Although it is impossible to predict how Covid and the resulting restrictions will impact on us over the next days and weeks, let alone the next months and years, it seems inevitable that many many people will be psychologically affected. Whether front line clinical staff, the people who have been treated and recovered from the virus, those who have lost loved ones, older people feeling frightened in care homes, or anyone who has felt isolated, alone, confused and displaced by the social distancing rules we have had to follow. There are also the many individuals with pre-existing diagnoses whose treatment has been delayed or prematurely ended as mental health services shift to crisis interventions, those who have struggled with receiving their support through digital means and those who have felt unsafe accessing both physical and mental health services because it might increase their risk of contracting the virus. In autumn 2019 I wrote a scoping paper for the PPN exploring how psychological therapists are able to support community wellbeing. Although many different psychological approaches and current ways of working within the community were described, this paper broadly asked the question how can we extend our ways of working to include preventative and community-based and community-developed interventions. It would seem that we are now in a time when these ideas will be more relevant than ever.
Lucy Johnstone emphasised in a letter to the Guardian (link below), how this virus/pandemic has brought into focus how much of mental health is contextual, as we all experience a natural emotional response to the uncertainty, instability and isolation. This is not to say the impact is equal, as those living in safe accommodation, without threat of violence, with financial security or access to open space have a different experience of life in lockdown. Likewise, although there will be some who will need psychological therapy to heal from what they have experienced, it is important to acknowledge all the different factors that can contribute to mental health problems, and not just the ones that are best treated by individual therapy. The people who are most likely to be able to inform this understanding, and to identify what might be the most helpful responses, are those that have been most affected. In the aftermath of a disaster, it is perhaps natural for interventions to be implemented 'top down' as decisions need to be made quickly. However, Sally Warren (see link), in light of learning from Grenfell, argues that these should be times for public services to work alongside communities to 'use all of our collective strengths to improve our health and wellbeing'. The COVID mutual support groups that have sprung up around the country are testament to how communities are able to mobilise themselves and support each other. Carl Walker (see link) suggests psychological professionals should build on these collective responses to individual need, and focus on 'preventative, community-led approaches to mental health and emotional wellbeing' as this how we can 'strengthen communities'. It may be early to start thinking about how we respond post crisis, whilst we are still trying to get to grips with working within the crisis, but maybe it is never too early to start identifying and connecting with those groups who are likely to be affected and thinking together about what is most needed.
Hannah Denton (Counselling Psychologist) with Alice Plummer (PPN SE Clinical Programme Manager) and Helen-Leigh Phippard (Service User Consultant)