Lessons for Resilience
Consider emotional health and wellbeing during COVID-19
COVID-19 has had widespread consequences on all aspects of health and wellbeing. In particular, it has taken a toll on emotional health and wellbeing as a result of remaining isolated or physically distant from friends, family and normal support structures. Additionally, the effects of COVID-19 on risk factors including socioeconomic inequalities, poverty, debt, unemployment, food insecurity, and physical inactivity have had significant impacts on the emotional health and well-being of many
These impacts can be understood on a continuum, from those experiencing some effects on their emotional health and wellbeing, perhaps for the first time, such as intermittent loneliness; to those suffering from more serious mental health disorders such as anxiety, depression or post-traumatic stress disorder; and those who require medical intervention and psychiatric care. This presents three core challenges for mental health provision:
- Prevent an associated increase in mental health disorders and a reduction in mental health wellbeing across populations
- Protect people with a mental disorders from COVID-19, and the associated consequences, such as increased risk of COVID-19 infection and mortality due to increased vulnerability
- Provide appropriate public mental health interventions including for health professionals and carers
The challenges of understanding how emotional health and wellbeing have been affected is complex as many people may develop negative psychological responses after an event, so, even as the threat of the pandemic lessens, more people may reach out for support. This is a particular concern for frontline medical staff, many of whom have not had time or space to process their experiences and may suffer from mental and physical fatigue.
The challenges faced in providing adequate care and support are not just related to the increasing numbers of people who require mental health services. Mental health services claim historically under-funding , and the expected compounding of the impacts of a global recession on the resources available; further stretching the sector. Across the UK, the voluntary sector has played a key role in service provision and developing innovative and flexible care models. Voluntary sector support ranges from helplines to peer support, and alternatives to inpatient care. They may be large national charities delivering a range of responses in different localities or smaller local social enterprises providing a specific service, such as a crisis cafe.
To meet the expected demand for mental health support, the Voluntary, Community and Social Enterprise (VCSE) sector organisations are working with their NHS and local government partners to respond to the pressing needs of the communities they serve and come from. Key priorities have been identified to maintain these services
- Rising service demands - there is a significant rises in helpline usage which has led to concerns about the provision of effective support to every caller; especially those in crisis
- Workforce - consideration of: reductions in personnel due to isolation or secondments to statutory services; gaining key worker status and recognition for voluntary mental health providers, and testing
- Loss of access to care coordinators - a care coordinator plays a key role in helping people to manage and monitor their care, including support with medication, physical health, housing, employment, finances and home care. Support service users who have not been able to contact their care coordinators due to their redeployment to COVID-19 response teams, and/or sickness, self-isolation, etc
- Infection control - PPE and clear guidance on its use is needed for regulated and unregulated services. A considerable number of staff are also working on the frontline with service users, and require protection
- Collaboration with statutory services - VCSE organisations have extensive experience of working alongside statutory bodies in the provision of mental health services. In many areas, partnership working between the VCSE sector, NHS and local government is well-established but, in other areas, it has not always been easy to form effective working relationships
- Advocacy services - appropriate access to advocacy services is important for people with mental health conditions. During COVID-19, some people who have been sectioned need more contact with others. While some people have been provided with mobile phones by hospitals, other people need more support to make contact with others to avoid isolation
- Adapting service delivery - with social distancing policies in place, many services are being moved online or to telephone. Provision for anxiety and crisis support have reported an increase in calls to helplines. Some have reconfigured services but consideration needs to be given to the sustainability of this
- Changes to legislation - emergency legislation (Coronavirus Act 2020) includes temporary changes to the Mental Health Act and local authorities Care Act. Consideration of the effects of this on the availability, accessibility, commissioning and provision of mental health care and support services is needed
- Sustainability of the VCSE sector - concerns about funding streams, cash flow, and long-term sustainability of service providers has been raised. While the Government have provided financial support, the long-term sustainability of the mental health sector at a time when services are needed should be considered
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