Life in quarantine: notes from a psychiatrist
26 March 2020
By Nuwan Dissanayaka
Last Tuesday a hacking cough and a spiking fever landed my son in home isolation. When I collected him from school he was almost in tears. The reason? It wasn’t because he was feeling really poorly or even that he was gutted about missing his friends. It was instead his concern that I wouldn’t be able to work.
He has grown up appreciating the importance of mental health and, within that, the value of my role as a consultant psychiatrist. He’s well aware that I’m terrible at following doctor’s orders and that I’m very rarely off sick, but thankfully he was quick to grasp how vital it was that we too played our part in curbing this virulent contagion. If only more of his “elders and betters” were modelling similar civic responsibility.
Whilst I live part time with my son, I am otherwise alone at home and this quarantine has given me a brief but powerful taster of what it means to lose my agency. I live a simple enough life. I love my time with my kids, my parents and my few close friends, I go to the gym and my other interests are pleasurable if a little ordinary. It’s only now that my life has become so insular that I appreciate the value of that ordinariness (even the gym).
this quarantine has given me a brief but powerful taster of what it means to lose my agency
But it is the human connections both at home and at work that I miss the most. An 18th century translation of the French “isolé” is “to stand detached from others of your kind”. That kind of resonates right now.
Our Assertive Outreach Team supports people who are often very isolated, and not just temporarily. In some cases we are the only familiar faces that they know and trust. They struggle to engage with both physical and mental health services, and they will be especially vulnerable during this crisis. It is good that the government plan to reach out to those who are at increased physical risk, yet I have heard nothing yet about the support that will be available for those with severe mental illness who even under ordinary circumstances find it hard to access help. And given the anxiety that this situation carries, their mental health is likely to be adversely affected. This will also be true for many others, including us "keyworkers".
It is good that the government plan to reach out to those who are at increased physical risk, yet I have heard nothing yet about the support that will be available for those with severe mental illness who even under ordinary circumstances find it hard to access help.
It is cold comfort that what is heading our way instead of mental health support are emergency measures to "relax" the safeguards within the Mental Health Act which protect us. These changes may be unavoidable right now but that doesn't mean that we shouldn't proceed with this potential attrition of our rights with extreme caution.
My anxiety over this outbreak oscillates between my patients and my family which is heightened by having a child and a parent who have autoimmune disorders. My folks who are in their 70s are sensibly locked down under curfew in Sri Lanka for the time being. I’m not sure when I’ll see them again and, inexplicably with no testing available, I have no idea what risk I will pose to them or others closest to me.
My Twitter feed is deluged with evangelical tweets proselytising the benefits of digital working, but Assertive Outreach really isn’t a specialty that lends itself fully to remote working.
My Twitter feed is deluged with evangelical tweets proselytising the benefits of digital working, but Assertive Outreach really isn’t a specialty that lends itself fully to remote working. So I can’t wait to get back to my team to be able to properly support them and our patients. I envisage the next few weeks being especially challenging, with our team’s priority being to try to meet the most basic needs of food, shelter and treatment.
And during these fevered times we would all do well to remember that it isn’t only physical health treatment that is life sustaining.
Let’s get better mental health support for all
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