Mental health COVID aftershocks will be with us for years

Whatever your views on lockdowns (I've seen two new pieces of graffiti today saying "lockdowns kill") and the government's performance during this crisis, there is one thing I hope we can all agree on: we will be paying the mental health price of COVID long after the vaccination programme is done, the No 10 press conferences are thankfully a distant memory and masks are something worn only at halloween. 

The impact of the lockdowns, the restrictions and the economic misery brought about by the virus and the response from government, employers and individuals are beyond calculation. The cost - the human cost in tears, fears and pain - will be impossible to measure but it will surely outstrip the catastrophic cost we are already enduring in lost lives, lost livelihoods and lost life chances. 

Every day we hear ministers, journalists and others talking about the importance of mental health and of us all needing to prioritise this as we enter this third lockdown, as if we hadn't thought about it, or almost anything else since March. Sadly, for many of us, these words ring very hollow. They smack of virtue signalling, box-ticking and going through the motions. There is a lot of talk and very little action. The same investment in mental health services and support is promised over and over again, old money recycled as if new, and then actions taken that rob people of the very coping mechanisms (including access to gyms, golf, outdoor swimming and the like) that could help them manage a bit better through these terrible times. 

Like many people studying or working in mental health, I hear the current cacophony of cries for help and see the explosion of demand for support and services - some of which have been themselves hit by COVID sickness rates, scaled back whilst resources are diverted elsewhere (with good intentions but terrible consequences) and getting overwhelmed by the sheer volume of desperate requests for help. This demand will naturally increase now in 'lockdown #3' but my biggest worry is what happens from the end of this lockdown. What is the long term plan? What is being done now to gear up for the mental health long COVID that will be with us for years? What are doing to get ready for the painful future we have ahead? 

I am training now to become a psychotherapist - hopefully qualifying in the summer of 2022 - and am constantly thinking about what COVID will mean for my future clients and for my practice. What do I need to be doing now and in the coming months to get ready to help and support people who will be living with the long term mental health effects of COVID and what can the NHS, employers and charities be doing to refocus and resource so much of their mental health offer? 

It doesn't take long to draw up a list of the types of issues that will likely dominate mental health demand, including for talking therapies, for years to come. Much of this is not new but will present with a fresh potency and pain, as it will be felt and experienced through this hideous, vicious virus:

• Loneliness - in part driven by the social distancing, shielding and the forced separation we have endured
• Relationship breakdown - impacted by the stresses and strains that COVID and the changes to lifestyles/living arrangements that have brought
• Loss - of our chance to say goodbye to people we love and to some of our pleasures, freedoms and friendships
• Grief - of people we love and people who love us 
• Addiction - people turning to or returning to a range of damaging patterns of addiction, including to alcohol, drugs and food
• Physical health - for some driven by cancelled medical appointments, operations and treatments - and for others who have struggled to get out for exercise or to achieve a healthy work-life balance or healthy diet during these awful months  
• Fear - of sickness; of infection; of each other 
• Isolation - from the people and things that previously gave us joy, energy and light 
• Trauma - not just from the direct suffering from the virus in care homes and hospitals but also including from the horror of domestic violence in homes the length and breadth of the country
• Death - by suicide but also as a result of crimes committed under the cover of lockdowns

This list could go on and on and on. Everyone will have their own worries about what COVID could mean for them and their family. I know that for me it has meant significant fear for myself, Dr and Miss J, but mostly for those close to me who are older and more vulnerable to getting this disease and with it being handed a death sentence.

I am struck too by this list and by the impact that COVID has had on just one group of people across our society; those working in the NHS caring for those struck down and giving everything of themselves and then some to keep those we love alive. Their traumatic experiences are hard to fully comprehend even when we try through our clapping and tears.  

The light at the end of the tunnel of the virus is the vaccine and I am full of hope about this, especially for those most of risk from its deadly grip. But when this light appears we will face a much longer darkness and be living with the long-term affects of COVID for years to come. The pain has only just begun and we need help to be on hand for every child and every adult across the country to help us all recover - not just our wallets and daily lives but our hearts and souls. 

I am sick of weasel words and empty promises about the future of mental health services and support. As a country we are already on the back foot as this mental health crisis worsens. We need action. We need a plan. We need to get moving. 

If the last ten months with its lockdowns and restrictions have been the COVID earthquake, the looming mental health crisis are the long COVID aftershocks and tragically we know that this is often where the most damage is done.