The changes in mental health seen so far (when the health needs assessment was completed in mid-2021) may not be the full extent of the impact of the pandemic on mental health. This is because:
- It may be too early to see some of the impacts of the pandemic on mental health.
- The ongoing challenge of the pandemic may continue to affect mental health.
- The pandemic may have environmental, cultural and socio-economic impacts, which in turn will continue to impact mental health. Examples include the possibility of recession, rise in unemployment and rise in deprivation.
Predicting any future changes is fraught with many uncertainties but may signal areas that need closer monitoring.
The Centre for Mental Health report predicts that as a direct result of the pandemic, up to 8.5 million adults in England (almost 20% of the adult population) will need either new or additional mental health support. The vast majority of these will be in people who have existing mental health conditions or the general population. In Plymouth these figures equate to almost 27,000 of the estimated 39,000 people with common mental disorders requiring additional support and over 17,000 from the general population requiring new support for mainly moderate-severe depression or anxiety. However, it is unclear from the model what the level of need will be and the timeframes for when people may need services. In addition, the model is due to be updated in May 2021 with more current evidence, but at the time of writing, this is not yet available.
There are a number of risk and protective factors that are well known to influence mental health. The pandemic is likely adversely to affect many of these factors and so will adversely affect mental health into the future. Strengthening protective factors and minimising risk factors provides a focus for action by which the mental health demands and needs can be addressed in the recovery from the pandemic.
A collated summary of these discussions is presented below:
- Service delivery models: There has been a rapid change to remote service delivery to support clients since the start of the pandemic, with limited ongoing face-to-face work at a reduced capacity when possible for specific needs. Remote delivery was good for some individuals due to the convenience of access; however, other individuals would prefer or need face-to-face interaction. Providers generally considered remote interactions to be of poorer quality due to the difficulties of building a relationship and trust and ability to pick up on non-verbal cues and additional or hidden issues.
- Level of need: Some providers reported that they were managing a higher level of need through their phone lines than they were equipped to.
- Demand: Changes in demand and need since the start of the pandemic are difficult to accurately quantify because of the changes in service delivery models. Demand generally fell at the start of the pandemic and increased thereafter. In some cases, this demand has stayed below pre-pandemic levels, but in others it is has overtaken pre-pandemic levels. There is also a suggestion that reduced access to mental health services during the pandemic may be increasing mental health needs.
- Ability to meet demand: At the time, providers felt that they are able to meet the need that they are faced with, however, there are signs of increasing need across many services.
- Challenges: Challenges for providers include: staff wellbeing, recruitment and retention; having meaningful engagements with clients; reduced capacity; difficulty keeping up with guidance; circular signposting; difficulties for individuals to access formal mental health services at the time of need; poor transitions between services; uncertainty about the future and resources; escalation of needs due to the pandemic; and additional stressors, such as the British Exit from the European Union.
- Improvements: Potential service and system improvements suggested were: a blended approach of face to face and remote delivery; strengthening of collaboration between mental health teams, primary care, social prescribers and VCSEs; strengthening of public mental health, prevention and early intervention; clear messaging about services available; greater awareness of trauma informed practice; strengthening of organisations working at a community level; wider consultation with the community to understand needs, issues and concerns; and improving outdoor space for young people.