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Covid 19: Advice for people severely affected by mental illness & carers

Covid 19: Advice for people severely affected by mental illness & their carers

02/10/2020

This information is for anyone who lives with a severe mental illness. We know that living with a severe mental illness can be challenging. And the current coronavirus pandemic could create additional problems. This information tries to help you ease or overcome some of these problems.

The NHS, social services and other services will continue to support people during the coronavirus crisis. But they might not be able to provide their normal level or support.

The government and the NHS publish their latest information on coronavirus on the following websites:

If you can’t access the internet you can call the NHS on 111.

We hope the advice and information in the frequently asked questions below will help you.

Frequently asked questions

You can join another household to form a support bubble if you live alone or you meet other criteria. You can read the criteria here.

Once you are in a support bubble you are classed as one household. This means that you and your carer can visit each other including staying overnight.

Where possible, you should avoid changing your support bubble. This will help prevent spreading the virus between households. But you can change who you’re in a support bubble with as long as you follow these rules.
Yes, you can still meet them outside for walks or exercise if:
- they are in your support bubble, or
- just you and your carer meet.
The government guidance recommends that you:
- only go out for exercise once a day, and
- remain in your local area.
But if your mental illness routinely requires you to leave home to maintain your health you can do that, including
- travelling beyond your local area, or
- exercising several times a day.
Outdoor public places where you can meet your carer include:
- neighbourhood streets,
- parks, beaches, forests and countryside that’s accessible to the public,
- public gardens,
- the grounds of a heritage site, and
The rules say you can’t meet people who aren’t from your household or bubble in a private garden. But if your carer is visiting you to provide care then you can go in the garden with them.
The rules say that if you want to go meet someone outside who isn’t in your household or social bubble, then you can only meet 1 other person.

But if you need ‘continuous care’ from your carer, then they can be with you when you meet a friend or relative outside. The government haven’t said what they mean by the term ‘continuous care.’ But we think that it would be reasonable to argue that you need ‘continuous care’ if you need it daily, or even less frequently, as long it’s regular.

So, we believe that if you can’t go for walks or exercise without your carer then you can take them with you when you meet a friend or relative for a walk.

You might want to go outside with members of your household or support bubble but need your carer to be there. This is also allowed, but again only if you need ‘continuous care’.

If you need more than 1 carer to be with you, this is allowed. But you can’t have more than 2 carers supporting you.
The government say that people in 2 groups are at greater risk of severe illness if they catch coronavirus:
- Clinically vulnerable – This group is at moderate risk
- Clinically extremely vulnerable - see ‘Definition of clinically extremely vulnerable groups.’ This group is at severe risk.
If you are in either of these groups your carer can still visit you to care for you. But you both need to be extra careful. Make sure that you both:
- wash your hands carefully and more often than normal,
- thoroughly clean frequently touched areas,
- keep socially distanced when you can, and
- keep rooms ventilated where possible.
You can still receive care at home from social care and medical professionals.

If you are clinically extremely vulnerable you should follow shielding guidance. You should:
- not attend work, college or university,
- limit the time you spend outside the home, and
- only go out for medical appointments, exercise or if it is essential.
You might be shielding and need help with things like shopping and getting prescriptions. You can get help from NHS Volunteer Responders or Local coronavirus support groups. See the ‘Who else can I get support from?’ section of this blog for more information.
If you are in a support bubble with someone, they might still be able to visit you. This is especially the case if you live in a self-contained flat. But your home might also be:
- the workplace of staff who work there to support you, and
- the home of other residents, especially if you share rooms or gardens with them.
So, staff at the supporting housing will need to think about the risk of visits and how they can be arranged to keep everyone safe. This might mean meeting your visitor in an outdoor space, for example.

Speak to staff to see what the arrangements are for visitors before inviting someone over. It will also help if your visitor speaks to staff too, so they can understand the arrangements and safety procedures.

Staff should also support you to:
- stay in touch with family and friends by things like video or phone calls, and
- see people outside of the supporting housing accommodation, if appropriate, in line with current rules.
See the following sections in this blog for more information on the current rules:
- My carer has formed a support bubble with me and my household. What does this mean?
- I don’t live with my carer. Can I still meet them outside for exercise?
- Can I meet a friend or relative for a walk outside and take my carer with me?
You might be supported by an NHS mental health team.

You can leave home to visit NHS services, including metal health services.

