As the country grapples with the Covid-19 pandemic and its economic consequences, an underlying epidemic is taking place. Lockdown, a deepening recession, and widespread bereavement are just some of the causes of the psychological impact coronavirus has had on the population. ONS released a series of statistics showing that prior to the pandemic, one in ten adults (9.7%) were experiencing some form of depression. This has now jumped to one in five (19.2%).
Before the pandemic, mental health services had seen their budgets slashed. Accompanied by low staffing levels and morale, defunded services struggle to provide basic care. Increasingly, it is the police who are on the front-line handling mental health crises in the UK. For young people, the problem is particularly acute. Although the government has now introduced compulsory mental health and wellbeing education in schools, this does not go far enough.
The UK is ranked one of the lowest in Europe for hospital beds and psychiatrists for young people struggling with mental health problems. Child and adolescent mental health services were among the first to be privatised. Experiencing severe mental health problems and then being forced to wait months for a referral is the harsh reality faced by many.
Not only are services lacking, but the causes for mental ill-health have been neglected, or become starker, in recent years. Austerity has paved the way for deepened inequalities, poverty and limited economic opportunities, which the pandemic has accelerated. Navigating a sanction filled welfare system, a degrading asylum process or constant assessments in schools, are all contributors to psychological distress, yet the responsibility is too often pinned on the individual.
The pandemic has hastened many trends, shining a light on the stark contrast between people’s life circumstances. Access to space, overcrowding of households, secure employment, savings, school equipment and childcare, domestic violence, food insecurity and access to internet connectivity vary widely in our society. All of them are relevant to people’s mental health. People under 40, women, those with a disability and those who said they would struggle to meet an unexpected cost of £850 were the groups most likely to show symptoms of depression in the latest research.
As the recession begins to bite, the difficulties that many people are facing will become more pronounced. Unless the government changes course and provides a decent financial safety net, many more lives are likely to be lost in the months and years to come. Those who are disproportionately impacted by existing wealth inequalities and the health impacts of the pandemic need to be protected, including BAME communities, many of whom are key workers and have been at the forefront of the struggle against Coronavirus.
Preventing people from being evicted or losing their job is urgently needed – through banning evictions, forgiving arrears, extending the furlough scheme, and improving Statutory Sick Pay and Universal Credit. Re-introducing benefit sanctions, and reassessment for people claiming disability benefits, as the government is doing instead, is nothing less than ‘appalling’ according to mental health charity Mind.
The pandemic has displayed the failures of a neoliberal mode of governance in healthcare, where a stripped-down state and outsourcing contributed to the botched Covid-19 response. But the government are digging in their heels. Just last week they decided to axe Public Health England, replacing it with the new health agency, NIHP, under Baroness Harding. PHE provided other services, including mental health and wellbeing. These will now be handed over to local authorities and the NHS, which have both been deprived of funding.
Health Minister Matt Hancock invited the private sector to “get involved” as he announced the scrapping of PHE, foreshadowing the direction the government is set to travel. New appointee Dido Harding likened the demonisation of private health care to “cutting off our hand to spite our face” when criticised for having private health insurance in 2017. Local councils are said to be deeply disturbed by the reforms.
Mind has established five tests for the government to deal with this mental health emergency: invest in community services; protect those most at risk, including addressing inequalities faced by BAME communities; reform the Mental Health Act; provide a financial safety net; and support children and young people. Unfortunately, the make-up of society has been designed to individualise failure and pit people against one another for a long time.
Now is the time to place mental health and wellbeing at the heart of policy and the recovery. Not all causes of depression are political, of course. But it is hard to dispute the impact which politics has had, and will have, on the country’s mental health. In addressing this mental health emergency, responsibility must be shifted away from the individual to the collective, and that means finding political solutions.