater acuity and a greater level of psychological distress by those who have been more profoundly affected.

The big story is the volume of demand. Already, this year in the past 9 months of 2021 we are at a 53 per cent higher volume rate than what we saw in the same period of 2019.

It's big, it's wide, it's deep. It's disproportionately affecting certain groups. We are using real time data and insights to constantly iterate the advice and support offerings that we're providing to people.

Shayne Elliott: Do you think in the long term there will be a greater appreciation or more understanding of mental health across the community as a result of what's happening at the moment?

Georgie Harman: Without a shadow of a doubt. There are three silver linings that stand out to me.

Firstly, there is a renewed focus on mental health. Everybody is talking about mental health and wellbeing, whether you're an employer or an employee or a government or a, you know, mum or dad. We're talking about mental health and wellbeing in a way that we haven't done before.

The second thing is that everybody now understands that in the right circumstances and the right combination of circumstances, no one is immune. This isn't about other people - it's about all of us. I think we have seen a much greater sense of empathy and understanding, appreciation and respect for the incredible challenges faced by many Australians who live with severe, complex mental illness.

The third thing has been the unequivocal spotlight on the connection between social connection, how much we need each other as human beings, and mental health and wellbeing; the importance of community.

I think there are some really great things that have come out and have shaped the conversation we've had as a country right down to community level and family level.

And I really hope that those things stick.

Shayne Elliott: In our business we focus a lot on people's financial health or financial wellbeing. Research shows from a financial perspective that everybody is vulnerable. It's really about the circumstances of the time, you know, and that you go through a period of vulnerability. While our focus is around financial health, I’d love to hear your thoughts on the importance of the linkage with mental health and how it manifests itself in terms of the community?

Georgie Harman: Financial health and mental health are two sides of the same coin. You cannot separate them. We all go through periods of adversity in our life. Money and mental health are absolutely linked.

We have commissioned some research with the Australian Securities and Investments commission (ASIC), with some interim findings already available. We are exploring in more detail this link between money and mental health. What those interim findings have shown is that that link is indisputable. That's not new news, but it's grounded in some really concrete research.

What is harder to do is establish both the direction and the order of influence between that link. What comes first and how to how do the two things work together?

The relationship is complex. It's likely to be reciprocal. The research is already showing that depression and anxiety symptoms are overrepresented among people who are experiencing financial difficulties and there is a downward vicious cycle where they feed off each other and reinforce each other.

Chronic disadvantage, long-term unemployment, bankruptcy, long-term mental health problems, adverse childhood experiences – these all increase your vulnerability to financial hardship. Nothing particularly new about that either, however there are several groups potentially more at risk: younger people, women, especially older generations of women these days, single parents, those living with or fleeing family violence and people experiencing intergenerational trauma. And again, people who've had those adverse early life experiences.

One thing showing from the research is that the dominant narratives actually stigmatise money and mental health issues, and they result in shame. The way we often talk about this stuff emphasises individual responsibility for financial hardship - ‘Why can't you afford to put food on the table’?

But also, that dominant narrative is around mental health issues as well - ‘Why are you mentally unwell?’ ‘Why can't you just kind of bounce back?’

Stigma is the real enemy here, both from financial wellbeing and a mental wellbeing perspective. It stops people from seeking help early, and it means many people get to the point of crisis when the interventions look very different, either from a financial rescue perspective or a mental health intervention perspective.

The two are inextricably linked, but I think there are some interesting findings that are going to come out that will really shape the way we think about our services, hopefully in industries like yours. And it's really going to have to focus on again that non-stigmatising approach and prevention and early intervention.

Shayne Elliott: Speaking to many team leaders both inside ANZ and outside of the organisation, and from my own observation, when you think about your care for your team and the people around you, it's a lot different in a remote world working from home. Any thoughts on how good team leaders raise the issue of mental health or mental wellbeing in their teams when it's perhaps a little bit more difficult or just different to do in a remote environment like this?  

Georgie Harman: It is harder because you don't have that direct eye contact. One of the things I have observed - and this is a real issue and it's an issue I talk to a lot of businesses about - is that we are having a different conversation about it and it's not got the same sort of taboos in the workplace that we had even 18 months ago.

Team leaders and teams have got to know each other at a deeper level. In many ways - we've seen the kids fighting, we've met the dogs and the cats. We've had to sit with and listen to someone losing a loved one and had to hold that space with them.

We’ve shared our lives with one another and we need to keep doing that because once you know your people, you know when they're not themselves and you can start to see changes in them, even if it is through a box on a computer screen.

I think it is absolutely about centring the conversation, not just about productivity - you know, ‘where are we up to with that project?’ and ‘how are we doing on that performance measure?’ But actually, ‘how’s it going? How are we all going?’

I find one of the strategies that works best is to show your own vulnerabilities as a leader. Open a conversation by saying, ‘Gosh, I've had a terrible day’ or ‘I thought I'd spend the weekend filling up my bucket again, but I ended up worrying about this, worrying about that’.

If you personalise it and make it human, use your own language and you actually say it's okay to talk about this stuff because it is affecting me too, you create a culture where it's actually OK to then open up, to disclose, to seek support, to turn to your colleagues, to turn to your team leader and say, ‘Hey, I'm not travelling well’  and then you can move into a conversation about support and what that looks like.

The basics are the same, but it has become more personal in times like this.

Shayne Elliott: People shouldn't be afraid to pick up the phone or contact Beyond Blue if they want to talk things through. How do they go about making contact and reaching out?

Georgie Harman: There are so many ways. We've got a dedicated coronavirus phone service – 1800 512 348 – there are trained counsellors waiting to take your call and you don't need a diagnosis or a referral. You can call just to chat things through. You can call if you're worried about somebody else. That's what we're here for. There is no issue too big or small.

You can also go to https://coronavirus.beyondblue.org.au/. I'd encourage everybody to have a look at that website. It has pragmatic, regularly updated content that reflects the things that we know are on people's minds every week.

At the moment, we're talking a lot about going back into the world after lockdowns and the social anxiety or getting kids back to school. Not only how to support your kids, but also how to deal with your own worries.  

There is advice for workplaces and employers, and for people who are caring for and supporting others. There's also advice there just for you. Jump onto the website and have a look.  

It's completely free, it's completely confidential. We want people to reach out to us because the earlier you pick up the phone or jump on the website, the sooner you'll get back to being you.