SYDNEY: It is dubbed Australia's "shadow pandemic", a worsening mental health crisis exacerbated by COVID-19 and the subsequent lockdowns aimed at suppressing the spread of the virus.
When Patrick McGorry, professor of youth mental health at the University of Melbourne, used the phrase to describe the secondary impact of the disease, he shone a light on the formidable challenge facing Australia today: How to manage the psychological and emotional toll of the coronavirus, especially on the young and vulnerable.
In truth the crisis has affected everyone, whether on a severe or more manageable scale, and there is no escaping the long-term ramifications.
"It's a major threat to our mental health," declares Professor McGorry, who is also executive director of Orygen, a not-for-profit centre of excellence for the study and treatment of mental health in young people.
"Losing our sense of security, having to confront the fear of the virus, losing a lot of other things in our lives like the ability to exercise, mix with other people, to have a social role, have professional role or a work role, these are really big challenges we are all facing."
And the battle is only just beginning.
A chain of pop-up mental health clinics has just opened in the worst-hit suburbs of greater Sydney, where the current lockdown is now into its third month.
They are aimed at all age groups and designed to provide emergency care to people who are finding it difficult to cope with the restrictions.
Promoted by the government as clinics under the Head to Health programme - an online and hotline service dealing with mental health - teams of support workers including psychologists, social workers and mental health occupational therapists will be on call to help by phone, video and face-to-face contact.
Australia's assistant minister to the prime minister for Mental Health and Suicide prevention David Coleman hopes the free clinics will "make a real difference for people impacted by the pandemic".
"We recognise that support for people's emotional wellbeing is critical in these extraordinary times with loss of freedom, lack of personal contact and work-related issues causing major distress and despair," he said in a media release on Sep 6, the day 10 pop-up clinics opened across Sydney.
The figures speak for themselves.
So far this year in New South Wales alone there has been a 49 per cent rise in the number of 12- to 17-year-olds turning up at hospital emergency departments with thoughts of self-harm or suicide on their mind, compared to 2019.
The nation's Bureau of Statistics reveals that one in three Australians between the ages of 18 and 34 admitted to experiencing high levels of psychological distress in June of this year.
And that was before the full impact of the latest Sydney lockdown was felt.
STRETCHED HEALTH SYSTEM
For those on the frontline of the war against mental, physical and social distress, the new pop-up clinics are seen as a welcome resource.
The Rev Bill Crews, an Anglican church minister who helps the hungry and the homeless in Sydney's inner west, has witnessed the harsh reality of life in the age of COVID-19.
Normally he would feed a thousand people a day at the Loaves and Fishes, a free restaurant and shelter, which is financed by his charity, the Exodus Foundation. But coronavirus-imposed restrictions mean the restaurant is only able to serve takeaway meals.
Instead, a fleet of vans ferries food to 11 other locations around the city where the meals are then distributed to the needy.
But while the hungry are kept fed, others who need psychiatric support often fall through the cracks.
"Several of our people have been hospitalised through no fault of their own because of a lack of follow-up by the health system which has been so stretched," he explains.
It is a failure compounded by the lockdown, but it is of no surprise to this clergyman.
"The government consistently overlooks the most marginalised people," he says.
"I've had to fight all along the way to get masks, hand sanitisers, vaccines and rapid testing kits - it's a constant fight."
THE RISKS OF ISOLATION
Even the most resilient have found the going tough when it comes to navigating Sydney's lockdown.
After a lifetime of hardship, Alex, who did want her surname published, lives out of a van after being made homeless.
Now in her mid-thirties, the mature age student relied on The Exodus Foundation's premises to wash, recharge her electrical devices and to find a quiet corner to study for her master's degree at university.
The lockdown put an end to that.
To add to her problems the university library shut its doors, cafes closed and her health deteriorated.
"As all those things shut down it meant that I didn't have anywhere to study and because of the severity of the current rules my shower has gone, my ability to get laundry done has gone and if I need anything like a note pad or a pen or a plate, I have to pay a lot more."
Then she got forced into quarantine after coming into contact with a COVID-19 case. She was fortunate not to be infected but the experience gave her an insight into mental health support as she received daily phone calls from psychologists.
Strengthened by so many years of personal adversity, she insisted she has no mental health issues of her own, but she acknowledges the importance of support for those in need and believes the pop-up clinics could play a valuable role, especially among the young.
"I think the intention is wonderful. There are people out there who are absolutely desperate for it and it will be an absolute lifesaver for them," she says.
But she worries about the elderly for whom life is a constant physical and emotional struggle under the current constraints.
"There are people who have been so isolated by the ongoing lockdowns that they've got to the point of suicide."
She recalls a fellow Loaves and Fishes regular who told her he was so depressed he had just overdosed on prescription medication.
"He was such a lovely caring person at retirement age and just so traumatised that he had to be hospitalised and isolated for an extended period. The lockdown has absolutely devastated people across all spectrums."
While state and federal governments are spending millions on mental health support, not-for-profit agencies such as the Black Dog Institute monitor what is happening on the ground.
Professor Jennie Hudson, director of research, argues that the current mental health crisis, whether caused by the pandemic or other social issues, requires a global strategy.
She thinks there will be long-term impacts, especially on the younger generation and their "feelings about the future, the opportunities for academic development and exploring the world".
"And I think governments have got to do something more immediate to address it," she tells CNA.
Reassuringly, Professor McGorry from the University of Melbourne is optimistic that the so-called "shadow pandemic" can be resolved.
"These are really big challenges we are all facing," he makes clear in a statement.
"On the other hand we have come through these sorts of crises many times before and people are generally resilient."