When lockdown was announced, some mental health services had to be postponed. Three people who struggled to access help describe the impact.
On 23 March 2020, life as we know it changed.
Lockdown was announced to try and stop the spread of coronavirus, and as a nation we found ourselves confined to our homes. Appointments were cancelled, meetings with friends were indefinitely postponed – and some medical treatments, including those for mental health, became harder to access.
Much has been said on the effect of lockdown on people’s mental health, with psychiatrists warning of a ‘tsunami’ of cases as lockdown eases, and for some young people, the support they relied on to keep themselves well seemingly dried up overnight.
A study by the BACP (British Association for Counselling and Psychotherapy) and Roehampton University suggests there has been a noticeable reduction in counselling services for young people and children during lockdown, with counsellors who provided services in colleges and schools saying the hours of therapy they provided before lockdown (on average around 13 per week) dropped to just over one hour a week after restrictions were introduced.
The results, seen exclusively by BBC Three, also showed the top reason for the reduction in therapy was that the organisation they worked at had physically closed. The third most common reason was that the organisation reduced the counselling services on offer because of lockdown.
Of the 742 counsellors and psychotherapists, who practice across the UK, who responded, all felt that greater recognition of mental health as a critical service was needed to ensure young people get the help they need.
Outside of educational settings, some young adults also had trouble accessing NHS services.
23-year-old Ella lives in the New Forest with her mum. She had been seeking dialectical behavioural therapy (DBT), a special kind of therapy designed for borderline personality disorder, since before lockdown, and says she was unable to get the help she needed as pressure on services increased.
“Just before lockdown I was just finishing my degree. My mental health started to deteriorate because it was quite hard, but I was getting private support. I hadn’t had much luck in the past with the NHS in this area so we moved over to private to get help that way. The counselling was good, but it wasn’t the DBT therapy I needed, so my mum and I decided to try the NHS route again rather than keep spending money on private,” she says.
“I’m lucky that my GP is fantastic. Things had got pretty bad in terms of feeling very low and suicidal. My GP said I needed specialist help. I was referred to a local place called Anchor House for therapy.”
After an initial consultation, Ella was hopeful she’d be referred for a course of DBT – something Anchor House does offer – but they told her it wasn’t possible.
“When lockdown was imposed, my mental health completely crashed. I’d finished my degree, I’m off work, and I’ve got nothing, I’m sitting in the house all day every day. I was in tears and begging my GP to put me on the course of DBT there. Now, they’ve got such a bigger influx and can’t help everyone, but I felt like deaths will be on their shoulders – people aren’t coping, I’m not coping, and if they’re just saying no, it’s pretty bad.”
Ella’s wellbeing plummeted further when she received a letter in May telling her she’d been discharged from the service. “That was the worst bit, it was like a knife in my heart. I couldn’t understand that,” she says. “When I next went to the GP, I did ask for them to explain to me why I’d been discharged. She said it’s not great but they don’t have much say in it, and even if they were to refer me back, the same thing would happen. She said especially now during lockdown they’re more in demand than ever.”
Instead, Ella was told she could self-refer to other voluntary services in the area, but she’s reluctant to do that for fear that the support they offer might not be right for her.
Dr Claire Corbridge, Consultant Clinical Psychologist and Divisional Lead for Psychological Therapies for South West Hampshire – where Anchor House is – told BBC Three: “Coronavirus has had a significant impact on our service users and the services we provide. During this time we have offered alternatives such as online resources or individual sessions via telephone or video call. We also continued to offer face-to-face appointments, but only where it was clinically necessary to protect our patients and staff.
“Unfortunately due to the restrictions put in place to protect patients and staff, there has been disruption to some therapies which rely heavily on face-to-face group sessions, for instance Dialectical Behavioural Therapy (DBT). Those attending groups at the time of lockdown were offered the option to continue this via one to one remote appointments. Unfortunately, some groups were put on hold at the beginning of the crisis. In June, the Trust began using a secure online platform to offer online groups, and we are in the process of resuming our group programme.
“We recognise how difficult the last few months have been which is why we would urge anyone who is struggling or needs support, to reach out for it. We would encourage anyone who isn’t satisfied with our service to get in touch with us directly so we can try to address any concerns and find a way to help.”
Ella plans to do just that – she says she will be writing to Anchor House outlining her concerns, and hopes to get the support she needs as lockdown eases.
It appears there has been an increase in people taking their mental health into their own hands – a representative for apps Clear Fear, Calm Harm and Combined Minds, which are made by the teenage mental health charity stem4, said that there was a 20% increase in downloads between late April and mid-May, and that the Clear Fear website saw a 98% increase in users. Stem4’s ‘Resilience in Teenagers’ web page saw visitors grow by over 800%.
