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It is no revelation that the mental health and wellbeing of many people has been impacted by the COVID-19 pandemic.
 
However, new findings indicate that for women, particularly mothers, that impact has been ‘profound’.
 
‘The pandemic has highlighted gaps in the current service delivery frameworks, especially for women with limited financial resources,’ social epidemiologist Professor Stephanie Brown said.
 
‘These gaps have resulted in many women in need of mental health support being unable to access mental health services.’
 
Professor Brown is Head of Intergenerational Health at the Murdoch Children’s Research Institute (MCRI) and led the Mother’s and Young People’s Study used to inform a policy brief on the pandemic’s impact on maternal mental health and wellbeing.
 
The prospective cohort study was originally investigating women’s health after childbirth, but expanded to include children and young people’s health and wellbeing, and how it links with their mother’s.
 
It identified that gaps in current health service delivery had widened during the pandemic, resulting in many women being unable to access appropriate services for mental health support.
 
In response, the researchers are calling for further policy action, including an extension of mental health strategies across the whole family.
 
‘It is important to provide multi-service frameworks that enable mothers, fathers, children and young people under 18 to receive appropriately tailored support,’ Professor Brown said.
 
According to an online survey of 418 women conducted as part of the study during Victoria’s second lockdown, almost one in three women reported ‘clinically significant’ mental health issues.
 
Notably, less than half (45%) of these women received support from health professionals, with just one in four talking to a GP or a psychologist.
 
More than half (55%) did not receive any mental health support from primary care or mental health services, and only 4% of women experiencing ‘clinically significant’ depression or anxiety had called a telephone support line.
 
The reported reasons for not receiving support from health professionals included prioritising support for their children’s mental health over their own, psychologists closing their books to new clients/long waiting periods, and a lack of confidence using telehealth.
 
Additionally, women experiencing mental health issues were almost four times more likely to delay their own medical care due to the cost of services.
 
Chair of RACGP Specific Interests Psychological Medicine Dr Cathy Andronis is not surprised by the findings.
 
‘The sense of isolation and disconnection from normal life as a result of the pandemic leaves many vulnerable people feeling abandoned by others and exacerbates underlying negative emotions 
and thoughts, leading frequently to helplessness and hopelessness,’ Dr Andronis told newsGP.
 
‘People give up on asking for help, particularly when there are urgent tasks at hand such as caring for a new baby that is needy night and day, and more helpless than their mother.’
 
The RACGP has recently raised a number of concerns around current Medicare structures for providing mental health care, leading to fragmentation and poor patient outcomes.
 
Acknowledging GPs’ essential place in providing mental health care, the college is lobbying for this space to be properly funded, including by implementing higher Medicare rebates for longer
consultations.
 
And although telehealth has helped expand access to care, Dr Andronis believes it is not always appropriate when it comes to mental health care.
 
‘The lack of human physical connection of telehealth services exacerbates this isolation [experienced by women in the study],’ she said.
 
‘We need real human, face-to-face connection when we are most distressed. Empathy and compassion online or over the phone is usually not as effective or responsive as live consultations.  
 
‘Fear by mothers of bringing COVID into their household was one more major stress that needed to be avoided when they were just coping with the necessary adjustments of the postnatal period.’
 
The Mother’s and Young People’s Study survey cohort also revealed that many women experienced:
 

• fatigue (53%)
• anxiety (41%)
• irritability (33%)
• sadness (27%)
• loneliness (21).

 
In January and April 2021, when many restrictions were lifted, 391 women took part in a subsequent survey which revealed that despite reports of these issues being reduced, they remained ‘well above’ pre-pandemic levels.
 
Professor Brown said the findings are expected given the many family disruptions caused by the pandemic.
 
‘Much of the responsibility for remote schooling was shouldered by women,’ she said.
 
‘For some women, this meant giving up their paid job, taking leave without pay or reducing their hours of work significantly.
 
‘The challenges of remote learning were particularly acute for mothers of children experiencing neurodevelopmental conditions such as ADHD or autism, and for women whose children started at a new school just prior to the pandemic.’
 
While underlying mental health issues were exacerbated by the pandemic, one in five women with no prior history of depression also reported ‘clinically significant’ depressive symptoms during the pandemic.
 
One third of women from the study continue to experience significant mental health problems including ongoing fatigue and parenting stress.
 
Professor Brown says these ongoing impacts present further cause for policy action.
 
‘[The] continuing day-to-day effects of the pandemic are likely to have both short- and longer-term impacts on women’s workforce participation, their own mental health and wellbeing, and the mental health and wellbeing of other family members,’ she said.
 
The MCRI policy brief states that the ‘process of healing and recovery from the pandemic will take time’, suggesting GPs will continue to play a major role supporting mothers well beyond the perinatal period for years to come.
 
‘GPs have been the most accessible and available healthcare providers during this pandemic and are likely to continue to be so,’ Dr Andronis said.
 
‘We are able to meet these women in our clinics and offer timely support. We are highly appreciated by vulnerable people when we offer our support and hold hope for them.
 
‘Managing these life events and transitions, collaboratively with patients is something we do well.’
 
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