You might need extra or different support for reasons such as:
- your carer can’t see you because either you or they need to self-isolate,
- your mental health might be getting worse, or
- your needs might have changed because of rules to do with coronavirus.
You can contact the person you normally deal with at your mental health team. This might be your care co-ordinator, your support worker or your CPN, for example. Explain the difficulties you are having and what help or support you need.

But it might be difficult for your mental health team to provide you with their normal level of support. This is because of the risk of coronavirus and how the virus impacts on staffing levels. But the team can tell you what support they can give to you.

Some mental health services have been provided digitally during the pandemic. But the government have said that they know this doesn’t work for everyone. So, they have said they will ensure that the option of face-to-face support is provided to people with serious mental health illness. But only where it is clinically safe to do so.
Your GP surgery can still help you, but they have changed the way they work because of the coronavirus crisis.

You will need to contact them first. If an appointment with a GP or another medical professional is needed, they might try to do it over the phone.

If you are offered a face-to-face appointment, they will tell you what you need to do to keep yourself and others safe.
Yes. If it is essential that the group meets face to face, then they can meet up. The group has to be formally organised and can’t have more than 15 people attend.

Many of these groups may still be meeting online using things like Zoom. If you are unsure what is happening with your group, then you can contact the group administrator to get more information.

Rethink Mental Illness runs a lot of support groups across England. You can find details here. https://www.rethink.org/help-in-your-area/support-groups/

Some of our groups have resumed some of their activities. But these are still restricted and differ from group to group.

Please contact individual groups for further information.
Social services should continue to support you if you have social care needs. But the level of support they can provide you with might be less than you are used to.

New legislation means there have been changes to social care law and your rights. You can read more about the changes here:

www.rethink.org/news-and-stories/blogs/2020/03/social-care-and-coronavirus-temporary-changes-to-the-law/

Your local social services can provide you with information on local social care and other support.
You might not be able to see your carer if either of you are having to self-isolate. You need to do this if you have symptoms of coronavirus or are told to by the NHS test and trace service.

As well as calling your carer you can stay in touch with them in other ways such as text message, Skype, WhatsApp or social media, for example.

You could work together with your carer on a plan for the day for you. Once you’ve done this, you can ask them to message the plan to you if you want to, so you have it in writing.

You could ask your carer to call you or message you with reminders. So, they can remind you about things like taking medication or having meals.
If you are running out of your usual medication you should speak to your GP or mental health team. They should be able to arrange a prescription for you.

Electronic prescriptions

Most prescriptions are sent electronically direct to a pharmacy from the GP surgery. You can choose which pharmacy the prescription is sent to. If you can’t pick up the prescription yourself, you can let the pharmacy know who will collect it for you.

Paper prescriptions

Sometimes a GP surgery will issue a paper prescription. You can take the paper prescription to any pharmacy.

If you can’t pick up the prescription yourself you can ask a friend, relative or carer to do this for you. You will need to call the GP to let them know that someone else is picking up the prescription. The person collecting the prescription will usually be asked for your name and address. Sometimes they might be asked for ID. They can then take the prescription to the pharmacy to collect your medication.

If you get free prescriptions the pharmacist should be told about the reason for this.

This information should be completed on the prescription form.

Controlled drugs

If you need someone to collect controlled drugs for you then the pharmacist may ask the person collecting it for proof of identity. And they may also ring you to make sure that your medicine is being collected by someone else.

Controlled drugs include some benzodiazepines and some pain killers. You can read a list of the most common controlled drugs by clicking here: www.gov.uk/government/publications/controlled-drugs-list--2/list-of-most-commonly-encountered-drugs-currently-controlled-under-the-misuse-of-drugs-legislation

Delivery services

If you don’t have anyone that can collect medication for you then you can ring your local pharmacy to see if they deliver.

There are also services that can post out your repeat prescriptions free of charge. And there are online pharmacies that can post out your repeat prescriptions free of charge. You can search for these online. Or ask your GP surgery for their recommendations.

Community Pharmacy Consultation Service (CPCS)

You might urgently need your normal medication and your GP surgery might be closed, or you might be struggling to speak to someone there.

You can use the Community Pharmacy Consultation Service (CPCS). You need to call NHS 111 to begin with and explain the situation. Be sure to say you want to arrange repeat medication through the Community Pharmacy Consultation Service.

