Providing Comprehensive Mental Health and General Healthcare Services in the Pandemic

 There is a huge amount of Evidence on how the Mental Health of individuals has been impacted by the Pandemic and the lockdowns over the past 15 months in the UK and world wide.  In the UK, the Cinderella service in the NHS, Mental Health resources notoriously underfunded for years, having been shrunk during the tenure of various governments over the last 40 to 50 years, found themselves on the back foot.  

Early on in the pandemic numerous charities who provide services to meet mental health needs in the UK, warned of a huge increase in demand for their services, alongside the demand on the NHS which increased quickly to unmanageable proportions, particularly as many mental health services had been impacted by demands of virus managements on resources.   

The government stepped in with a lot of new funding to increase service availability in both the NHS and Charitable and Private services, but it remains evident that mental health services, particularly talking therapies have waiting lists of months or years in some sectors.  Someone who presents with an urgent need, will face delays at the least or a complete non-availability of services locally, being expected to travel long distances to access those services, when they are at their most vulnerable.

That government and local public health authorities have recognised the lead has led to an explosion of "Self Help" services and advice, provided free, online to service users.  These are aimed more widely than those exhibiting or presenting with symptoms, but the for the wider mental health well being of those newly affected, those isolating, the more elderly and vulnerable who might have never needed such services in the past.

There is also the impact of  dealing with the demands of the virus across the NHS and health service providers, which it is believed will leave a lasting mental health harm for years to come.

Some simple examples are those living in care homes who have been deprived of person to person contact with family and friends for well over a year.  Many suffering from dementia have gone downhill due to the lack of such contact, which has left them and their families desperate and disappointed.

Those who have been bereaved by the virus, who have been unable to be with their loved ones during their last hours and than, have had to put up with funeral arrangements reduced to a minimum for public protection.  This is storing up huge issues for them in the future.  One friend, who was bereaved recently, is in a waiting list of at least three months for access to bereavement counselling from a national charity.  Informal support is in place from friends and family, but proper support from an independent counselling service is suggested as the preferred method of support and family and friends are to close to be objective.

I doubt if the challenges of delivering services as the rate expected before the pandemic can be effectively calculated, the scale of the problems being so huge and wide spread.  But we are constantly being told that waiting lists have doubled for everything except emergency treatment, with projected trebling of demand and waiting lists stretching as far as two years for routine scheduled surgery or treatment. 

One of the biggest impacts has been on cancer services. While a limited number of treatments have continued to be available, they tend to be in specialist cancer centres, not in the mainstream hospitals as is the norm.  The other recognised issue is the inability to refer any possible cases for investigation. I believe that Oncology specialists are seeing less than one third of the normal cases expected to present annually.  There is hope for cancer sufferers as the NHS becomes less burdened with covid cases, some routine services for cancer will reopen as a priority.

Last July my spouse suffered a stroke. I managed to get her emergency care very quickly, but having been taken to an Acute Neuro unit, she was transferred after three days to another hospital as we were supposedly in different CCG groups from the Acute Stroke Unit. The acute unit was closer to home and had its own Rehab Unit, but she was sent 24 miles to a hospital much further from home than needed due to the stroke of a budget holders pen.  This caused her (and me) considerable distress as I had further to travel to take her the necessary items she needed for a prolonged stay, even though I could not actually visit her.  Fortunately she was able to come home after 27 days in the hospital and the after care at home from our local Neuro unit was excellent.   I thank God that prayers were answered as she was fit enough to return to work by November on a reduced hours, adapted workplace environment. Ongoing she has surrendered her driving licence as the conditions for its return are quite difficult and means engaging with GP, Consultants and having a driving assessment (driving test) which she is reluctant to undergo.  That is a loss for her of her independence.  Needing me to drive her to work and collect her afterwards.  How many others have lost their former independence due to the pandemic conditions?

We can only hope that things will get better soon, but continue to be careful, observing "Hands, Face, Space" for a considerable time to come.