Britain is sleepwalking into a mental health crisis as the government struggles to deal with the monumental effects of the Covid-19 pandemic.
Health experts and charities have told the Observer the coming winter will devastate the mental wellbeing of the nation as lockdown uncertainty, fear, isolation and loneliness are exacerbated by the colder and darker months ahead.
In England, the Centre for Mental Health has predicted that up to 10 million people – almost a fifth of the population – will need mental health support as a direct consequence of Covid-19, with 1.5 million of those expected to be children and young people under 18. The effect on patients with pre-existing mental health problems and on those from underprivileged backgrounds is even greater, painting a bleak picture for those already suffering.
Professor Roshan das Nair, a clinical psychologist from the Institute of Mental Health, is “deeply concerned” about the country being able to cope with the looming crisis.
“The sheer numbers of people developing problems – and some may not be fully-fledged or reach the threshold for diagnosis – will escalate,” he said. “What this means for the healthcare service, when at the best of times we have long waiting lists, is a real concern. How are we going to cope with the increased demand in the next few months?”
Primary school-age children are considered especially vulnerable to anxiety and emotional and behavioural issues. Polly Waite, co-author of a University of Oxford study into the health of children and adolescents during the pandemic, revealed that the number of children who would meet the threshold for clinical diagnosis had increased by 35% during the pandemic.
“That isn’t the only alarming figure,” said Waite. “We know that children from lower-income families are two-and-a-half times more likely to suffer poor mental health and this inequality persisted throughout lockdown. There is a domino effect: elevated family stress in the coming months around finances, jobs, social restrictions, uncertainty – all of that poses a huge risk to the emotional and mental safety of kids as well as their anxieties around peer relationships in schools, exams and learning.”
Speaking to the Observer, the shadow health minister Rosena Allin-Khan accused the government of being “asleep at the wheel” and playing “political football” with what was unequivocally a cross-party issue.
“My freedom of information request revealed that the secretary of state did not meet with a single mental-health organisation within the first three months [of the pandemic]. There is no single group that’s unaffected – mental ill health affects people regardless of class, gender, ethnicity or socioeconomic background.”
Allin-Khan, who also works as an A&E doctor, proposed a “care for carers” package to protect the mental health of three million frontline NHS and care workers – a group that has been especially susceptible to stress, burnout, depression and post-traumatic stress disorder. The policy was rejected by the Conservatives, in a move Allin-Khan described as “unconscionable”.
She added: “People are facing huge uncertainty for protracted periods of time with no coherent plan from government as to when they could expect to see light at the end of the tunnel – and that uncertainty breeds anxiety.”
In the Commons earlier this month, Nadine Dorries, the minister for mental health, said the government would pledge “an extra £2.3bn of funding into mental health services”. This figure was short, however, of the £2.6bn required by the NHS’s five-year plan on national mental health, which was conceived before the pandemic.
With a global crisis in mental health arising, the World Health Organization warns that depression and anxiety could increase susceptibility to infection and transmission of the virus, and affect how nations respond and recover. There is also evidence to suggest that poor mental health affects adherence to social distancing and mask-wearing, and could affect uptake of a vaccine.
“It is the people who are already discriminated against or already vulnerable who will find it hardest to cope now and in the winter,” said Geoff Hayes, the head of health policy and influencing at the mental health charity Mind. “There is a huge concern that as hospital wards begin to fill again and Covid takes priority, patients with severe mental health will suffer.”
He wants lessons to be learned from the first lockdown, when 2,500 patients with severe mental health problems were discharged in March to free up ward space for Covid cases.
“This is an opportunity for the government to look at this relatively small group of people we know are highly vulnerable and provide a package of care for them. Covid has massively dented the progress of delivery of mental health services, and suddenly there isn’t the money to do the things promised.”
The charity Samaritans has already fielded more than a million calls during the pandemic, a quarter of them asking for help connected to coronavirus. A spokesperson said that “as social restrictions and uncertainty continue, it is essential that we look after our own mental health and others’ by continuing to check on one another and share how we have been feeling”.
Doing good for others, checking in on neighbours and staying in contact with friends and family are proven to have strong positive mental health benefits, alongside daily exercise and positive mental reframing – taking the “glass half full” approach. Professor das Nair recommended that a public health drive encouraging these behaviours in the coming months would have a significant effect on reducing the sense of pervasive gloom. “We have to prevent people from getting to the stage where they feel mental ill health, as doing things that are positively rewarding is really useful in improving people’s wellbeing,” he said.