While the vast majority of us will avoid the Coronavirus directly, many will be impacted. Either because they contract the virus itself – and for the most vulnerable we know this could have serious or fatal consequences – or because of its broader impact.
As the Government has recently switched from containment to measures aimed at delaying its spread, focus continues to shift to telephone, video and digital services in providing a vital alternative path to face-to-face help and treatment.
Although the impact today is being felt by a relatively small number of people – those with the virus and the family and friends of those who have tragically died from it – this will undoubtedly escalate. Broader knock-on effects seem likely to affect most of us to some degree.
People who rely on primary care for access to therapy and community teams, for example, will be affected as medical staff are diverted to test people for the virus or to care for those who have the disease – or who are themselves in quarantine. Again, it’s digital services which have the potential to provide a safe, ‘virtual’ solution.
There are many people who already choose online counselling; the Kooth mental health and wellbeing support service for children and young people and provided via the NHS is now seeing more than 2,400 logins every day, a number already rising as anxiety around the virus increases. Many young people on the site are expressing concern.
According to Dr Lynne Green, Chief Clinical Officer at XenZone, the organisation behind Kooth: “We are seeing increasing numbers of young people discussing Coronavirus on our live forums and seeking out articles on the disease; some articles on the virus are attracting well over 150 comments. It’s clear that there is growing anxiety around catching the virus and concern around family members who may be affected. General uncertainty is fuelling concern.”
Meeting demand for mental health support at a time of threat and uncertainty is a significant challenge. One that Steve Gilbert OBE, a respected speaker on mental health issues who has worked with many mental health organisations and politicians and who has lived experience, feels we are not totally prepared for: “If we look at mental health provision on a normal day, there is massive variability in how teams work and are able to meet the needs of their patients. Throw Coronavirus, a massive unknown, into the mix and I’m not sure we are best prepared. What I would hope is that services are aware of those people within their care that have the most pressing needs and that they find a way to make sure that whatever care is being provided isn’t interrupted.”
As providers of services to adults through its Qwell service, Dr Green is preparing for further increases in demand for support: “As face-to-face support is curtailed, we are preparing our mental health support services for a spike in demand to support continuity of care for those engaged in face-to-face support. We’re ensuring we have sufficient numbers of professionals on hand to help people who need emotional support. And as our practitioners work from home, they’re able to provide ongoing support safely. It’s important that we keep our NHS commissioners informed too, providing data on access and service use so that we can work together to meet demand.”
For those who can’t access their usual face-to-face support systems, this is likely to be a testing and stressful time. Those accessing help via community teams risk being stranded without a lifeline, with many expected to feel lonely, especially if self-isolating.
Meeting demand from people experiencing loneliness, anxiety or who are reacting to a lack of routine medication will be essential to avoid issues escalating into crises.
Steve Gilbert: “For those living with a mental health condition which is debilitating to any degree, the virus represents an additional thing to be anxious about, and that in its own right has an impact. But then if there is any reduction in the level of care available, then actually that has the impact of creating crises which will be very difficult to manage under current circumstances.”
As far as dealing with the threat of the virus, the prospect of self-isolation and the potential loss of routine, there are related practical concerns, for instance around picking up medication. To this end, mental health charity Mind has recently published advice for those worried about accessing regular medication, advising them to look into ordering by phone or online, or through the NHS app. In the case of self isolation, it has also published a checklist with suggestions on how to manage issues such as food, connectivity, routine and money.
For those receiving treatment for mental health, support from peer communities can be vital in ensuring they are connected, have an outlet and an opportunity to talk. Without this, feelings of isolation and loneliness could have a significant negative impact.
Accessing online groups can be a viable alternative, while ensuring that any digital community sites are clinically robust and safe. Look for clinical accreditation from groups such as the British Association for Counselling and Psychotherapy (BACP). Live discussion forums on Qwell, for example, are moderated enabling people on the site to express themselves with peers freely and without fear of any negative backlash.
As the situation evolves, the impact will grow, with the prospect of schools and workplaces temporarily shutting down leading to financial worries for some. The best approach, according to Dr Green – as the Mind advice suggests – is to try to prepare for what might happen and talk to friends, family or a professional about any anxieties you may be experiencing: “If it’s possible to make some provision for continuing any treatment you are currently having, or to find alternative ways of accessing support, it’s best to start thinking about how you might do this. Try to take in the facts rather than rumour. Importantly, it’s important to remember that this is a temporary situation, and that life will return to normal.”
Steve Gilbert also reminds us that even if self isolating we can still be community minded: “Remember you can still check on neighbours, even if that’s just talking through a window or giving them a call. And the beauty of technology is that we can all stay in touch. In a lot of ways, tackling the Coronavirus is the ultimate team building exercise.”