Shropshire Star

Hidden costs of lockdown are great: Help offered for those suffering from mental health during coronavirus pandemic

Covid-19 has cost the UK more than 30,000 lives. That’s the equivalent of the entire population of Lichfield – or, in Shropshire the populations of Bridgnorth, Whitchurch and Ludlow combined.

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The hidden cost is greater, of course. Daily mortality rates do not account for deaths caused by factors associated with Covid-19; for instance, higher death rates among cancer patients who have missed treatment.

Youngsters face the risk of a dole queue future as 800,000 UK school leavers find job opportunities drying up. Youth unemployment is expected to reach the one million mark in the coming year, according to forecasts from the Resolution Foundation.

The UK is expected to suffer a 35 per cent drop in economic output as a result of the coronavirus lockdown measures, according to forecasts by the Office for Budgetary Responsibility (OBR).

The OBR expects the UK economy to slump by 35 per cent between March and June before recovering in the last six months of 2020, although it would still contract by 12.8 per cent for the year as a whole. Unemployment is set to increase by more than two million to 10 per cent in the second quarter, before gradually falling.

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The UK is being saddled with the highest level of debt in its history. The scheme to “furlough” workers during the Covid-19 crisis may cost up to £40 billion because so many firms have taken up the offer. Chancellor Rishi Sunak’s Job Retention Scheme could end up funding eight to 10 million people being laid off for weeks or months, the Resolution Foundation think tank estimated.

The worst affected sectors such as travel, hospitality and leisure could see declines in output in 2020 of anywhere from 14 per cent to 37 per cent in alternative scenarios. They should recover next year, but it could be a long process for the worst affected sectors as it will depend on consumer confidence returning as well as the gradual easing of social distancing measures.

All around us, business are collapsing, lives are being torn apart.

The impact of Covid-19 on the economy will affect not just people’s incomes but also their health. A recession will lead to a large rise in the prevalence of chronic ill health. During the most intense part of the financial crisis of the late 2000s in the UK, there was around a five per cent fall in the employment rate, a drop that was low by international standards.

Assuming a (possibly conservative) fall in the employment rate in the coming year of the same size, the prevalence of chronic conditions in the working-age population will rise by somewhere between seven per cent and 10 per cent. This increase translates into around 900,000 more people of working age who will suffer from at least one chronic condition.

Freelancers and gig economy workers will be hard hit. Many who have incomes of less than £1,000 per month will find themselves with no work. Low-income workers are more likely to experience health shocks related to Covid-19 and the income supports in place will leave some low-income workers exposed.

The traumatic effects of Covid-19 on essential workers are substantial.

For many doctors and healthcare professionals, this may be a time of increased pressure and stress. It is quite normal to experience feelings of distress in the current situation and it is important to recognise that this is not a reflection on their ability to do their job or to cope.

It is important during this time they take time to prioritise their own mental health and wellbeing, recognising that it is more difficult to provide outstanding care for others when they are not adequately cared for yourself.

Against such a backdrop, it’s little wonder that the nation’s mental health is suffering. An unprecedented national suicide prevention plan has been launched by a Government advisory group to address the risks presented to vulnerable people.

Chair of the group and the national adviser to the government on suicide prevention, Louis Appleby, said the plan was centred on getting far quicker access to data on suicides and self-harm episodes, which is the strongest indicator of suicide risk.

He said: “We are in unprecedented times, we haven’t got a lot of evidence on what happens to suicide rates during pandemics, so we’re having to infer from what we know generally to see where the risk might lie.

“We don’t actually know the suicide rate will go up, we can see the reasons why it might, but we don’t know it will, and obviously we’re trying to prevent that happening.

“This is a serious attempt, in some senses an unprecedented attempt to prevent a [physical health] crisis turning into a mental health crisis. There are risks in the current situation but there is also a way of dealing with those risks and there’s whole batch of experts, and agencies and front-line people, all of whom will be thinking about how to best protect vulnerable people.”

The national group is asking mental health trusts and charity the Samaritans for “soft intelligence”, on where risks are likely to be and what is happening on the front-line, along with a “rapid review” function looking at any evidence published around the world.

Tales abound locally of those whose lives have been turned upside down; of workers whose income has fallen by 80 per cent, of business owners who are facing ruin, of people unable to attend funerals or grieve for those who have passed away, of relatives unable to visit family members in hospitals or care homes, of relationships that have fractured under the pressures caused by Covid-19.

The effect on people’s mental health mirrors the effect on our economy. Loneliness and depression are increasing as people experience social isolation.

People of all ages are suffering. ChildLine, for instance, received an unprecedented increase in telephone calls when the UK went into lockdown. School routines are important coping mechanisms for young people with mental health issues.