NHS 111 can then contact the pharmacy that you want to collect the medication from. NHS 111 can tell you what you need to do next. You should then be able to collect your medication from the pharmacy. But please note:
- If your GP surgery is open the pharmacist might tell you to contact them. If you are struggling to speak to someone at the surgery, tell the pharmacist.
- The medication is issued at the pharmacist’s discretion. So, the pharmacist might have a reason to not issue the medication to you. If this is the case, you can ask the pharmacist the reason.
- The pharmacist wouldn’t usually issue controlled drugs under this service.
There have been some changes to welfare benefits rules and things like statutory sick pay, for people who are off work because of coronavirus. These changes have been made to make things easier for people during the crisis.

Our Mental Health and Money Advice Service have produced information on this. You can read it by clicking here:

www.mentalhealthandmoneyadvice.org/en/top-tips/mental-health-and-money-advice-for-covid-19-outbreak/
The Mental Health Act can be used to detain people in hospital. This only happens if someone with a mental disorder is very unwell and they need to be in hospital to keep them or others safe.

Because of the coronavirus crisis, some changes have been made to the way the Mental Health Act is being used. You can get information on the changes by clicking here: www.rethink.org/advice-and-information/covid-19-support/nhs-guidance-on-temporary-changes-to-the-mental-health-act-due-to-coronavirus-old/

There is no change to entitlement to free Section 117 after-care. You can get more information about ‘Section 117 after-care’ by clicking here: www.rethink.org/advice-and-information/rights-restrictions/mental-health-laws/section-117-aftercare/
You are entitled to question the government’s response to the coronavirus pandemic. And you have a right to your views. You may think that the government’s measures are too controlling. Or not controlling enough. Whatever your opinion on the government’s measures to stop the coronavirus from spreading and keep people safe, we believe that it is important that everyone follows government and NHS guidance and regulations.

Distressing thoughts about the government, police and health professionals are quite common with some severe mental illnesses. The feeling that someone is trying to harm you when there’s no proof that it’s true is often known as ‘paranoia’ or ‘being paranoid’. Everyone experiences paranoia from time to time, it is a natural human reaction designed to keep us safe from harm. However, for some people this feeling doesn’t go away, and can take over their thoughts. This can severely affect them on a daily basis.

Most people believe that coronavirus is a contagious virus that can lead to illness, which can be serious. And they are following the laws and guidance that the government have made. The police have been given powers to make sure people stick to the rules. This isn’t because they are watching you specifically, but because people are worried about the virus spreading and making people very unwell.

Try speaking to someone who cares for you. A family member or friend. They may not always agree with what you are saying but they will usually have your best interests in mind.

If you are feeling particularly distressed by your thoughts it may help you to contact an NHS Early Intervention Team. These are medical professionals who help people who have distressing thoughts and beliefs about things like the government and the police. You can find their contact details by doing an internet search for NHS Early Intervention Teams in your area. Or you could call your GP or NHS 111 to help you.
You might be anxious about speaking to professionals on the phone. Your carer might be able to speak on the phone for you.

You might have to speak on the phone first, then explain to the professional that your carer is going to speak for you.

You can ask for your carer to be recorded on the organisation’s records as your ‘nominated person’. This shows you have nominated them to speak on the phone for you. The nominated person will probably have to provide the organisation with personal details like their name, post code or date of birth. This is so the organisation can make sure it’s them when they call.

You could ask for a nominated person as a ‘reasonable adjustment’ under the Equality Act. You can find out more about reasonable adjustments in our information on ‘Discrimination and mental health’ by clicking here: www.rethink.org/advice-and-information/rights-restrictions/mental-health-laws/discrimination-and-mental-health/
NHS Volunteer Responders

NHS Volunteer Responders are there to help vulnerable people who are self-isolating during the coronavirus crisis. If you have a severe mental illness, this includes you.

If you have no-one else to collect shopping or a prescription for you, they can help. They’re there if you need a friendly chat too.

To get help from them you need to call them on:
- 0808 196 3646 (8am to 8pm).
You can read more about NHS Volunteer Responders here.

Your local authority

If you’re clinically extremely vulnerable and you are shielding you can register with your local authority here for extra support.

You can use this service to:
- ask for priority access to supermarket deliveries,
- ask your local authority to contact you about any local support that may be available if you’re shielding, and
- update your details, like your address.
If you need help registering, someone else can do it for you.

