Rapid report 2: Symptoms of anxiety and depression during the first 12 weeks of the Coronavirus (COVID-19) pandemic in Australia.

Background: The MindSpot Clinic, funded by the Australian Government, is a national digital mental health service (DMHS) providing services to people experiencing anxiety and depression. We recently reported increased service use in the early weeks of the COVID-19 pandemic (19 March to 15 April 2020), and a small increase in anxiety symptoms. This follow-up paper examines trends in service use and symptoms, over 12 weeks from 19 March to 10 June 2020.

Methods: Demographics, symptoms, and psychosocial stressors were compared for participants starting an online assessment over four time-periods: A baseline "Comparison period" prior to the COVID-19 pandemic (1 to 28 September 2019), "Weeks 1-4" of the COVID-19 pandemic in Australia (19 March-15 April 2020), "Weeks 5-8" (16 April-13 May 2020) and "Weeks 9-12" (14 May-10 June). Responses to questions about the impact of COVID-19 and strategies used by participants to improve their mental wellbeing are also reported.

Results: A total of 5455 people started a mental health assessment with MindSpot from 19 March to 10 June 2020. The number of assessments per week rose steadily from 303 in week 1 to a peak of 578 in week 5. Symptoms of anxiety were highest in Weeks 1-4, declining steadily over subsequent weeks. Psychological distress and depression, as measured by the K-10 and PHQ-9 respectively, remained stable. Concern about COVID-19 was highest in the first week then steadily declined during the following weeks. The proportions of participants reporting changes to routine were consistent across the 12 weeks, and most participants reported adopting helpful strategies to improve their mental wellbeing.

Conclusions: We observed an initial increase in service use, which reduced over the 12 weeks. The initial rise in anxiety symptoms returned to baseline. Reported concern about the effect of COVID-19 declined steadily over 12 weeks. Symptoms of psychological distress and depression measured by the K-10 and PHQ-9, and the proportion reporting suicidal thoughts and plans did not change, and to date we have not identified indications of a mental health crisis. However, the long-term effects of COVID-19 on the economy and large sections of society are yet to be fully realised, indicating the importance of ongoing monitoring and reporting of trends as indicators of the mental health of the nation.