Mental health and Covid-19: it’s not all over

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22 October 2021

By Andy Bell

It’s now widely accepted that the Covid-19 pandemic and its effects on our lives have taken a toll on our mental health. This has come across in surveys worldwide, with lockdowns, school and college closures, and peaks in infection linked to dramatic increases in poor wellbeing.

While the trajectory of the remainder of the pandemic itself can’t yet be predicted, we have been reviewing evidence about the mental health impacts since the start and produced a number of forecasts based on the best available research. These aim to look beyond the here and now, and the stresses and strains of restrictions and disruptions, at the longer term risks to mental health.

With lower levels of restriction in place at present – and at present little prospect of their immediate return – it’s tempting to think that the biggest risks to mental health have now gone. We’re no longer in lockdown; schools, colleges and universities are open; many working people have found a new balance between home and work; and unemployment rates remain thankfully low.

The evidence we have reviewed suggests that the biggest and most serious mental health impacts will manifest over a longer period of time.

The reality for our mental health is not quite so rosy, however. The evidence we have reviewed suggests that the biggest and most serious mental health impacts will manifest over a longer period of time. There are a number of reasons for this.

First, for many of the people whose mental health will be most seriously affected, the harm may have been done but the effects may take longer to manifest. Trauma, loss and grief may take months or even years to translate for some people into poor mental health. People who have been bereaved during the pandemic, people who have been seriously unwell with the virus, and people trapped in homes facing violence and abuse, face a higher risk of poor mental health that will last beyond the crisis itself. Health and care staff facing burnout may be coping in the midst of an emergency (which for many goes on) but that may come at a price later on.

Frightening headlines about ‘epidemics’ or ‘tidal waves’ of mental ill health often miss the point that a large proportion of need is hidden, suppressed and unmet.

Second, we know that it can take time for people to seek and secure help for their mental health. It takes an average of a decade for children and young people, often slowed down by fears about stigma, complex systems that make help-seeking difficult, and poor responses from professionals when they disclose distress. Frightening headlines about ‘epidemics’ or ‘tidal waves’ of mental ill health often miss the point that a large proportion of need is hidden, suppressed and unmet.

And third, we do not yet know how the virus will continue to affect us, and how this might interact with flu and other illnesses, especially over the winter. Each successive wave of the virus risks cumulatively creating yet more distress, and this time without the protections of the furlough scheme or the £20 Universal Credit boost that together kept millions of people out of poverty.

We’re already seeing an increase in referrals for mental health support, partly resulting from the low level seen in most of 2020, and partly because of the extra distress caused by the pandemic.

So there remain reasons to be concerned, and that’s why it’s so important to plan now. We need to reduce the risks to mental health, by taking steps to control the virus and its impact, by tackling poverty, and by creating trauma-informed schools and workplaces. We need to keep expanding mental health support so that when people need help it’s available quickly and close to home. And we need to explore new ways of meeting people’s needs, such as early support hubs for young people, digital interventions for those who prefer them, and skill-sharing with communities. We’re already seeing an increase in referrals for mental health support, partly resulting from the low level seen in most of 2020, and partly because of the extra distress caused by the pandemic.

It was clear from the outset of the pandemic that the mental health impacts would be both immediate and protracted. Covid-19 is not over. From a mental health perspective, it is still developing. And it will have impacts that come to the surface over months and years. Recovery will not be quick, but the need for action to turn the tide on this ongoing crisis is pressing.

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