It is time to focus on mental health
John (name changed) is in his 40s, I’ve known him for some time and generally he has been a relatively happy man, if prone to a bit of anxiety and generally more worried about his health than he needs to be. So when I saw him booked for a call to discuss his mental health I was a bit surprised. Talking through the problems on the phone with him, he wasn’t in a great place - some warning signs flashed up; such as seeing no hope for the future, and not being able to identify good parts of his life. Exploring the reasons for these it became more obvious why this had happened. Like a lot of people, his social network had disintegrated; his family live overseas, he hasn’t been able to see them for several months and is worried about them. His main source of social activity is through his work, but his work has totally dried up which has also left him with worrying financial concerns. Self-employed, he doesn’t get a lot of support from the state and he can’t see things getting better in the near future. His life has lost purpose and structure.
A recent Office for National Statistics survey found that in June almost 1 in 5 people suffered depression symptoms (using the ‘Patient Health Questionnaire 8’ (PHQ8)). This rate is double the rate prior to lock down. This was worse for people with money worries. These findings are troubling and fits with what we are seeing as health professionals at the moment. GPs across the country are reporting lots of phone calls for people who have problems with their mental health. A lot of the calls include core symptoms of depression: low mood, low energy, poor sleep, lack of pleasure in life, poor appetite, tearfulness, irritability, thoughts of death, poor self-esteem, and a lack of interest in socialising. A lot also include problems which are more subtle but can indicate problems with mental health: unexplained symptoms such as abdominal pains, increase in chronic pain, fear of getting ill. And there is a lot of anxiety.
Assessing these problems on the phone is also quite tricky and time consuming. Most healthcare is now ‘phone first’ for sensible reasons, but these problems really require the human contact and communication that is best face to face. Video consulting can be a useful alternative and is better than phone for this purpose but still not ideal. Added to the challenges at the moment is a lot of people with mental health problems find group-based activities and social support really helpful. Day centres or exercise groups can be life savers for people. With Covid-19 restrictions a lot of these have stopped or changed, which removes another pillar of support. A lot of mental health charities and services (for example Oxfordshire Mind) are offering excellent phone line support and some virtual groups, but they are always going to struggle to replace the vital human closeness that we need.
Talking through things with John, we agreed it would be helpful to meet face to face to explore the problems more. He is now on antidepressants which should help him alongside therapy that I’ve managed to find from a local volunteer psychologist. With close support I’m confident he will get through this difficult period in his life. It is really important that people feeling like this are able to access good support and services; a lot is through their GP but there are other resources that are accessible directly (see links below).
What we especially need at this point is for our society to pull together and focus on mental health recovery as a priority, and resource the services properly as the country tries to recover from Covid-19.