Ella wasn’t the only one who struggled. Jaz, 23, from Eastbourne, was living in London and had been receiving therapy since 2018. “I got a provisional BPD (borderline personality disorder) diagnosis, but the counsellor I was seeing couldn’t make an official diagnosis so I was told if I wanted that, I’d have to see someone else,” she says.
Usually, only a psychiatrist – a doctor who treats mental health issues from a clinical perspective rather than providing talking therapy – can make a diagnosis. When lockdown hit, Jaz got a call from a doctor telling her that all that was available for her was group therapy, but she couldn’t start it until after the pandemic.
“There are several reasons – which are all on my notes – that group therapy isn’t the best option for me,” she says. “I was told that because I’m not in danger and actively suicidal right now I was being discharged, but that if I felt in danger, I should go back to the doctor and get another referral.”
Jaz’s situation was complicated by the fact that she moved back in with her family in Eastbourne when lockdown was announced, but she was registered with a doctor in east London, where she’d been living, so seeking help during the pandemic would have meant registering with a new doctor and starting from scratch again.
The Waltham Forest NHS trust, that dealt with Jaz’s pre-lockdown counselling, told BBC Three: “To ensure we have been able to support the NHS to respond to coronavirus, continue to treat our most vulnerable patients and protect our staff, we were mandated to make some changes to the care we provide to our patients. In line with national instructions, some of our community health and mental health services were reorganised to focus on high risk and crisis cases, and some psychological therapy services were suspended to support this. Our services are now returning to pre-Covid arrangements and anyone who is concerned about their mental well-being can contact us – further details are available on our website.”
Help from other sources has also been paused. Amy, 22, was seeing a counsellor through her university for help with managing an eating disorder. When she first approached them for counselling, she says they were quick to refer her and she was pleased with the help on offer. She’d had some sessions in her first year four years ago, and decided to start them up again last term when she began her masters. But the lockdown scuppered those plans.
“I was told they weren’t doing counselling because of lockdown, and it had changed to online classes,” she says. “I haven’t heard when it might resume, I just don’t think it’s a priority at this point. The help that I want isn’t a luxury, but I’m not so ill that I can be referred by a doctor. They say you can talk to your tutor, but you can’t really, I don’t think [my tutor] would get it. He doesn’t even respond to my emails about work.”
Amy’s uni, said: “The University of Westminster takes the well-being of its students and staff very seriously. The University provides a Student Wellbeing Service, Specialist Mentoring Support for students with disabilities as well as a Student Counselling Service, all of which have continued to be offered through remote video or audio provision since the national lockdown was introduced by the UK Government in March 2020. Since the beginning of lockdown, student engagement with our support services has continued.
“In the early stages of lockdown we needed to temporarily pause the provision of the Student Counselling Service specifically for those based out of the UK, while we ensured that the provision remained legal and safe for this student cohort. After this temporary pause, the Service resumed for our whole student population. We would like to encourage all of our students to please get in touch if they are still in need of support.”
Lockdown’s impact on mental health is concerning students and young people nationwide. In Maryport, Cumbria, a campaign called We Will – part of the Ewanrigg Local Trust, a voluntary organisation working to improve various services of the local area – is calling for a mental health contingency plan as lockdown continues to ease.
“We’re concerned that the need for young people to access specialist mental health support during and after Covid-19 is likely to increase exponentially,” campaign officer Kate Whitmarsh explains. “We know that young people find it really difficult to ask for help. They think that lockdown and the lack of face-to-face contact with teachers, employers and health workers has made it harder for trusted adults to spot the signs of a young person who is in need of help and to then make referrals.”
Something else We Will wants to see – similar to the counsellors who took part in the University of Roehampton’s research – is for mental health to be higher on the agenda. They’re calling for every school to have a governor responsible for mental health. With schools and colleges due to reopen fully in September, the group predicts a spike in mental health problems.
“Every teacher we have spoken to is dreading a huge spike in referrals of young people to mental health services this September,” one unnamed activist said.
An NHS England spokesperson said that mental health services had continued during lockdown, with additional “online and telephone support and the establishment of 24/7 open access all age crisis services”.
“The pandemic has turned lives upside down and for some people it will have put greater strain on their mental health, and while some people will have had understandable concerns about seeking help during the lockdown, NHS services, including face to face appointments, have been open to people who need them, despite the Covid-19 outbreak,” they said.
For those who struggled to get support during lockdown, the prospect of things getting easier and services resuming as lockdown eases offers some hope – but whether the future of mental health support will be largely online remains to be seen.
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As lockdown approached many mental health services had closed for the foreseeable leaving young people with no help and support they needed. As restrictions are eased mental health services will hopefully be able to offer their support to young people again and get the help they need and deserve. UK Care and transport services also offer support for young people in which we are available 365 days a year, contact us today to see how we could help.