Written: April 24, 2020
I run a Suicide Crisis Centre where we are witnessing first-hand the impact of the lockdown on some people’s mental health and suicide risk.
Lockdown is having a particularly severe impact on people who have experienced trauma – either recent or historic. Being under lockdown can replicate aspects of the original trauma: feeling trapped, imprisoned or with no escape route. The state has taken control, and this may leave them feeling extremely powerless – similar to how they felt during the traumatic event.
We know that feeling trapped can increase a person’s suicide risk. There can be an overwhelming need to find a way to escape from the situation. It is vital that they can access immediate support at that point. It is imperative that they are able to ventilate the powerful feelings which may have built to intolerable levels – and be provided with strategies to try to alleviate the feeling of being trapped. We know that support can greatly alleviate such feelings.
We have found that the people reporting the most severe post-traumatic reaction to lockdown live alone. They are isolated in their suffering.
It is not just people living alone who are suffering, of course. A significant percentage of our clients in the last four weeks have been describing relationship breakdown or conflict with their partner, compounded by being “trapped together” in the same home.
We are also seeing people who are being profoundly affected by their neighbours. Although there have been many thousands of wonderful examples of neighbourly support during the COVID-19 crisis, not everyone has that experience. We know that behind closed doors, some people have reached crisis point as a result of feeling trapped in a home where noise from neighbours is constant, whether from DIY or loud music. To the person trapped in their home, the banging or hammering from DIY can feel relentless, inescapable and threatening – particularly if they have a history of trauma which involved violence.
Understandably, lockdown has impacted severely on people who were already depressed. Clients coming to us have explained that their depression has deepened, and they feel an even greater loss of hope for the future. It is hard for some of them to see an end to lockdown. The increased social isolation is clearly having a very detrimental impact, too. They have felt a desperate need for some human contact, they told us. Our clients told us that lockdown also meant that they have not been able to use some of the strategies which made life just about bearable for them.
Now, after only four weeks of lockdown, we are also starting to see people who are “newly depressed”, for example, a young woman who feels that she has only started to become depressed since lockdown began. She told that she had enjoyed a fulfilling life which included extremely meaningful voluntary work, as well as access to a number of mental health support groups. All of that had instantly disappeared. She felt completely isolated, and felt that she had lost her purpose in life.
We have also noticed a marked increase in people expressing thoughts of self-harm, even when they have not had such thoughts for years. And importantly, some are describing thinking of or using methods of self-harm which pose a far greater risk of serious harm or death.
The majority of clients we are seeing are either currently under mental health services, or have been in the past. They are deteriorating and reaching crisis point because there is a reduction in community mental health services, at a time when there is an increased need for them.
Many of our clients who are suffering the most severe post-traumatic responses under lockdown were partway through psychological therapy, but it has been on hold until the current restrictions are eased.
Thankfully, mental health services should now be able to start increasing the services which they provide, in the light of this week’s government announcement.
However, we remain concerned that we are not seeing so many clients who are “off the radar” of services. We have always had a particular remit to reach people who would not seek help from traditional services, when they are in suicidal crisis. I worry that even more of them than usual are simply not seeking help.
It may be partly because of the way in which the COVID-19 crisis is being presented as a war-like situation. The Government talks in terms of fighting the virus, both on a personal and a national level. There is a sense in which we are all trying to pull together for the national good and in particular to defeat the virus. I think some people may feel that they would be “letting the side down” if they acknowledge that they are struggling and need help. There are also multiple references to being “strong”. This may risk discouraging people from feeling that they can show vulnerability. I think some people may be suppressing their own distress and masking their own risk, believing that they are doing so in the national interest.
One client expressed guilt at being in mental health crisis at a time of national emergency when so many people’s lives are at risk from COVID-19. She felt really worried about “using resources” and was adamant that she would not have contacted her GP.
It is so important that a strong and clear message is given out nationally which legitimises and recognises the extent of mental health suffering under lockdown – and which ensures that people do not feel reluctant to seek help, or guilty for doing so.
There are still many areas in the UK which do not have alternative crisis services such as ours. That is why we need to encourage people to feel able to call their GP surgery or the 111 service, which can link them to immediate local crisis help. Alternatively, the charity Mind runs a national information line on 0300 123 3393 which can give information about local services. It is imperative that we encourage people to feel able to seek help – and emphasise that they are deserving of immediate care and support in this unprecedented situation.
Joy Hibbins is the CEO of Suicide Crisis, a registered charity which runs Suicide Crisis Centres: http://www.suicidecrisis.co.uk
For information about mental health or crisis services in your area, contact the national Mind information line on 0300 123 3393. For immediate help, call the NHS 111 service. NHS 111 is a 24 hour service which can ensure that you have access to immediate help or can link you with appropriate crisis services.