Covid-19: Decision-makers must weigh up risk of mental health difficulties associated with restrictions
Professor Siobhan O'Neill
Interim Mental Health Champion for Northern Ireland
WE are now recognising that the pandemic, and its effects, are likely to be with us for longer than we initially anticipated, and again the impact on mental health has become a talking point.
However, the discussion has taken a different, more worrying, tone because mental health is increasingly being used by those who want to see a complete end to the restrictions and who believe the pandemic and Covid to be fake. Covid deniers pose one of the greatest threats to mental health by promoting dangerous behaviour that increases the risk of the spread of the virus.
Let there be no doubt, widespread illness, an overwhelmed health service, and the associated trauma to health care workers and the bereaved have huge mental health implications.
The illness caused by this virus not only takes lives, but can have significant long-term health implications, which also have a grave impact upon mental health.
The best way of controlling the virus remains the test, trace, isolate, and support strategy, and for this to work we require adherence and trust. The infection rate is such that significant restrictions to human contact are required to protect lives, and the nature of those restrictions must be guided by the science in terms of the benefits of the measures, versus the potential harm.
Restrictions do have a mental health impact, and the evidence shows that they cause stress and anxiety. However, most people will not develop mental illness as a result. Indeed, many of the mental health impacts of restrictions can be mitigated against, by retaining jobs and measures to compensate those who are impacted financially.
We must however be particularly careful about the extent to which we impose restrictions in time critical periods of development such as in childhood and adolescence.
Notably the evidence shows that younger age groups are more likely than older people to report loneliness and symptoms of depression and anxiety.
The evidence is clear that adversity in childhood is associated with an increased risk of mental illness later in life. School not only has the function of providing children with an education, it also provides structure, safety, a meal, and opportunities for intervention for preventable problems, that if not addressed early, have lasting implications. In order to provide this vital service, teachers need to be appropriately supported in a safe environment with clear strategies for managing infection.
Unfortunately it is we adults who will need to modify our behaviour and stay at home, not only to protect ourselves and those who are vulnerable to the more serious implications of the virus, but also to give our children the best chance of a healthy life.
The research evidence tells us about which groups are more at risk, these are parents looking after young children, women, young people, people with physical health problems, and those living in deprivation and poverty.
As our decision-makers weigh up the risk of mental health difficulties associated with the restrictions, it is the impact on these groups that they must prioritise. Hindsight is a wonderful thing and undoubtedly there have been errors of judgement and unclear messaging, that have contributed to public suspicion and mistrust. However, we must not let anger, fear and misinformation win the battle for hearts and minds.