TURNING MENTAL DISORDER
ON ITS HEAD

Institute & Centres

Flinders University Institute for Mental Health and Wellbeing

Article published on 13 November 2020

A new plan represents a pivotal change in how mental health assistance is being sought and delivered in the era of COVID-19.

The Flinders University Institute for Mental Health and Wellbeing, in partnership with the South Australian Health & Medical Research Institute (SAHMRI) Wellbeing and Resilience Centre, has found that 80% of participants in its research are showing high levels of psychological distress or low levels of wellbeing since the start of COVID-19 restrictions, up from around 50% pre-COVID.

This is the reason that waiting times to see a mental health professional have increased dramatically since COVID-19.

However, the Flinders University Institute for Mental Health and Wellbeing's inaugural director Professor Mike Kyrios and his team have smart and helpful solutions to offer, implementing new evidence-based strategies that can be delivered effectively online in a group format by trained facilitators.

When the pandemic hit, the institute acted swiftly, issuing online mental health and wellbeing advice built around several acronym-led suggestions for how to cope with COVID-19: the STREAM, APPEAL and CARE frameworks. But the great leap forward has been introducing the Be Well Plan, developed in conjunction with the SAHMRI group. This evidence-based online program enables participants to tailor their own suite of exercises and strategies for building strong, positive levels of mental health and wellbeing, and data on participants show it has excelled in prevention, alleviating mental distress after only five online sessions undertaken during COVID-19. The program was particularly effective for those participants with pre-existing mental health challenges.

By providing early intervention through such a convenient online delivery method rather than placing increased pressure on already over-burdened mental illness assistance systems, the Be Well Plan represents a pivotal change in how mental health assistance is being sought and delivered.

“We call it a mental health system, but in truth it's a mental illness and mental disorder system – and this is rather removed from addressing mental health,” explains Professor Kyrios. “The mental health system only looks at people with disorder. It ignores a very large group of people with low wellbeing, and this represents a high risk factor for future mental illness.”

Professor Mike Kyrios

Professor Kyrios says the Be Well Plan is built upon vast review and analysis of all studies that have recorded mental health and wellbeing outcomes. “We have only incorporated strategies or interventions that are proven to be effective. We’ve translated them into a language that is easy for people to understand, and continue to measure their effectiveness through the community – including very specific cohorts such as Indigenous healthcare workers, hospital healthcare staff, high school students and university students.”

Professor Kyrios says the Be Well Plan provides a toolbox that people can keep dipping into as their circumstances change. He notes that when people are shown a lot of trust and responsibility to steer their own care path, they respond with increased positivity to treatment. “Self-agency is one of life’s most important skills. Being given a sense of hope and permission to take control, along with the skills and guidance on how to do things, improves a person’s self-esteem immediately,” says Professor Kyrios.

“People start to identify other strengths that they didn’t know they had. Traditionally, the clinical world looks at what deficits people have and focuses on how to get rid of their symptoms. It has only recently looked at directly targeting how to improve the quality of lives. We take the approach that the glass is half full, rather than being half empty. We want to fill that glass by augmenting people’s strengths.”

The plan is now supported with Be Well Tracker, an ongoing online assessment of wellbeing that people can keep monitoring. “This is the beauty of the online world,” says Professor Kyrios. “The program is nimble enough to be reactive and adaptive. It’s able to provide a snapshot of what is happening right now, and this helps people who are at risk.”

The easily accessible online delivery of the Be Well Plan plugs a gap that exists in current mental health assistance. It is clear that online programs will now flourish, as the pandemic has accelerated people’s online literacy in many areas, including the telehealth delivery of mental health services. “The first thing young people do is go online to find help,” says Flinders University Institute for Mental Health and Wellbeing researcher Dr Dan Fassnacht. “If they find something that appeals to them, then they will use it online as well.”

This provides a versatile platform for mental health delivery – via mobile apps, SMS messages, Zoom meetings, online portal access to treatment programs – that offers both formal support (such as sessions with doctors and specialists) and informal support, such as social networking to maintain contact with others.

“The key is to make certain that people in need know where to find evidence-based help, so the introduction of the tested Be Well Plan can have far-reaching policy and service implications,” says Professor Kyrios.

^{_{“Everyone talks about multi-step care in mental health delivery, but at present our public health systems do not really provide it. The Be Well Plan can provide the element of change by delivering an easily accessible and up-scalable program that will save money for governments, industry and the community – and it will support individuals in their lives.”}}