Symptoms of psychosis significantly increased during pandemic

18 October 2021

*** Please note this article was corrected on 20/10. These statistics have been revised following the identification of a data quality issue with the information provided to NHS Digital ***

The charity Rethink Mental Illness has raised alarm at the significant increase in the number of people referred to mental health services with suspected First Episodes of Psychosis during the pandemic.

According to NHS data which identifies the primary reason for referral to mental health services, the upward trend in the number of referrals began after the first lockdown was eased, with significant increases recorded over recent months.

Over 9,440 referrals were made in April 2021, a 29% increase compared to pre-pandemic levels in 2019. The increase was sustained throughout May 2021, with more than a 26% increase in referrals to mental health services compared to same month in 2019, while in June 2021 referrals remained over 21% higher.

The most recent data for July suggests that the number of people presenting to mental health services with symptoms of psychosis has returned closer to pre-pandemic levels, but the charity is insisting these figures must be carefully monitored.

This is some of the first concrete evidence to indicate the significant levels of distress experienced across the population and the growing numbers of people pushed towards crisis, following numerous studies that have acknowledged increased rates of conditions such as anxiety and depression in the wake of the pandemic.

Psychosis can involve seeing or hearing things that other people don’t (hallucinations) and developing beliefs that aren’t based on reality (delusions), which can be highly distressing. It can be a symptom of mental illness such as schizophrenia, bipolar disorder or severe depression, but psychosis can also be a one-off, potentially triggered by a traumatic experience, extreme stress or drug and alcohol misuse.

Despite the continued pressure on mental health services, Rethink Mental Illness is highlighting the importance of rapid access to treatment for those who go on to be formally diagnosed to prevent further episodes of psychosis and reduce people’s risk of developing severe mental illness.

Currently, NICE guidelines for people experiencing a suspected first episode of psychosis state they should receive an assessment within two weeks.

However, the charity fears that if this increase in referrals is sustained, more people will have to wait longer for vital treatment.

Brian Dow, Deputy Chief Executive of Rethink Mental Illness, said:

“Psychosis can have a devastating impact on people’s lives. Swift access to treatment is vital to prevent further deterioration in people’s mental health which could take them years to recover from.

“The increased number of suspected first episodes of psychosis are cause for alarm. We are now well beyond the first profound shocks of this crisis, and it’s deeply concerning that the number of referrals remains so high. As first presentations of psychosis typically occur in young adults, this steep rise raises additional concerns about the pressures the younger generation have faced during the pandemic.

“The pandemic has had a game-changing effect on our mental health, and it requires a revolutionary response. Dedicated additional funding for mental health and social care must go to frontline services to help meet the new demand, otherwise thousands of people could bear a catastrophic cost.”

Tom Dunning, 30, has a diagnosis of borderline personality disorder, social anxiety disorder and PTSD:

“I was about 22 or 23 when I first started experiencing symptoms of psychosis. It was pretty much overnight having after finishing my degree that my head told me to deal with hearing voices. Hearing them was a daily occurrence and it pretty much made me feel scared of myself because I didn’t think anything was wrong so I couldn’t tell anyone how I felt.

“I had experienced bullying in my childhood and now I felt like my own mental health was bullying me by the voices telling me to do things. Everyone around me started to notice differences and knew something was wrong but I was scared to acknowledge that. I eventually saw my GP and it was the first time that I thought I needed support but it was also the first time that I knew it was something I could get through.”

For more information about psychosis, linked condition and treatment, please visit


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