Surge of Covid-19 mental health issues set to come

Lock down continues to prevent a sense of normality returning to our high streets. Image (c) RMC Photography.

Delays in help seeking behaviour; unprecedented wave of new patients is imminent

Easing of restrictions will result in an unprecedented demand for mental health treatment

30% of new patient referrals cite Covid-19 as a reason they are seeking support

New data points to an imminent surge in Covid-19 related mental health issues. Data scientists at Ieso believe that current levels of referrals are alarmingly low for a collective crisis such as the coronavirus pandemic. Low levels of referrals indicate that patients may be bottling up mental health issues and postponing help-seeking. This phenomenon has been associated with previous incidents involving widescale trauma such as terrorist incidents and natural disasters. Due to the scale of the pandemic, this delayed onset of issues will result in an unprecedented surge of new cases descending on the UK mental health system, which before the current crisis was already struggling to reach its target of treating 25% of the one in four people who usually suffers from mental health issues.

Ieso has identified that 30% of all new referrals for therapy cite Covid-19 in their reasons for seeking support. Just 5% discussed money worries in the sessions suggesting these issues, for the moment, pale in comparison.

Dr. Ana Catarino, Principal Scientist at Ieso Digital Health, warns that the UK’s mental health system will be under huge pressure. She says: “The scale of the mental health emergency is going to put services under incredible pressure; there simply aren’t enough therapists. Many services are switching to remote therapy delivery but haven’t had sufficient time to train in this mode of treatment. We need to innovate and look at other ways to help patients if we are to have any chance of resolving this issue.”

Across the board, NHS admissions are at a record low, with members of the public choosing not to risk going to hospitals, or burdening the NHS. Referrals to mental health services across the country have seen a drop of 30-60% in April, despite digital services being put in place. The lack of supportseeking indicates people are experiencing too many pressures; and do not have the time or ability to address any issues they’re experiencing.

There are vast sets of triggers for mental health issues in the context of a pandemic. Dr. Catarino explains: “You have people who spend time in hospital without support from loved ones. You have their family members at home alone, unable to be there for their dying relatives or those unable to attend funerals. Those at high-risk who have to live for weeks in a state of hyper-vigilance, constantly thinking they are going to get ill and die. You have hospital staff and undertakers seeing thousands of bodies awaiting disposal with no hope of giving them and their families the usual levels of respect and time. The list goes on.”

As restrictions begin to lift across England, Dr. Catarino warns that this will not necessarily mean anxieties will be alleviated. She said: “The Covid-19 situation is unique in comparison to other disasters. It is not a discrete point in time, but something prolonged over several weeks and months, causing trauma exposure at a global scale at various levels.”

“Compounding this is the lack of ability for people suffering from anxiety and depression to return to anything that remotely resembles “normal life”, which is usually the primary path to recovery - a psychological first aid. In the immediate aftermath of disasters, people need continuity of normal life, and to spend time with others, get back into the swing of their routine. With social distancing measures looking likely to continue for some time, this isn’t possible.”

These findings are a result of a preliminary analysis of the impact of the Covid-19 crisis on data collected by Ieso Digital Health. We will continue to monitor and explore this data in more detail during the next stages of this crisis, including investigating the impact of Covid-19 on other variables, such as the types and severity of disorders; changes in average treatment duration; and changes in clinical outcomes including how long treatment lasts and recovery rates.

Ross O’Brien, Digital Innovation Director at Central and North West London NHS Foundation Trust, added:

“There is potential for the mental health impact of COVID-19 to be more severe than the physical effects of the virus. Patient referral rates have been alarmingly low over the past few months across IAPT services in England, in London alone we have seen up to a 50% reduction in referrals. This is a concern because we know that people are struggling with their mental health and not reaching out for support from the NHS. There is a wealth of digital technology that is enabling therapy to continue without people needing to leave their homes. We need people to seek the help that is there and not feel that they are going to burden the NHS.”