Health

Can mental health services cope with the devastating effects of Covid-19?

Just six months after qualifying as a social worker Paddy Hartigan found himself on the frontline of the mental health crisis triggered by the coronavirus pandemic. Almost overnight he had to rethink how to continue supporting his clients. Many have serious long-term mental illness such as schizophrenia or bipolar disorder whose symptoms and social isolation were exacerbated by Covid-19. 

“For people already struggling with quite serious mental illness everything has become amplified and things are much harder,” says Hartigan, a mental health social worker for Camden and Islington NHS Foundation Trust. If you feel that you are in need of support for your mental health during this unprecedented time, reach out to https://www.betterhelp.com/start/ today.

With routine home visits ruled out, he has to rely on telephone and video calls to gauge how well a person is coping. “The challenge, and the negative side of that, is that I am not going into people’s homes so I don’t get to see the full picture. You can get a real sense of somebody within seconds of seeing them. People might be able to present quite well on the phone but be feeling quite unwell.” The pandemic forced him to hone and refocus his skills: “I have had to learn to practise with my ears open and really listen to people and hear what they are saying.”

Hartigan, 30, may be new to the profession, but his experience is far from unique.

Sean Duggan, chief executive of the mental health network of the NHS Confederation, which represents trusts and other healthcare providers, says mental health services had to transform “very quickly” in March when face-to-face consultation were “shut down” and rely instead on digital options which has left some service users excluded.

The impact on mental health caused by Covid-19 has been devastating. Research last month by Mind found that two-thirds of adults and three-quarters of 13 to 24-year-olds with a pre-existing mental health problem said it had become worse during lockdown.

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And new figures show that one-fifth of vulnerable people in Britain have considered self-harming or killing themselves during lockdown. The Royal College of Psychiatrists reports that 43% of psychiatrists have seen an increase in emergency and urgent cases and predicts a “tsunami” of referrals on the horizon. The Centre for Mental Health forecasts an estimated 500,000 more people experiencing mental ill health difficulty over the next year. But if there is a second wave of Covid-19 and the economy is damaged further, the effects on mental health will be greater still, and last much longer.

Trusts are already reporting an increase in mental health referrals, says Duggan: “There is national work going on to try and quantify that to get a handle on how much and in which sectors.”

It is clear that the mental health workforce will have to grow in order to meet this increased demand. The government already has plans to expand the mental health workforce in England. Some 24,000 staff are needed by 2023-24 to fulfil the mental health reforms outlined in its five-year plan for mental health. These are in addition to 21,000 new posts proposed in the Mental Health Workforce Plan published in 2017. The government also intends to spend an extra £20m on additional places for graduates to train as mental health social workers.

But filling those places, and encouraging people to consider a career in other mental health roles may be more difficult than expected according to research published today by Think Ahead, which runs a fast-track training programme to get graduates and career changers into mental health social work, and pollsters YouGov. It suggests that while the public appreciates the value of the work done by mental health practitioners , employers may struggle to persuade job seekers to follow a career in these professions.

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One of the biggest public misconceptions is that 90% of people think they’re at risk of being attacked or injured if they work in mental health. And while 60% of parents said they would be “proud” if their child worked in mental health, 31% would worry about their safety. Yet latest figures from the violence at work survey by the Health and Safety Executive reveal only 1.4% of health professionals were physically assaulted in 2019.

Ambulance staff are the most at risk. They are 10 times more likely to be attacked in the workplace than psychologists. Today’s research also shows a significant lack of knowledge about the variety of roles available in mental health. While more than 80% of respondents had heard of a psychiatrist or mental health nurse, fewer than 30% had heard of psychological practitioner roles and just under a fifth knew what a peer support worker was. And nearly a third had no idea what training you need to be a mental health professional.

Still, some 11% of people of working age said they might consider a career in mental health in the next five years, representing a potential recruitment pool of 4 million people, if those figures were replicated across the UK population.

“I think one of the most encouraging things to come out of this research is that there is no shortage of people that might consider a career in mental health,” says Matthew Brown, director of strategy, evaluation and communications at Think Ahead. “But we now need to work together to bust some of the myths around working in mental health and raise the profile of some of the roles.”

But there are already signs that for some roles there’s no struggle to fill posts. “We are already seeing big increases in applications for support staff, one of the reasons for that is that jobs are disappearing elsewhere but also, because of Covid-19, people think that the NHS is a good place to work,” says Duggan.

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But it’s not just a question of hiring more people. More than 50 organisations signed a letter to Boris Johnson in June calling for “a mental health renewal plan” for England to support its recovery from coronavirus. “If we just look at the service end of the system, then we just won’t meet the demand, post-Covid, because the system isn’t built to sufficient scale,” says Mark Rowland, chief executive of the Mental Health Foundation thinktank. “We have got to place mental health in society – in the workplace, in our schools and our communities rather than just seeing it as a solely medical service that requires treatment.”

Back in north London, Hartigan has no regrets about his career change. He used to work in insurance and marketing before a volunteering stint with a charity helping people with mental health problems to get back into work led him to apply to the Think Ahead programme to retrain as a mental health social worker.

He has a persuasive message for anyone interested in following in his footsteps on a new career path in this field.

“I think the biggest satisfaction you get working in mental health is the bond you develop with people. I give a lot of myself to the role and when you see a genuine improvement in people and see they are able to cope with what are serious mental illnesses, that’s really rewarding.”

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