Mental Health

Only 7% Of Loneliness Support Organisations Have Returned to Normal Service, According to a New Review

Millions of older people are still at risk of suffering from loneliness because many support organisations closed permanently during lockdown and only seven per cent have returned to normal service since, according to a new review by 10 leading loneliness charities. The Guardian has the story.

Loneliness, social isolation and living alone are all associated with an increased risk of early death, the Older People’s Task and Finish Group has said.

The group, part of the Department for Digital, Culture, Media and Sport Tackling Loneliness Network, also says that so many support organisations closed for good during lockdown that millions of older people are continuing to suffer loneliness, depression and deteriorating physical health. 

The network, Co-Chaired by Independent Age and the Alzheimer’s Society, has found that only seven per cent of 96 support organisations questioned have returned to normal service after the pandemic.

Almost three-quarters of older people questioned in the network’s survey said they had no or significantly less support from the charities they had relied on before the pandemic.

“For people who told us loneliness was not just a product of lockdowns and shielding, but a symptom of their everyday life before the pandemic, the easing of restrictions is not a silver bullet,” said Deborah Alsina, the Chief Executive of Independent Age.

Some older people are coping well since restrictions began to lift, but the group found that a sizeable minority are finding life is just as tough as during lockdown. 

“The extremely damaging side-effects of lockdown – long periods of isolation, a loss of routine and social interaction – have caused significant mental health as well as physical health deterioration for people with dementia, many of them just ‘giving up’ on life, fading away,” said Fiona Carragher, the Director of Research and Influencing at the Alzheimer’s Society.

“Many people we’ve spoken to are concerned that their isolation and loneliness will continue as restrictions ease because the support services they used previously have either shut down or are yet to be reinstated,” she added.

A further survey by Age U.K. found that, compared with before the pandemic, one in three respondents said they had less energy, one in four were unable to walk as far as before, and one in five felt less steady on their feet.

In addition, one in five found it harder to remember things, and more than one in four felt less confident about spending time with family.

Worth reading in full.

Over 80% Of Americans Have Had at Least One Symptom of Depression during Lockdowns

More than eight in 10 Americans have reported at least one symptom of depression during lockdowns, according to the results of a new survey conducted by YouGov and commissioned by Field Trip. Here are the key findings:

Close to half of Americans reported symptoms of mild or more severe depression according to validated depression metrics. Interestingly, even though these measures indicate a nation suffering with mental health challenges, 76% of respondents self-identified their mental health as “good” or better, suggesting a disconnect with one’s self-perceived state of mind and objective measures of mental health…

Women are more likely than men to indicate negative mental states (with 24% describing their current mental health as either poor or fair, compared to 18% of men)…

Younger Americans are also more likely to rate their mental health as poor or fair…

The negative feelings Americans are feeling are so severe that in the two weeks prior to this survey alone, nearly one in four Americans (24%) indicated that they have felt that they would be better off dead or thought of injuring themselves. 

The MailOnline has more on how Americans have tried to cope with their negative emotions over the past 12 months.

Americans reported drinking more alcohol, taking more drugs, watching more porn and overeating more frequently amid the pandemic compared to before Covid…

Every day for more than a year, Americans have either been stuck at home, watching global Covid cases and deaths climb from the hundreds to the thousands, from the thousands to the millions, or have been working jobs on the front lines with little diversion or social contact. 

And as infection and death rates rose, so did rates of depression, anxiety and mental illness…

Many [of the survey’s respondents] were trying to cope on their own, using mechanisms that could do more harm than good. 

One in five people said they were drinking to help them cope, with 37% saying the amount of alcohol they consumed had increased since the start of the pandemic. 

Unsurprisingly, with more time spent at home, and fewer activities to do, a quarter of respondents said that they’d been overeating. 

Women were more likely to use food to cope…

Men found themselves overusing another coping mechanism: porn. 

17% of men said they had been using porn to deal with negative feelings amid the pandemic, and 34% said they were watching more porn than they had pre-pandemic. 

Opioid use was up, too. One and 10 young adults (between 25 and 34) said they had turned to the addictive painkillers to help them cope, and 20% of those said they were using the drugs more often…

While many people were already getting help for, or planning to get help for their depression and mental health issues amid the pandemic, the survey suggests that there will be months, if not years, of mental health fallout from the pandemic ahead. 

The MailOnline report is worth reading in full.

Travellers Complain of a Deterioration in Their Mental and Physical Health While Staying at “Prison-Like” Quarantine Hotels

People travelling into the U.K. from countries on the Government’s “red list” must isolate for 10 days in a quarantine hotel – and pay £1,750 per adult for the privilege! They’re not exactly getting their money’s worth, however. Some travellers have complained of a deterioration in their mental and physical health while isolating due to a lack of fresh air, exercise and proper food. The Guardian has talked to nine travellers who are or have recently been in quarantine hotels.

Some of them had travelled abroad due to sickness or death of loved ones and so were already in a distressed and traumatised state before entering the quarantine process…

While nobody challenged the need to quarantine, it is the way the process has been handled that has generated the complaints. A Facebook group called U.K. Hotel Quarantine Support Chat has been set up and has thousands of members, many of whom have raised concerns about quarantine arrangements.

Dr Sanjay Gupta, an NHS cardiology consultant, who was returning from Kenya where he had travelled to be with his dying father, said: “Not everyone can afford to pay the £1,750 cost. There seems to be something shamelessly opportunistic about this situation. But if you’re arriving from a red list country you don’t have a choice.”

Dr Thanjavur Bragadeesh, also an NHS consultant, who had returned from India where he was helping to care for his elderly parents after both had had surgery, said: “It took several hours to reach the hotel after arriving at the airport. The food is not good and the quantities are small. I got a small box of cereal for breakfast with a cheese omelette that was so hard that if I had thrown it, it would hit someone. One of the things I got for dinner was half a naan bread. I don’t know who got the other half!”

A quarantine hotel breakfast.

He said people quarantining had to be escorted by security guards for their 15 minutes of fresh air. “We are not prisoners, we are not trying to escape,” he said.

“I really feel for the people who are quarantining with children. The hotel staff have been polite but the conditions here are claustrophobic. It is perfectly reasonable and sensible not to bring infection into the country but things don’t need to be this draconian.”

Zahid Siddiqui, 58, returned from Pakistan where he had spent several months visiting his sick father. He expressed concerns about the lack of ventilation, fresh air and exercise and poor food.

“The whole thing was a nightmare,” he said. “I have various medical conditions such as atrial fibrillation and medical advice is that I need to take daily exercise. But I was only allowed to go outside for two of the 11 days. I have never been in jail in my life but this experience felt like it. I have never before suffered from depression but after my time in the quarantine hotel I now understand the meaning of the word.”

There are currently 43 countries on the Government’s travel “red list“, which will be reviewed, along with the “green” and “amber” lists, every three weeks.

Worth reading in full.

Alcohol Deaths Rise to Highest Level Since Records Began in England and Wales

Alcohol killed more people in England and Wales last year than in any other year since records began, according to data from the Office for National Statistics (ONS), as many Brits turned to drink to cope with the isolation – and other forms of suffering – caused by the lockdowns. MailOnline has the story.

An ONS report published today revealed there were 7,423 fatalities linked to drinking last year, which was a fifth more than in 2019 and the highest number since records began in 2001.

People living in the poorest parts of the countries were four times more likely to have died from alcohol abuse compared to those in the wealthiest areas.

Alcohol-related deaths have been rising for decades. But they rose quickest from March 2020 onwards, after the first national lockdown came into force, and got progressively worse as the year went on.  

Most deaths were related to long-term drinking problems and dependency – with alcoholic liver disease making up 80% of cases. 

But experts told MailOnline that a year of social restrictions likely exacerbated Britain’s drinking problem. Dozens of surveys found people drank more than usual during lockdowns to cope with isolation, boredom and anxiety about the pandemic.

One in 10 of the alcohol-related deaths were from mental and behavioural disorders due to alcohol misuse and 6% were from accidental alcohol poisoning…

Professor Paul Hunter, an Epidemiologist at the University of East Anglia, previously told MailOnline it was possible some of the increase was caused by excessive drinking during lockdown speeding up the deaths. 

“If people with liver disease start drinking again, especially binge drinking, that would certainly be very bad for their liver and could lead to liver failure and subsequent death,” he added. 

He added the spike in liver disease deaths could be down to patients struggling to access healthcare. Waiting lists have soared to record levels as a result of the NHS focusing on Covid patients. 

The number of people dying because of alcohol got worse as lockdowns progressed through 2020.

Compared to 2019, there were just 8% more fatalities by March last year, compared to 30% more between October and December.

But between 2019 and 2020 the rise was 19.6%. 

The spike highlights the “devastating impact” of the pandemic on problem drinking, according to the Portman Group – a regulator for alcohol labelling, packaging and promotions.

The increase in people dying from drink may partly explain last year’s drop in registered suicides – along with delays to coroner inquests – since they would be recorded as unintended injury deaths rather than as suicides.

The MailOnline report is worth reading in full.

Current Level of Depression More Than Double What it Was Before the First Lockdown

New data from the Office for National Statistics (ONS) provides an insight into the extent of the damage done to the nation’s mental health by a year of lockdowns. Most notably, the percentage of British adults who experienced some form of depression in the first months of 2021 was more than double that recorded before the first lockdown began. Here are the key findings:

Around one in five (21%) adults aged 16 years and over in Great Britain experienced some form of depression (indicated by moderate to severe depressive symptoms) in early 2021 (January 27th to March 7th), an increase from 19% in November 2020. Rates in early 2021 were more than double those observed before the coronavirus pandemic, where 10% of adults experienced some form of depression.

…Younger adults and people living with a child aged under 16 years had the largest increases in rates of depressive symptoms in early 2021, when compared with pre-pandemic levels.

For adults aged 16 to 39 years, rates in early 2021 were more than double (29%) when compared with before the pandemic (11%). In comparison, 10% of adults aged 70 years and over experienced some form of depression in early 2021, compared with 5% before the pandemic.

In early 2021, around one in three (35%) adults who reported being unable to afford an unexpected but necessary expense of £850 experienced some form of depression, compared with one in five (21%) adults before the pandemic. For adults who were able to afford this expense, 13% experienced depressive symptoms in early 2021, increasing from 5% before the pandemic…

After controlling for sex and other characteristics, when compared with those aged 70 years and over, younger adults continued to be more likely to experience some form of depression, with adults aged 16 to 29 years having the highest odds of all age groups.

At the same time, the quality of the treatment given to mental health patients has fallen because of the (lockdown-induced) difficulty – and, at times, impossibility – of in-person meetings. We recently covered a study that found that for some patients, video calls made matters worse.

The ONS report is worth reading in full.

Stop Press: The Mail has run a story about GPs’ “fears over a lockdown depression time bomb”.

Registered Suicides in England Fell in 2020 Because Inquests Were Delayed During Lockdowns

It was reported last week that despite fears of the mental health crisis prompted by the lockdowns leading to a spike in suicides in 2020, the number of people committing suicide in the U.K. did not rise after the first lockdown. While the provisional rate of suicides for 2020 is lower than that of 2019, this may be due to delays to coroner inquests, meaning the actual figure could be much higher, according to the Office for National Statistics (ONS). The Mail has the story.

Registered suicides in England fell in 2020 as inquests were delayed during the coronavirus pandemic, official data shows.

Some 4,902 suicides were registered across the country last year – giving a provisional rate of 9.9 suicide deaths per 100,000 people, the ONS said.

That represents a fall from 2019, when the rate was 10.8 suicide deaths per 100,000 people.

The ONS said the fall “most likely reflects delays to coroner inquests, because of the impact of the coronavirus pandemic, as opposed to a genuine decrease in suicide”.

The 2020 figures are provisional and will be finalised by the ONS in late 2021.

All deaths by suicide are investigated by coroners, with deaths usually registered around five to six months after they occur due to the length of time it takes to hold an inquest.

Of the suicides registered in 2020, more than half (51.2%) occurred that year. Some 3,674 involved males, and 1,228 females.

Between April and June 2020, during the first national lockdown, the provisional suicide rate fell by 36.1% compared with the same period in 2019.

The number of registered suicides in this quarter was the lowest since 2001.

This is most likely to be due to the impact of the pandemic on the coroner’s service, such as delays to inquests as the service adapted to social distancing measures, the ONS said.

The number of registered suicides increased in the second half of 2020, most likely due to inquests resuming, the ONS said. 

In November, the charity Rethink Mental Illness said the number of people turning to its website for support with suicidal thoughts had tripled in the first six months of lockdown. A new study also found that the lack of in-person treatments – because of lockdowns – has made mental health patients feel as though they “were missing out on care”.

The Mail’s report is worth reading in full.

Stop Press: A report from the Journal of the American Medical Association shows a decrease in U.S. suicides in 2020 by 2,700, from 47,500 to 44,800. But, at the same time, there was a substantial increase in the number of “unintended injury” deaths (an increase of 19,000 from 2019) which was “largely driven by drug overdose[s]”.

Dr Gary Ordog, MD, from the Department of Health Services in the County of Los Angeles (retired) said:

I was surprised by the suicide rate reported to have a major decrease in 2020. It seems from most other reports that the suicide rate has increased since the pandemic began. This may be explained by the fact that the category of “Unintentional Injury” had a major increase at the same time, and the fact that this category includes drug overdoses. As there is often inadequate history in a fatal drug overdose case, many of these may be purposeful and so suicidal. This would explain the perceived increase in suicide rate since the current pandemic began. Perhaps further analysis of the data would elucidate this incongruity.

Mental Health Patients Missed Out on Care Because of Lockdowns

The loss of face-to-face treatments has made mental health patients feel as though they “were missing out on care” over the past year of lockdowns, according to new research. For some patients, video calls made matters worse. The Observer has the story.

Mental health patients found their conditions deteriorated during the pandemic because the NHS switched from in-person help to support by telephone, video and text messages, new research reveals.

Many reported a lower quality of care, according to a study by University College London; others had trouble accessing medication, had appointments cancelled or felt the loss of face-to-face help meant they “were missing out on care”.

Researchers led by Dr Brynmor Lloyd-Evans found that, for many patients, the switch to remote care heightened the isolation and loneliness they were already feeling because they could no longer see friends and family.

“People with pre-existing mental health conditions experienced serious disruptions to their access to, and the quality of, mental healthcare as a result of the pandemic. The opportunities and challenges of remote mental healthcare were an important aspect of our findings,” Lloyd-Evans and colleagues write in the journal Social Psychiatry and Psychiatric Epidemiology.

“While for some people telephone and digital support provided continuity of care, for others there were issues around access to technology, maintaining therapeutic relationships remotely, and digital interfaces exacerbating difficult feelings or symptoms associated with their mental health.”

After interviewing 49 people with mental health conditions in London about their experience during Covid’s first wave, the researchers found key issues included “inadequate access to mental health services”, “difficulties in day-to-day functioning” and “struggles with social connectedness”.

One patient said: “Lockdown has made me feel very angry. I feel the professionals used it as an excuse to stop offering appointments. I was seeing her every week and it’s been cut to every three weeks [by telephone].”

Another said of their therapist: “She did text me a few times: we keep conversation [by] texting but it is not good enough really.” Another, who was offered video calls rather than in-person help, said: “For my paranoia, they make it worse, so I tend not to do them.”

The Royal College of Psychiatrists, which recently said England is “in the grip of a mental health crisis“, believes the extent of the crisis “will likely get a lot worse before it gets better”.

Over one million more treatment sessions were given to adults between April and December last year (1,078,539), an increase of 8% on 2019. There were also 159,347 urgent crisis referrals made for adults, an all-time high, and an increase of 2% on 2019.

The Observer report is worth reading in full.

Closing Playgrounds during Covid Has Fuelled “Pandemic of Mental Health Problems” among Children, according to Parliamentary Committee

Of all the negative impacts of lockdowns, one of the most profound has surely been the stunting of children’s educational and social development, and the suffering among the young of “vicious cycles of increasing distress“. One of the causes of “a pandemic of mental health problems” among children was the closure of playgrounds in the first lockdown, according to a parliamentary committee. The Telegraph has the story.

The All Party Parliamentary Group on a Fit and Healthy Childhood is calling for practical measures to help children recover from repeated lockdowns, which have left too many confined for long periods at home. 

Their report calls for the halting and reversal of closures of children’s playgrounds – saying it is now more important than ever to encourage more outdoor play.

Its authors said the decision to close off playgrounds during the first lockdown followed longer-term trends which have seen too many play areas sold off in recent years. 

MPs said children growing up in the shadow of Covid needed far more help to recover from the pandemic, warning that one in six children are likely to be suffering from mental health problems – up from one in nine three years ago…

The report warns that spending on play facilities has fallen by 44% since 2017/18, with 347 playgrounds closed since 2014. It also calls for “outdoor play” to be put on the National Curriculum, warning that the lack of free play, and the amount of time spent glued to screens, is fuelling a rise in children’s mental health disorders.  

Experts said the closures of children’s playgrounds and play facilities across the country during the first lockdown had exacerbated such problems, adding to frustration and anxiety. 

And they said that many children had also suffered fallout from their parents’ stresses during the pandemic, with many exposed to heavier drinking at home.

Responding to these findings, the children and parents’ campaign group UsForThem said policies should be optimised to support the health and well-being of children. The closing of playgrounds, it said, is “unnecessary, unscientific and damaging to children”.

Lea Milligan, the Chief Executive of MQ Mental Health Research, is quoted in the Telegraph report saying that the problem of poor mental health among children has become an “emergency”.