When schools are closed, they lose an anchor in life and their symptoms could relapse.

It’s not as though the UK had not already got problems on its plate. The three-year divide over Brexit was followed at the beginning of the year by flooding, which had a profound effect on local communities.

Psychologist Professor Dame Til Wykes, of King’s College London, said repercussions could be felt for a long time.

“This has been a national trauma like no other that we have experienced. Consider the terrible flooding we had earlier this year. People watched river levels rise and listened to weather forecasts to find out if they might be inundated the next day or the day after. That was stressful.

“But it was nothing compared to this threat which has hung over us for weeks already and is likely to go on for much longer. Spending months looking over your shoulder all the time is going to cause considerable, lasting anxiety for many people. In addition, if you look at other natural disasters, you can usually find help or comfort from people around you. However, it is the people around you that are the threat in this case. So there is no consolation there.”

Rory O’Connor, professor of health psychology at Glasgow University, agrees: “Increased social isolation, loneliness, health anxiety, stress and an economic downturn are a perfect storm to harm people’s mental health.

“If we do nothing, we risk seeing an increase in mental health conditions such as anxiety and depression, and a rise in problem behaviours such as alcohol and drug addiction, gambling, cyberbullying or social consequences such as homelessness and relationship breakdown.”

And yet while Covid-19 will have an impact on the mental health of the population at large, it is people who have existing conditions who are most likely to be effected.

The Lancet, one of the world’s most respected medical journals, reported: “The mental health effects of Covid-19 on the general population might be profound and long-lasting, and deserve serious attention; but they cannot be the exclusive focus of conversation. Those who wish to build fairer societies and health systems after the pandemic ends must learn about and prioritise the needs of people living with severe mental illness as a matter of urgency.”

Local support groups are providing help for those most in need. From Mindful About Men, which helps people in Dudley, to the Think Again Peer Support Group, whose Walsall-based members prevent isolation and build friendships; many organisations are stepping up to the plate.

The NHS is assisting those on the frontline and a new mental health hotline has been launched for local workers.

NHS staff will be able to call or text a free number staffed by thousands of specially trained volunteers, to receive support and advice for the pressures they face every day during the global health emergency.

The volunteers will listen to NHS staff and give support to those in need.

Anyone who requires further help will be signposted to other services ranging from practical and financial assistance through to specialist bereavement and psychological support.

The phone line will be open between 7am and 11pm every day, while the text service will be 24/7.

Steve Morrison, Regional Director at NHS England and NHS Improvement Midlands, said: “As the pandemic continues, our people will face new and growing challenges on a daily basis, and it’s therefore more important than ever that they are able to access resources to help them manage their wellbeing, in a way that suits their needs.

“We need to do everything we can to support our incredible NHS people as they care for people through this global health emergency.

“That’s why we have developed a range of support for all NHS staff, from one-to-one mental health support to a sympathetic voice to confide in.

“The NHS is rightly doing everything we can for our staff, but the best thing the public can do for nurses, doctors and other NHS staff, is to protect them by staying indoors and washing your hands.”

The more than 1,500 volunteers who will be staffing the lines have come from charities including Hospice UK, the Samaritans and Shout. The NHS has also partnered with Headspace, UnMind and Big Health to offer a suite of apps for no charge to assist staff with their mental health.

The apps offer support in everything from guided meditation, tools to battle anxiety and help with sleep problems.

The NHS, however, cannot assist everyone. In Telford, the region’s Primary Care Wellbeing Service has been paused. New referrals are unavailable as members of the team assist in urgent and critical areas of the NHS at this difficult time. Some branches of the Samaritans have also suspended face-to-face services.

The simple message is that people should reach out and make contact with charities if they are unable to access services through conventional routes.

Sane’s chief executive, Marjorie Wallace, said: “Loneliness can be a killer.

“While there is all this focus on physical health, we are in danger of overlooking the impact of coronavirus on the mental health of the country, which could pose a risk in itself.”

She continued: “Saneline, our telephone helpline, is receiving more calls from people suffering from depression, anxiety, panic and obsessive compulsive disorder, who are becoming acutely distressed.

“Already 80 per cent of our callers talk about self-harm and suicide, and we fear that, without being able to reach us or find other help, they may be tipped over the edge.

“For some people, particularly the elderly, the prospect of isolation can be daunting. For others, four months at home may be seen as a change in lifestyle, but for those with no real home or who are living in a substandard flat staring at the four walls, as many patients are, isolation can loom like a living hell.

“Psychiatric services need to be on red alert for patients who are deteriorating.”

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