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The findings of the first major representative study of COVID-19 mental health impacts in NSW, undertaken on behalf of the Mental Health Commission of NSW, shows that one-in-five people in regional and rural NSW experienced a new mental health issue during 2020, compared to one-in-10 across the state as whole.

NSW Mental Health Commissioner Catherine Lourey said rural and regional residents reported experiencing fewer relationship, financial and practical impacts than those in the city during 2020.

Mental health responses to the most recent stay-at-home orders in greater Sydney are yet to be measured, but Ms Lourey said 'pandemic fatigue' may well have increased negative mental health experiences for many people.

"Unsurprisingly, the impact of COVID-19 and the associated shut-downs has been more muted in rural and regional communities than it has been in Sydney," she said.

"Overall, younger Sydney metro residents were more likely to report either negative or positive impacts than older people living in rural or regional NSW.

"Over 30 per cent of those in rural and regional communities reported experiencing no negative impacts during 2020, compared to 20 per cent of those in the greater Sydney area. Having said that, they also experienced fewer of the positive impacts reported by those in metro areas, such as being more careful with money, less road and public transport congestion and a slower pace of life."

Ms Lourey said while the negative impacts of Covid-19 were less in regional NSW, one third of rural and regional residents reported that they felt more anxious, stressed and less in control than usual in 2020.

At the same time, regional and rural residents were more likely than those in the city to name looking out for neighbours and the elderly as ways in which their community has benefited from the COVID-19 pandemic," she said.

The study involved 2000 NSW residents aged over 18 - including more than 600 from rural and regional NSW - representing a cross-section of the community, with a further sample of people who reported a mental health issue in 2018-2019 or a new mental health issue in 2020 - as advised by a health professional.

The research was commissioned to provide insight into the impact of COVID-19 on mental health in NSW, the types of support being accessed and their impact on those living with mental health issues, and identify what is needed to support wellbeing as the fallout from COVID-19 continues.

Any community members who are concerned about their own or a loved one's mental health are encouraged to speak with trusted support services such as a family GP. Alternatively, find local services via Wayahead's NSW Mental Health Service Directory or call one of the following support lines:

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