Why I believe that the mental health crisis we are facing will be even more destructive than Covid19

Pic courtesy
  www.toledolibrary.org/blog/mental-health-awareness

Why does Great Britain have the worst covid death rate of any major country on the planet? The answer is simple. We were completely unprepared for it. It would be simple to blame Boris Johnson, but the truth is that he'd been Prime Minister for a couple of months when the crisis hit. The planning for such an outbreak had been neglected for decades. Countries such as South Korea, that had a SARS/MERS outbreak a decade or so ago managed matters far better and had a miniscule death rate compared to ours. It took us the best part of six months and probably trillions of pounds to get to a point where we now manage the crisis. Most of us have been cut off and isolated from friends and family for the best part of a year. Whilst we seem to be getting to grips with Covid, it is widely accepted that what will most likely be a far greater long term problem is just starting to rear its ugly head.

I am talking about the nations mental health. Being cut off from friends, family and support networks, whilst a deadly disease has taken people we love, whilst we are bombarded every day with appalling news regarding deaths and disease is not conducive to a great sense of wellbeing. I don't know anyone who hasn't had a heightened feeling anxiety at some point during the last year. Recently I've been getting in contact with friends I've not seen for a while, with a view to meeting when allowed. One friend, someone who I've always thought of as a  robust individual told me that they would not be coming out to play for a very long time. Another told me they'd not been on a Tube train for over a year and wasn't looking forward to it. This is just the tip of the iceberg though. We try and put on a brave face, hoping that there will be a magical day when things 'normal' again. What concerns me is that for many, what was considered feeling normal may not return just because the pubs are open and that we can visit our Grannies and kids.

The former bassplayer in my band, who passed away a decade ago, found himself in trouble with the law and ended up serving a year in prison. When he was released, we went for a beer and when I asked him how everything was, he told me that he was feeling anxiety about sleeping with the door unlocked. He'd got used to the routine of prison life and he told me that it was difficult to readjust to freedom. Having spent a year the dreaming of being able to roam freely, be with his girlfriend and do as he pleased had given way to a fear of going out when faced with the chance to actually do it.

The furlough scheme has insulated many from the worst of the financial hardships, but many businesses are facing difficult choices right now. No one knows what the trading situation will be like. Many business owners will have re-evaluated the way they do business. It seems likely that many will find themselves in a position where the jobs they are furloughed from do not come back. I imagine that for many, having to find new opportunities, having been sat at home for a year may prove to be a stressful endeavour. 

For young people, the last year at nurseries, schools and colleges must have been a truly awful experience. The exam fiasco last summer has cast a shadow over them. Many who worked hard for GCSE's and A Levels only to have their plans thrown into chaos, with random grades imposed. I cannot imagine how that would undermine one's self confidence. Then there are those who finished degrees last year, just as the whole jobs market shut down. Most have put their lives on hold.

In the last year, I am aware of five young people who found it all too much and took their own lives. Two are children of friends of mine. I am only too aware of their pain and grief. Many young people, stuck at home with no positive stimulation have delved deep into dark websites, chat groups and other harmful and corrosive aspects of the web. Coupled with the intense isloation and claustrophobia of our current situation, many will be feeling vulnerable. Schools are now open, but we are still living under a dark cloud and with the constant testing, things are by no mans normal.

I started this blog by stating the reason that the UK was hit so hard by covid was because we were not prepared. I believe that the mental health fallout of the crisis will dwarf the scale of the damage we've seen and for many will live with them for the rest of their lives. The Government, local authorities, the NHS and healthcare providers need to start developing robust plans for supporting those suffering from mental health issues. Before the crisis, these were inadequate. With what is coming, they could make the stress on the NHS caused by Covid seem a cakewalk. Covid patients in a critical condition are by and large static and easy to monitor. The medical requirements are fairly well defined. Treatment for mental health issues is a very different matter. Whereas covid can be diagnosed with a simple test, mental health conditions are hard to diagnose, hard to treat and the people who are suffering often do not turn up for sessions, don't take proscribed medication and are resistant to therapies. I am not a medical professional. I have however spoken to several and the message is the same. We are chronically unprepared for what is coming.

In the Borough of Barnet, the Council and healthcare providers are aware of the issue and there has been talk of how this should be addressed. Ultimately what we need to do is have a cross community response. It is to big for just the council, the NHS and other care providers. Each one of us may be affected. We may need the support of friends, we may need  support ourselves. Churches, Mosques, Synagogues, schools, AA Groups,  playgroups, football teams, scouts, guides groups all have a role to play. Our communities need to come together to face this. When we can see people without fear, when we can drop in for a coffee, drop off some shopping or even just have a chat in the street, we can all do our little bit. If a friend or family member is feeling down, do not simply say "that's sad". Keep an eye on them, ask them if they need anything. If they don't want to chat, arrange to call back later or the next day. Speak to other members of your support networks. If you say "How are you?" Most people would say "I'm fine". If you say "This has been a difficult time, what aspect have you found most difficult?" you may get a very different answer. 

I would like to see the Council taking the lead by facilitating small scale, local support to be made available for friends and family of people who are struggling. Often very small amounts of resources deployed at an early stage will be far more effective than huge amounts once there is a serious problem. Support needs to be accessible and well signposted. It can often be more cost effective to assist through family and friends than directly and it is always more effective for these efforts to be coordinated. 

At this stage, we all need to be aware that friends and family may well be struggling or could start to struggle as things open up, just when you'd expect them to be starting to feel better about things. Human beings are designed to feel stress when we are faced with change, coming out of lockdown is as much of a change after all this time as going into it. Stress is our response to such change, both good and bad, this is how our body prepares us to deal with issues that challenge our survival. Anyone who is about to go on a first date will know that even things we are really looking for can be stressful. In our complex, internet led society, we are dealing with a new type of stress and one for which we are not well adapted. It's OK to feel anxiety and it's OK to feel stress. Don't be ashamed to admit it, don't be ashamed to seek support and if someone asks you, and you don't feel able to help, don't feel ashamed to seek advice on what to do if you are worried. But the first thing we need to do, is to make sure we are prepared, so we have a proper response, unlike the chaotic early stage of covid, where we couldn't even decide whether we wanted 'herd immunity' or lockdown.