Covid-19 and the nation’s mental health – The Centre for Mental Health

Andy BellThe Covid-19 pandemic is having a major impact on people’s mental health. Centre for Mental Health’s Andy Bell explores what we know so far from research and what to expect in the near future.

The global Covid-19 pandemic is a health emergency unlike any we have known in living memory. But it is also a mental health emergency, with significant immediate and long-lasting effects. Centre for Mental Health has been exploring the evidence about the potential impacts of the pandemic on the public’s mental health as well as monitoring the effects being felt by people with existing mental health difficulties. We want to ensure that the mental health impacts of the pandemic are understood and where possible anticipated so that the right support can be made available to protect and promote wellbeing where possible, and provide support when it is needed.

At the time of writing, there are many limits to what we know and there is so much that we cannot with any confidence predict about even the near future. But it is clear from research into both epidemics and recessions of the recent past that the current crisis poses a major risk to mental health. Surveys and emerging international research about the mental health impacts of the pandemic also point to significant and growing concerns. The risks they identify come in many different layers, and they affect different groups of people in very different ways. We are not all in this together when it comes to our mental health.

For some people, the mental health impacts of Covid-19 will be direct, immediate and potentially severe. There is evidence that being treated in intensive care is a traumatic experience that for many survivors results in post-traumatic stress symptoms that can last for a long time. Similar risks exist for staff working in those services, or in care homes, as well as those in occupations that put them at a high risk of contracting the virus. People who experience these traumatic events first hand will need especial support for their mental health – this cannot be left to chance.

Sadly, for many families, Covid-19 results in bereavement and loss, often without the ability to be with the person when they die or to grieve in ‘normal’ ways. This increases the risk that bereavement results in complicated grief – which can result in severe and lasting distress. It is vital that anyone who experiences a bereavement at this time – due to coronavirus or not – is offered support for their mental health too.

It is also now evident that some people and communities have greater risks from the virus, and thus to their mental health longer term, than others. These are very often the same groups of people whose mental health is also at higher risk in ‘normal’ times, such as Black, Asian and minority ethnic communities and people living with long-term health conditions and with disabilities. For communities that feel let down and betrayed during this time, it is likely that the psychological effects will be long-lasting as the injustice and inequalities they face are laid bare so dramatically and painfully.

For many more people, the mental health impacts of Covid-19 will be indirect, but potentially just as serious. One of the biggest determinants of our mental health is our economic wellbeing. As the Institute of Fiscal Studies recently estimated, if the recession that follows Covid-19 is of a similar scale as the 2008 banking crisis, an extra 500,000 people will experience a mental health problem, most commonly depression. If there are further waves of the virus that cause greater economic shocks, the impact on mental health will grow exponentially.

Mental Health Scenarios

There is also clear evidence that the lockdown has increased exposure to violence and abuse, especially for women and children, which is also known to be a major risk factor for serious and long-lasting mental health difficulties. This means that schools and employers in particular need to be aware as people return that many will have found the lockdown especially distressing and will need safe spaces to go back to.

These risks all present major challenges for a health and care system that has had to refocus a lot of its energies on responding to the virus. An increase in mental ill health following the most acute phase of the virus looks very likely. And while not everyone experiencing a mental health difficulty will seek help for it, we also know that early intervention is key to enabling people to recover and can prevent later crises.

So it will be vital that the NHS and local authorities work together with other local partners, drawing on the collaborative approaches that have emerged in response to the crisis, to protect and promote our mental health as much as possible (for example supporting schools and businesses to help children and adults returning after the trauma and isolation of the lockdown); to secure swift and easy access to help whenever it is needed, including a proactive offer of help to those who have been treated for the virus or been bereaved by it; and to improve psychological support for anyone with a long-term health condition, many of whom face many more months of isolation and anxiety.

We will continue to explore the evidence about the mental health impacts of Covid-19 and offer further forecasts as more research and information emerges and we are able to make further predictions about their implications for our wellbeing in the longer term.

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