Public Health - Mental health and wellbeing in Australia inc ICARE


Dr Joanne Enticott, Dr Rhonda Garad, Prof Helena Teede

Our work aims to understand the impacts of climate change on women and their families and amplify our evidence-informed solutions to multiple audiences, including policymakers.

Climate change is the defining public health issue of the twenty-first century. What is absent in Australia is a clear national government policy that communicates and responds to climate change as a public health issue. We are working to change this.

Our point of difference is the MCHRI consumer-led, evidence-based implementation approach. Our work is developed with women and for women, and their families.

We collaborate with leaders in this field to produce impactful research that makes a meaningful difference to the lives of women and their families, through influencing policy, clinical practice, and within an empowerment framework.

We are also part of a large international study called iCARE which aims to better understand the behaviours, attitudes and knowledge surrounding COVID-19 and vaccine confidence, by surveying nationally representative samples in Australia.

The COVID-19 pandemic has made an unprecedented impact on the day to day lives of people around the world. Without a vaccine or effective treatment, limiting the impacts of COVID-19 requires behavioural change and adherence to public policy and regulations. Thus far, Australia has successfully implemented these changes and controlled the virus with minimal loss of life.

Until a vaccine is developed the only protection Australians have is effective policy and community behaviour change to prevent the spread of the virus. To inform the most effective “behavioural vaccine” we are partnering with Australians to find out what we believe, what we’re actually doing and what motivates and supports us to change behaviours and protect Australians against COVID-19.

To better understand the behaviours, attitudes and knowledge surrounding COVID-19 in Australia, we surveyed a nationally representative sample. This research is part of a large international study called iCARE. More than 60,000 people from 140 countries have completed the survey (available in multiple languages), and we are still going!

Below is key information from the Australian surveys. Recruitment for this longitudinal Australian survey occurred in two waves: first wave May 2020, and second wave July 2020.


The known: Victoria is experiencing its second wave.

The new: Two nationwide surveys in May and July show that 1-in-4 Australians report sub-optimal physical distancing and self-quarantining when unwell. A second wave was therefore inevitable.

The implications: COVID-19 waves are inevitable in Australia because not enough Australians adhere to the behaviours needed. A suppression strategy may only become effective if adherence increases to more than 9-in-10.  Messaging to control COVID-19 in Australia needs to evolve so that the vast majority of Australians can feel confident and able to implement the needed behavioural strategies.


Objective: Evolving strategies to control outbreaks of COVID-19 requires public policy and behavioural adherence. We examined self-reported Australian behaviours, knowledge, motivations and concerns around COVID-19 at two recent time points, two months apart.

Design and setting: Recruitment for this longitudinal Australian survey occurred in two waves: first wave May 1st to 5th, 2020, and second wave July 1st to 7th, 2020. Representative national sampling using an online survey based on evidence-based behaviour change models. Representative sampling for key demographics of Australian population was done by gender, age and residential location.

Results: Overall 2,056 surveys were completed in both waves 1 and 2, and 63% (1296/2056) of surveys were longitudinal data contributed by n=648 individuals completing surveys in both waves. The remaining surveys were contributed by n=760 individuals completing a survey in only one wave. Age range of participants was 18-99 years (median 53, IQR: 34-64). Survey response rate was 10.1% for the sample contributing only one survey; response rate improved to 63% for those providing longitudinal data.

Not physically distancing most-of-the-time was reported in over 1-in-4 in both waves with differences by sex and age: in May was 27% men vs 23% women (p>0.05) and 38% under 30 years vs 19% >30 years (p<0.001); and in July was 31% men vs 26% women (p=0.04) and 46% under 30 years vs 31% >30 years (p<0.001).

Self-quarantining: In both May and July, sub-optimal policy adherence was evident including not self-quarantining most-of-the-time in 1-in-4 when unwell with differences by sex and age: in May was 29% men vs 17% women (p=0.001) and 31% under 30 years vs 23% >30 years (p=0.12); July was 36% men vs 17% women (p<0.001) and 34% % under 30 years vs 25% >30 years (p=0.04).

Having a test as soon as you have symptoms was only asked in the July survey, and also sub-optimal: 59% men vs 72% women (p<0.001) and 56% under 30 years vs 68% >30 years (p=0.01). Similar results were reported for seeing a doctor or seeking a test if you have symptoms: 54% men vs 73% women (p<0.001) and 50% under 30 years vs 66% >30 years (p=0.001).

Wearing a mask: The responses to wearing a mask every time you left home were similar in both waves 1 and 2, as under 20% reported this most/some of the time (Table 2). There were non-significant differences between sexes (p<0.05). Younger people were significantly more likely to report wearing a mask most of the time (13% under 30 years vs 9% over 30 years, p=0.01). Younger people were significantly more likely to report wearing a mask most of the time on public transport or in crowded areas (22% under 30 years vs 14% over 30 years, p=0.03).

Information sources: Where Australians get their information was reported by participants. The majority reported sourcing information from conventional media, and this included ABC specific broadcasting for fifty percent.


In May 2020, the vast-majority of Australians were aware of public health measures designed to limit viral spread. Most people received information about covert from mainstream news sources (newspapers, television, internet news) as well as their national leader. A small proportion of the population relied on scientific literature, the WHO and healthcare professionals.


Most Australians reported adherence to recommended measures such as hand washing, non-essential travel, staying and home, socially distancing and self-isolation

Some Australians extended beyond recommended measures with behaviours such as mask wearing and disinfecting groceries.


Australians tend to be motivated by education, information on behavioural impacts on spread, saving lives and returning to normal, as well as regulatory punitive measures.


Most Australians were concerned for others, rather than themselves, on health system overload and on risk of a second wave

Gender difference were also notable, with women being consistently more concerned than men.

Want to know more

This survey work is ongoing. To participate in the wider international arm of this survey study, please visit: