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Mental health and social change in the time of COVID-19

Craig Morgan & Nikolas Rose

Co-Directors, Centre for Society & Mental Health

08 April 2020

Efforts to contain and delay the spread of COVID-19 have transformed our social worlds – more or less overnight. Governments have introduced severe restrictions to limit physical interactions and our daily routines have been curtailed, often with legal sanctions. Added to this is widespread uncertainty, worry and distress – about the virus, our loved ones, education, work and money.

Although the latter response is understandable, we need be wary of rushing to frame them in terms of mental health. There has been a flurry of advice from governments, experts and amateur gurus about what needs to be done – yet not much of this is evidence-based.

Increased anxiety and fear is normal

A spike in symptoms of depression and anxiety was reported the day after the UK Prime Minister announced the lockdown. This is not surprising. However, to think of these responses as symptoms – as indicative of mental health problems – risks pathologising the natural process of adapting to radically changed circumstances.

This is not to suggest people do not need help and support. The cruel irony of our current situation is that the pandemic and subsequent restrictions both generate anxiety and fear and deprive us of the natural supports offered by family and friends.

Consider the facts

Previous research tells us that we should pause before rushing to provide individual counselling and therapy. How we think about and understand the impact of these changes on our mental lives will shape how we respond.

We are not all in it together

While anxiety is a natural and widespread reaction, the impact of COVID-19 falls most heavily on those with the fewest social and economic resources to alleviate the effects of social restrictions. Enforced social isolation affects most those in:

  • deprived neighbourhoods
  • insecure jobs and/or low-income jobs
  • insecure housing
  • single parent households
  • abusive relationships

It also acutely affects those with existing mental health problems, whose symptoms may worsen when access to help is limited. This includes when contact with care workers – often the sole source of social contact – is reduced or lost altogether.

The most effective responses are likely to be those that mitigate uncertainties around employment and education, provide safety nets for loss of income, and harness community resources to support those already experiencing social deprivation, poor mental health, isolation and loneliness.

What should we do?

The emergence of online resources, designed to help maintain good mental health during the current crisis, is essential. As is support and treatment from mental health professionals – both now and in the coming months – to manage the anxieties, fears and distress of some people, particularly those with existing mental health problems.

However, we need to do more. Because COVID-19 is damaging our social life and the communities in which we live and thrive, we need policy and community-level responses. Informed by robust research, these responses should reduce uncertainties in people’s lives (including employment) and restore and build social connections (including online). In short, we need policy and community-level responses that promote and sustain mental health.

It is by responding appropriately and addressing these root causes that we will prevent understandable worry, sadness and distress from crystallising into more persistent anxieties, hopelessness, and depression.


 

About the Centre for Society & Mental Health

We look to understand and respond to the impacts of rapid social change on mental health. We could not have known that a few weeks after our January launch we would be living through the most profound period of social change in living memory.

The major social and economic trends that we research provide the backdrop to the pandemic. This is because changes that erode job and financial security, as well as strip bare public services, amplify the effects of a pandemic and undermine our ability as a society to respond effectively.

In the coming months, we’ll be investigating the impacts of the pandemic and related restrictions on social life and mental health. Our aim is to inform public debate and help develop appropriate responses, particularly amongst the most disadvantaged and vulnerable.

In this story

Craig Morgan

Craig Morgan

Professor of Social Epidemiology

Nikolas Rose

Nikolas Rose

Professor of Sociology


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