The most vulnerable in our society are the ones who will be carrying the heaviest burden post-pandemic. The increase in mental illness in the UK was already an alarming trend before Covid struck. Now it is an emergency.

Without action, many of our children could face a lifetime of depression, anxiety and other mental illnesses.

Worth reading in full.

Extent of England’s Mental Health Crisis Is “Terrifying”, Psychiatrists Warn

England is “in the grip of a mental health crisis” because of lockdowns, according to the Royal College of Psychiatrists, and under-18s are “bearing the brunt”. The number of children being treated for eating disorders has reached record levels, as well as the number of people reporting being lonely. Here are the key findings:

~ 80,226 more children and young people were referred to CYP mental health services between April and December last year, up by 28% on 2019, to 372,438.  

~ 600,628 more treatment sessions were given to children and young people, up by a fifth on 2019 to 3.58 million. 

~ 18,269 children and young people needed urgent or emergency crisis care – including assessments to see if someone needs to be sectioned because they or others are at harm – an increase of 18% on 2019, to 18,269. 

The data on adults is equally bleak.

Over one million more treatment sessions were given to adults between April and December last year (1,078,539), an increase of 8% on 2019. There were also 159,347 urgent crisis referrals made for adults, an all-time high, and an increase of 2% on 2019. 

In November, the Government announced a £500 million support package for mental health services to aid the nation’s recovery from lockdown. The RCPsych has called for this funding – which includes £79 million for children – to reach the frontline as soon as possible. Dr Adrian James, the College’s President, says that services are at a “very real risk of being overrun” because of the scale of the mental health crisis.

“The extent of the mental health crisis is terrifying, but it will likely get a lot worse before it gets better.

“Services are at a very real risk of being overrun by the sheer volume of people needing help with their mental illness.

“While the recent funding announcement is welcome, we need this money to reach mental health services as soon as possible to tackle this crisis.”

The Chair of the college’s Faculty of Child and Adolescent Psychiatry added that services were already struggling before Covid struck and now face even greater queues for treatments due to the impact of school closures and the denial of social contact.

“Our children and young people are bearing the brunt of the mental health crisis caused by the pandemic and are at risk of lifelong mental illness.

“As a frontline psychiatrist I’ve seen the devastating effect that school closures, disrupted friendships and the uncertainty caused by the pandemic have had on the mental health of our children and young people.

“Services were already struggling to cope with the number of children needing help before the pandemic hit, and they risk being overrun unless Government ensures the promised money reaches the frontline quickly.”

Worth reading in full.

Young Suffering “Vicious Cycles of Increasing Distress” In Lockdown, Experts Warn

Psychiatrists at the University of Cambridge have drawn attention to the impact of lockdown on young people. Writing in the British Medical Journal, they said that action is needed “to ensure that this generation is not disproportionately disadvantaged by Covid”.

Studies carried out during the pandemic suggest that although some families are coping well, others are facing financial adversity, struggling to home school, and risk experiencing vicious cycles of increasing distress. Probable mental health conditions increased from 10.8% in 2017 to 16% in July 2020 across all age, sex, and ethnic groups according to England’s Mental Health of Children and Young People Survey (MHCYP).

A probability based sample of 2,673 parents recruited through social media reported deteriorating mental health and increased behavioural problems among children aged four to 11 years between March and May 2020 (during lockdown) but reduced emotional symptoms among 11-16 year olds. The more socioeconomically deprived respondents had consistently worse mental health in both surveys – a stark warning given that economic recession is expected to increase the numbers of families under financial strain.

The authors report that, while numbers are too small to be definite about the relationship between the first English lockdown and increased suicides among young people, they are more clear regarding a link to eating disorders.

The national referral statistics for eating disorders in England show a doubling in the number of urgent referrals during 2020 and a smaller increase in non-urgent referrals. Known triggers for self-harm and poor mental health are aggravated by pandemic restrictions, including separation from friends, arguments with parents, unresolvable arguments on social media, strained finances, academic stress, and feelings of isolation. School closures are particularly difficult for families facing other adversities.

The evolving consequences of the pandemic are set against longstanding concerns about deteriorating mental health among children and young people, and the inadequacy of service provision. Although children are at lowest risk of death from COVID-19, concerning signals remain about the pandemic’s effects on their mental health, which are unevenly experienced across different age groups and socioeconomic circumstances.

The reopening of schools may help to alleviate the current sufferings of the nation’s young, provided false positives don’t keep perfectly healthy children stuck in their rooms.

Worth reading in full.