We face a mental health crisis – but can we come out of it stronger?
This week marks a month since the UK went into lockdown to stop the spread of the Coronavirus. In this blog Brian Dow, our deputy CEO, looks at what we’ve experienced so far and asks if we can come out of this crisis stronger.
John F Kennedy said, “when written in Chinese the word ‘crisis’ is composed of two characters, one represents danger and the other represents opportunity”. As is often the case with good quotes, the truth does not quite match the rhetoric.
Chinese speakers and linguists will tell you that while the first character does represent danger the second is more accurately translated as ‘a changing point.” But that somehow feels more apt. We face a crisis unprecedented in modern times. It poses a danger to both our physical and mental health. And it will undoubtedly change us. But we also know that change can be both good and bad. Our challenge, probably the greatest our generation will ever face, is to eventually come out of this crisis stronger.
On one level mental health is simple. We all have mental health. It fluctuates. Sometimes we feel more resilient, sometimes we do not and like physical health some people, but not all, can become very unwell. But at the same time, it is also very complex and there are limits to what we know. We cannot predict with certainty who will become unwell or not (although we know who is more at risk). We cannot test for mental illness with certainty and while we can help manage and support people to live well with mental illness, there is not a cure for many of the more severe illnesses.
Our mental health is influenced by an interplay between human experience and our biology. Our task is to provide the best support available to keep people safe and well in their communities. At a population level it is to reduce risk, we know that those who experience trauma and disadvantage are more likely to become unwell.
"The coronavirus pandemic has, and will be, traumatic for many people. For those who become unwell, their loved ones, those on the front line of caring and treating people, but also for everyone else whose way of life has been massively disrupted."
For children and young people no longer at school. For people living with physical and mental health problems who are struggling to access traditional support. For those whose livelihoods have been affected.
People tell us that because of coronavirus they fear ‘spiralling back’ in their recovery from mental illness, and that they have had to adjust to working with their care teams remotely to continue therapeutic work instead of delivering care in person. One of our supporters, a carer and mental health nurse, explained how coronavirus is impacting on every aspect of her life, and that her worries for vulnerable family members and the service users she cares for was making her feel increasingly anxious.
Living with the virus in our midst will almost certainly increase levels of anxiety, distress, and trauma in the general population. Some people will experience significant mental health problems for the first time, an unsettling and distressing experience which may be compounded by other consequences of the pandemic, such as unemployment, homelessness, or bereavement.
The initial research is concerning. The Mental Health Foundation in partnership with the Institute of Public Health at the University of Cambridge found that at the outbreak of the pandemic millions of Britons “felt, panicked, afraid and unprepared”. Leading psychiatrists and psychologists have warned of the crisis having a “profound” effect on people’s mental health.
Coronavirus also has the potential to exacerbate problems for people living with mental illness. Another survey by YoungMinds found that 83% of young people with mental health needs reported that their mental health had gotten worse since the outbreak of the pandemic. Social distancing prevents people from accessing vital face to face support in the community. As resources are diverted, acute care is placed under significant pressure. The physical measures in place to prevent the spread of the virus will affect everyone, including those detained under section who will have even less contact with the outside world than usual, and whose recovery may be delayed.
The NHS is valued more than ever but it is working under huge pressure. Like the rest of the nation we thank and applaud the selfless commitment and hard work of the NHS and all its staff to keep us safe. Charities like Rethink Mental Illness have a crucial role to play in supporting the system to respond to the demand for mental health care intensified by coronavirus.
We must focus on prevention and encourage people to seek support before they reach crisis. Rethink Mental Illness supports people to stay well, reducing demand on services and reducing A&E admissions. Where our accommodation services have capacity, they are being offered to local services to increase the number of beds available in the community for the most vulnerable. This will not only relieve pressure on the NHS, it can also save lives.
Working with people with lived experience of mental illness and local service commissioners we are strengthening the capacity of community services to provide support at every level. This ranges from the provision of information and resources and emotional support helplines, to providing care for those in crisis.
We are also adapting our services to provide support remotely. We can use technology to help reduce feelings of isolation, anxiety, or distress. We’re transferring some of our existing peer support groups to online and phone support, while many of our local helplines are experiencing increased demand.
Because of the pandemic, our beneficiaries will need more support than ever, but like many charities we are expecting a huge reduction in income as fundraising initiatives are put on hold. The outbreak has resulted in both greater mental health need combined with a health system and charity sector stretched to its limits, with no scientific model to indicate when demand for mental health services will peak. In response we have launched an emergency appeal to ensure that we can continue to fund the vital work of our Advice and Information Service.
Before the pandemic there was a growing awareness of the importance of good mental health. A positive we can draw from the crisis, while acknowledging the trauma people individually and collectively experience, is that this awareness is now cemented in our national consciousness as an integral building block of our wellbeing. We have also shown as individuals, as organisations and as a nation that we can move at pace to adapt and provide support where it is most needed. In a short space of time we have refocused our activity to respond to this crisis. We are in the process of rephasing what we do to adapt to what is happening. In time, we will recover. This momentum must be maintained. Now and in the years to come.