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‘Complex and quite ambiguous loss’: what Covid has done to our mental health

After 18 months, psychologist Chris Cheers has begun to understand emotional responses to the global Covid pandemic as a kind of grief.

It’s a collective grief, experienced by the whole world at once, but also deeply personal: our losses are not the same just as our experiences have not been the same.

Some have lost loved ones – from Covid and in other ways – and have been unable to attend funerals. Some have experienced a loss of health through long Covid, or a long-term loss of income or loss of work. The impact of both the virus and the restrictions have been disproportionate, affecting marginalised communities more than others.

It is a “complex and quite ambiguous loss”, Cheers says, which makes it difficult to process.

“When the losses are so ambiguous and complex, it’s really difficult to reach that place of acceptance, so we just kind of get stuck. Stuck in the grief and stuck in the distress.”

The usual support networks that scaffold us in grief have also gone. In states with lockdowns in place we are not allowed to gather and seek comfort from each other. And even when we are able to reach out, those who might usually offer support are grieving their own losses.

“People’s capacity to support each other – I think it’s starting to diminish,” Cheers says.

When Australia first went into lockdown in March 2020, the prime minister, Scott Morrison, warned the pandemic could last six months. He was wrong. The pandemic is still going, and the mental and physical effects of living under it have accumulated.

“In terms of lockdown’s impact on mental health and on the brain, this doesn’t get easier, this gets harder,” Cheers says. “The impacts of stress and the impacts of all the loss that lockdowns bring are cumulative. That cumulative stress moves people away from the hope.”

During Melbourne’s 112-day lockdown last year, there was a sense of collective purpose that provided some meaning behind the restrictions: we were locking down to save elderly people, to save our community. We were locking down one last time.

Data from the Medicare Benefits Schedule shows a surge in demand for services during Melbourne’s second wave lockdown last year, which was not matched in other states.

This year, with the Delta variant racing against the vaccine rollout and winning, that sense of purpose has fractured to be replaced by “a sense of frustration and anger”, says Cheers.

“When that doesn’t shift, it then moves to that hopelessness or apathy, which I’m seeing more so in many clients now,” he says.

His waitlist has never been longer. The decision to double the number of Medicare-subsidised psychology appointments from five to 10 was welcome news for clients, but the number of psychologists has not changed.

Even with a Medicare rebate, those booking a private psychologist have to be able to pay the gap. Doubling the number of sessions does not make it more accessible.

The pivot to telehealth has also required a rapid reskilling. Cheers has been conducting one-on-one therapy via zoom in his spare room in Melbourne for the past 18 months, replacing years of practice in reading body language with a new skill of making eye contact through a webcam.

“If you make eye contact with someone on video, it doesn’t feel like eye contact because you’re looking at them on the screen not on the camera,” he says. “To make eye contact I have to make up with the camera. So I feel like I’m doing therapy with a green light at the moment.”

And psychologists are also living in a pandemic, living through the same lockdowns and restrictions as their clients. It gives them “a pathway to understanding and empathy”, says Cheers, but it has also wrung them dry.

“I think a lot of psychologists would join me in saying that right now we’re exhausted, but we all are incredibly needed,” he says. “Our waitlists are long, our clients are in need. And that’s a very challenging place to be, to know that there’s so much support that’s needed that you can offer, at the same time when your capacity to support is depleted.”

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