IN October 2021, during the COVID-19 Delta outbreak, we surveyed 5100 Australians in the Australian Health Consumer Sentiment Survey to elicit their views and experiences as health consumers. The survey found that women and young people have taken the hardest psychological and financial hits as a result of the pandemic.

Key findings from the survey

More than one in four (26%) women across Australia reported serious levels of psychological distress, such as feelings of sadness, nervousness or worthlessness. The results were even more concerning for women from Victoria, where the lockdowns and restrictions were harshest, with close to one in three (31%) women reporting seriously high levels of psychological distress.

Women were more likely than men to have lost their job during the pandemic. They reported increased domestic responsibilities, and experienced greater financial hardship. For example, of the women in the survey, 15% reported having to go without food because of a shortage of money and 7% could not pay for the health care or medicines that they needed.

The pandemic has also seriously affected young Australian adults. A concerning 42% of young people aged 18–24 years reported serious levels of psychological distress. Young people from this age bracket were also more likely to have lost their job or worked fewer paid hours than other age cohorts.

Digital health care provides part of the answer

In a welcome finding from the survey, during the pandemic, participants with severe levels of psychological distress were more likely than others to consult with a health care professional via a digital service such as videoconferencing, a telephone advice line (eg, Lifeline) or an email or webchat advice line (eg, headspace online). Further, 85% of people with severe psychological distress were satisfied with the care they received via digital care. Indeed, the option of virtual care has become the “new normal” in Australia and internationally, but little is known about its immediate, medium or long term clinical value. Key flaws in previous research into the effectiveness of digital mental health research highlight the need for more robust studies that are supported by strong theory and real-world understanding. Increased emphasis on evaluating digital health care needs to be a priority to support future clinical practice.

Background to the survey

Working together, in October 2021, the Consumers Health Forum of Australia, the Australian Institute of Health Innovation, and the National Health and Medical Research Council (NHMRC) Partnership Centre for Health System Sustainability undertook this unique population-based survey of Australian adults aged over 18 years, with 5100 respondents. The results reported here are related to questions we asked consumers about their mental health, digital access to health care and COVID-19-related questions.

The survey, supported by the Commonwealth Department of Health and the Australian Commission on Safety and Quality in Heath Care, is a barometer of opinions and experiences of health care among the Australian population, and a unique resource to inform policy and practice. It is purpose-designed to help identify critical issues such as Australia’s mental health and wellbeing.

We sought national representation on geographical location, age group, gender, and simultaneous collection of detailed socio-economic data.

What’s next?

The Australian Health Consumer Sentiment Survey is an invaluable resource for not only informing policy and practice now but also for providing a benchmark to evaluate improvement initiatives over time. Comparisons from the first survey conducted in 2018 with the 2021 results are helping us map changes to care over time, monitor progress and uncover drivers of change. The use of digital services for health care, for instance, showed an increase to 46.6% in 2021 from just 11.8% in 2018, when telehealth and videoconferencing weren’t as readily available.

Our analysis of consumer’s views shows that digital health services can not only be an effective delivery vehicle for mental health care, but they are also embraced and, in some instances, preferred by people experiencing mental distress. So, among the worrying findings, there are glimmers of hope.


Our sincere appreciation goes to many people involved in this work, particularly Leanne Wells, Dr K-lynn Smith, Genevieve Dammery, Chrissy Clay, James Ansell and Jenna Gray; and to all of our respondents: thank you sincerely for sharing your views with us.

Dr Louise Ellis is a Senior Research Fellow for the Australian Institute of Health Innovation, Macquarie University.

Professor Jeffrey Braithwaite is the Founding Director of the Australian Institute of Health Innovation, Macquarie University, and leads the NHMRC Partnership Centre for Health System Sustainability.

Associate Professor Yvonne Zurynski is Associate Professor for Health System Sustainability at the Australian Institute of Health Innovation, Macquarie University, and co-lead for the Observatory on Health System Sustainability within the NHMRC Partnership Centre for Health System Sustainability.



The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated.

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