Local coronavirus support groups

Local coronavirus support groups are organised through things like social media and WhatsApp. They aren’t face-to-face support groups where people meet. But people chat to each other and help each other through things like social media and WhatsApp.

They may be able to help with things like shopping, collecting prescriptions and providing phone calls to stop you feeling isolated.

You can go online and search for support groups in your local area. Or contact one of your local councillors and ask if they know of any groups. You can find details of your local councillors by clicking here: www.gov.uk/find-your-local-councillors
If you need urgent help you can do the following.
- Get in touch with your crisis contact. You might have been given a crisis contact by a mental health professional. Or your care plan might say who to contact in a crisis.
- Contact your local NHS urgent mental health helpline. Most areas will have one. You can find details of your local NHS urgent mental health helpline at: nhs.uk/service-search/mental-health/find-an-urgent-mental-health-helpline. Or you can call NHS 111 to ask them for details.
- Ask your GP for an emergency appointment. GPs usually keep some appointments free for urgent cases. Your GP can make a referral to the local crisis team if necessary.
- You can call the emergency services on 999. They may then get in touch with mental health services such as the crisis team or take you to hospital if they think it’s necessary.
- You can contact NHS 111. The phone line is for when you need medical help fast but it’s not a 999 emergency. You can call 111 if you don't know who to call or you don't have a GP to call. Or if you need health information or reassurance about what to do next.
- Call an emotional support line. Please see the information below under ‘How can I get emotional support?’
- Use Shout text service: You can text Shout to 85258 to connect to a trained person to help you. See www.giveusashout.org/; for more information.
You can read our information on ‘Suicidal thoughts: How to cope’ by clicking here: www.rethink.org/advice-and-information/about-mental-illness/learn-more-about-symptoms/suicidal-thoughts-how-to-cope/

You can read our information on ‘Self-harm’ by clicking here: www.rethink.org/advice-and-information/about-mental-illness/learn-more-about-symptoms/self-harm/
Talking about how you feel can have big benefits. And people who care about you like friends and family are usually happy to listen and support you. But you can also call the following lines to talk about how you are feeling.

Samaritans

Can be contacted by telephone, e-mail and mini-com. They are open 24 hours a day, every day of the year.

Telephone: 116 123

Email: jo@samaritans.org

Website: www.samaritans.org

Sane Line

Work with anyone affected by mental illness, including families, friends and carers. They also provide a free text-based support service called Textcare and an online supportive forum community where anyone can share their experiences of mental health.

Telephone: 0300 304 7000 (4:30pm – 10:30pm every evening)

Textcare: www.sane.org.uk/what_we_do/support/textcare

Support Forum: www.sane.org.uk/what_we_do/support/supportforum

Website: www.sane.org.uk

Support Line

We offer confidential emotional support to children, young adults and adults by telephone and email.

Telephone: 01708 765200

E-mail: info@supportline.org.uk

Website: www.supportline.org.uk

Papyrus UK

Support people under 35 who are having suicidal feelings. And with people who are worried about someone under 35. Their helpline is open 9am – 10pm in the week. And between 2pm and 10pm at weekends and bank holidays.

Telephone: 0800 068 41 41

Email: pat@papyrus-uk.org

Text: 07786 209697

Website: www.papyrus-uk.org

C.A.L.M. (Campaign Against Living Miserably)

Their helpline is open between 5pm and midnight every day of the year.

Telephone: 0800 58 58 58

Webchat: through the website

Website: www.thecalmzone.net

Silverline

Aimed at people over 55. The Silver Line operates the only confidential, free helpline for older people across the UK that’s open 24 hours a day, seven days a week, 365 days of the year.

Telephone: 0800 4 70 80 90

Website: www.thesilverline.org.uk

The Mix

Aimed at people under 25. Their helpline is open between 4pm and 11pm, 7 days a week. They also run a crisis text service which is open 24 hours a day, 7 days a week.

Telephone: 0808 808 4994

E-mail: through the website.

Crisis text message service: Text THEMIX to 85258

Webchat: through the website. (4pm - 11pm, 7 days a week - chats may not be connected after 10:15pm)

Website: www.themix.org.uk

Mood Swings

Aimed at anyone affected by a mood disorder, including friends, families and carers.

Telephone: 0161 832 37 36

E-mail: info@moodswings.org.uk

Website: www.moodswings.org.uk

This blog will be updated as more information becomes available. Last updated 04.11.20

Covid 19: Advice for people severely affected by mental illness & their carers

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