1  Introduction
The spread of the Coronavirus, COVID-19, has been both dramatic and horrifying. Between the 1st of March and 15th of April 2020 the number of known cases in Australia grew from 24 to 6447, with more than 60 deaths (Australian Health Department). Based on observations of the effects of outbreaks in countries including China, Iran and Italy, the Australian state, territory and federal governments issued unprecedented restrictions on travel, social gatherings and non-essential business, with the immediate effect of putting a significant number of people out of work.
The medical and economic effects of COVID-19 are expected to be profound, and possibly comparable to those of the influenza pandemic of 1918 and the great depression. The psychological effect on the population is also expected to be significant, either from fear of the illness itself, the distress and shock associated with changes in routine, the loss of social contact and the economic consequences. This means that demand for mental health services is likely to increase at a time when many face to face mental health services have had to temporarily close or, with recently announced additional Australian Government funding (Office of the Prime Minister, 2 April, 2020), attempt to transition to telehealth, either using telephone or video conferencing. There are early reports of high levels of concern among health professionals and others (Druss, 2020; Ayanian, 2020) but few studies have attempted to measure the effect of the COVID-19 pandemic on psychological symptoms in large samples of the population, and at this early stage, little is known about the immediate impact of COVID-19 on the mental health of people accessing mental health services.
The MindSpot Clinic (www.mindspot.org.au) is a national digital mental health service (DMHS) funded by the Australian Department of Health. MindSpot launched in late 2012 and has since provided telephone and online psychological assessments, treatment and referral services to more than 100,000 Australian adults, of whom nearly 30,000 have enrolled in free online treatment courses (Titov et al., 2015, Titov et al., 2017; Titov et al., submitted). A feature of MindSpot is the routine measurement of symptoms at assessment, during treatment and at follow up using validated self-report scales that are sensitive to change, and importantly, the distribution of MindSpot users closely matches that of the population of Australia. On 19th March 2020, one week after the World Health Organization confirmed COVID-19 as a pandemic, additional questions specific to COVID-19 were added to the online MindSpot assessment. Hence the data collected by MindSpot on large samples of people from all over Australia provides an opportunity to evaluate the early psychological effect of the COVID-19 pandemic and may assist in service planning. This report examines service demand, symptom profiles, and concerns of MindSpot users during the early phase of the COVID-19 pandemic in Australia, from 19 March 2020 to 15 April 2020.