Tackling mental health problems during the pandemic

Lockdowns made it challenging to access mental health services so a team of researchers in NSW found a way for people to get the help they needed from home.

When COVID-19 swept through the world in 2020, many cities turned into ghost towns and social isolation became the norm. As case numbers surged and stay-at-home orders moved into full swing, the prevalence of anxiety and depression jumped by 25% in the first year alone.

Professor Richard Bryant, a psychologist at UNSW Sydney, saw it coming from the start. “It was clear there was going to be a spike in anxiety and depression,” says Bryant, who is also an external fellow at the Black Dog Institute in Sydney.

Particularly in the first few months, the pandemic triggered a storm of multiple stressors, from social isolation and fear of infection to financial worries and grief over the loss of loved ones. Bryant and his Sydney-based team knew they needed to act quickly to help people access mental health support from the confines of their homes.

In 2020, Bryant and his team trialled a six-session mental health program delivered via videoconferencing to help people cope with pandemic-related distress. Each hour-long group therapy session was led by a clinical psychologist who shared strategies for dealing with challenges during the pandemic, such as fears and worries about catching the virus, along with how to maintain an active lifestyle and build social support during lockdown. The project was awarded $750,000 under the NSW Health COVID-19 Research Grants scheme, which funded research projects that directly supported the state’s response to the pandemic.

The program was adapted from one Bryant and his colleagues had developed with the World Health Organization (WHO) prior to the pandemic, which was aimed at people in low- and middle-income countries who were experiencing adversity. This version comprised five online sessions that covered strategies for managing problems, developing support networks, and staying active and engaged in difficult circumstances.

“They’re really simple strategies,” says Bryant. “But we know that they can give people the best return in maintaining a good mood during difficult times.”

In late 2021, Bryant and his colleagues published the results of their trial, which NSW Health shared with the Agency for Clinical Innovation’s Mental Health Network, which aims to design and promote better healthcare for NSW. The researchers recruited 240 participants who were experiencing COVID-related psychological distress. Half were randomly allocated to the six-session videoconferencing program while the other half were provided with emailed self-care handouts as a control.

At the beginning of the trial, nearly all participants scored positive for anxiety while over two-thirds were experiencing depressive symptoms. After two months, participants enrolled in the six-session program saw greater reductions in anxiety and depression compared to the control group. Participants also had fewer worries and fears about COVID-19 after taking part in the program. These psychological benefits persisted after six months.

“In other studies, you tend to see the benefits taper off over time,” says Bryant. “The fact that we were able to target major problems like anxiety and depression is encouraging.”

Bryant and his team have also trialled a similar program to provide psychological support for healthcare workers in Europe. While the findings are yet to be published, the early results are promising, says Bryant. “The program was also effective for doctors and nurses.”

Overall, the results also show that videoconferencing is a viable and scalable approach to deliver mental health support, particularly to people in remote and rural regions where psychological support is limited or unaffordable. Group therapy sessions also offer a more cost-effective alternative to one-on-one therapy, and can help people connect with others and brainstorm to find solutions, says Bryant.

“This is one of the positives of the pandemic,” says Bryant. “It’s really shifted healthcare – and videoconferencing can be very effective, particularly in the psychology domain. It really gives people far greater capacity to access services.”