Unsettling and unjust: mental health inequalities and coronavirus

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22 April 2020

By Andy Bell

We are often told that mental health doesn’t discriminate – that anyone can have a mental health problem, and that one in four of us will be experiencing some kind of mental health difficulty at any one time.

While these statements are both true, they hide a deeper truth that is much more uncomfortable and unjust. While any of us can experience a mental health difficulty, our chances are far from equal. And that inequality exists on multiple dimensions, putting some people at a vastly inflated risk of poor mental health. For many, the chances of experiencing mental illness are considerably higher than one in four. And very often it is people who have the least power, autonomy and wealth who have the poorest chances of enjoying good mental health.

While any of us can experience a mental health difficulty, our chances are far from equal.

In the last few months, a similar fault line has opened up in the way the coronavirus pandemic has developed, both internationally and in the UK. We are told, rightly, that anyone can get coronavirus and anyone can pass it on: that coronavirus does not discriminate. And of course, this is very clearly true.

But, once again, there is a deeper truth that the impact of coronavirus is not being felt equally. As with mental health, there are stark inequalities in the ways we are experiencing both the virus and the measures that have been required to respond to it. And very often, these mirror the deeply entrenched inequalities in society that existed long before Covid-19.

As with mental health, there are stark inequalities in the ways we are experiencing both the virus and the measures that have been required to respond to it.

Multiple inequalities have already been observed in relation to coronavirus. These most obviously relate to age and the presence of long-term physical health conditions in the risk of dying with coronavirus. But it is also now becoming clear that people from Black, Asian and minority ethnic communities in both the UK and the US face a higher risk of dying with the virus than white people. The reasons for this are as yet unknown, but as this BMJ commentary underlines, there may be numerous explanations: biological, economic, environmental and more.

Inequalities are also becoming evident in the wider impacts of coronavirus: from its financial effects on people with the most precarious livelihoods, to the greater risk of victimisation for those living in abusive relationships during the lockdown.

While anyone can experience the trauma of coronavirus, the risks to mental health will be much greater for those who also face abuse in their daily lives, who fear for their financial future with few resources to fall back on, or who see people like them dying at a much higher rate from the virus.

The mental health impacts of the pandemic are as yet unknown, but they are likely to be significant and long-lasting, in some cases only becoming apparent in the months and years to come. Given the inequalities that are already evident in relation to both mental health and coronavirus, it is highly likely that they will intersect and accentuate the injustices that are already there. While anyone can experience the trauma of coronavirus, the risks to mental health will be much greater for those who also face abuse in their daily lives, who fear for their financial future with few resources to fall back on, or who see people like them dying at a much higher rate from the virus.

These are uncertain and unsettling times for all of us, and for some of us the tragedies will be deeply personal. We are all in that together. But the inequalities that divide us are as great as ever, and our experiences of the pandemic will not be the same. At Centre for Mental Health, we will be monitoring the mental health impacts of coronavirus and focusing on inequalities that might otherwise be hidden from view.

Image by Adi Goldstein on Unsplash
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