NHS mental health crisis

Data from NHS Digital has shown that more people are contacting mental health services than ever before – 10m people, including 1.5m children now need mental health support as a direct result of the pandemic.

Children as well as adults are suffering with anxiety and depression caused by social isolation; parents are stressed and overwhelmed with the demands of work and home learning; and key workers are still having to go to work and be exposed to the virus.

Meanwhile, many are suffering grief from the loss of loved ones and some who had mechanical ventilation at the start of the pandemic are suffering from Post-Traumatic Stress Disorder (PTSD). It is thought to be the worst mental health crisis since the Second World War.

Figures show that NHS staff treating Covid patients are also facing record levels of mental health issues. Rates of anxiety, depression and burnout are soaring among frontline staff amid the intense pressures of caring for critically-ill patients.

A survey of 709 healthcare workers conducted by King’s College London in nine ICUs in England, found more than one in eight respondents (13 per cent) had thoughts of suicide or hurting themselves in the previous two weeks.

“An already overstretched NHS has been pushed to its absolute limits with Covid-19. At the beginning, front line staff were desperately trying to manage the risk of treating patients without appropriate or complete PPE,” said Dr Kathryn Lloyd-Williams, a Unite rep and clinical psychologist working in older people’s mental health.

Despite more than 3m cases and 80,000 deaths from Covid-19 within the UK there has been minimisation and denial. Maskless protesters stood outside St Thomas’ hospital on New Year’s Eve shouting ‘Covid is a hoax’ while inside NHS staff battled to treat patients critically ill from the virus and people were dying. Doctors have reported receiving daily abusive social media messages, something which is heinous and demoralising for those on the frontline.

“There needs to be recognition that the pandemic may reactivate previous traumas for staff.  Clinicians have their own life histories and are trying their best to navigate the pandemic.  Even if clinicians don’t fall within the ‘high risk’ groups they have partners and family members who might,’ explained Dr Lloyd-Williams, who has recently published a paper about the mental health crisis facing NHS teams amid the pandemic.

“Some made huge sacrifices to step up to the frontline. Some stayed away from home for periods to protect patients and also their own families. Many may not have chosen this lightly, but saw no other option. There may also be those who are ‘hero innovators’ and put themselves in the midst of the war on the virus, but at a cost to their own wellbeing,” she added.

At the beginning of the pandemic, as we entered our first lockdown, the concept of the ‘super hero’ emerged. Thursday nights on the doorstep clapping with your neighbours became a unified way of showing how grateful we were to keyworkers on the frontline.

“This gratitude was important for morale and unity. Health and social care workers put their own lives at risk in order to treat those who had become seriously ill. However, many staff felt uncomfortable about the super hero image. For them, they were just going to work and doing their job. Now there is also a demand for change, not just applause,” said Dr Lloyd-Williams.

It is likely that everyone will have to continue to live and work in this environment for the time being.

“Now more than ever, we need to show compassion towards one another. We have seen many positives come out of this pandemic – some teams have felt more connected with the use of remote video meetings, allowing them to attend more often than usual. Some staff working remotely report a much better work life balance and are more productive and motivated as a result of this flexible way of working,” said Dr Lloyd-Williams.

“It is possible that we can make team life better – an end to ‘presenteeism’ where often staff can feel stifled and oppressed by being micromanaged. Some may be craving for a return to business as usual. Those in management roles may feel safer as this perhaps fosters a sense of control, productivity and familiarity. The introduction of the use of the word ‘recovery’ may have led to a misinterpretation of a rapid return to ‘business as usual’, but the world we are living in is far from usual,” she added.

This pandemic has shown the unintended consequences of framing clinicians as super heroes, rather than dedicated, compassionate human beings who need support and care too.

“Our work rests on the idea of teams – it is foundational. The pandemic has disrupted this in both harmful and at times, helpful ways. We must remember that all different roles have equal value and retain a sense of each other as human beings. Then we can, and will get through this pandemic and create a strong, caring culture,” said Dr Lloyd-Williams.

You can find out more about Dr Lloyd-Williams’ work in her latest research into the impact of Covid-19 on healthcare teams here.

By Jody Whitehill