People with no history of mental illness are developing serious psychological problems for the first time as a result of the lockdown, amid growing stresses over isolation, job insecurity, relationship breakdown and bereavement, the Royal College of Psychiatrists has disclosed.
Adults and children are having psychotic episodes, mania and depression, with some taken to hospital because of the heavy toll on their mental wellbeing.
Men aged 18-25 are reported to have been badly affected by first-time mental health issues. Previous research has suggested they feel the worst affected by restrictions on their movement, and are most likely to flout the lockdown.
Eight weeks into lockdown measures, the Royal College of Psychiatrists is warning that services could be overwhelmed by “a tsunami of mental illness”.
A survey it undertook of psychiatrists across the UK revealed that families were experiencing significant tension as a result of staying at home together all the time. Four in 10 psychiatrists report an increase in people needing urgent and emergency mental healthcare – including new patients – in the wake of the lockdown.
Dr Kate Lovett, dean of the royal college, said: “During the pandemic, people are presenting for the first time with symptoms of serious mood disorders, such as mania, significant depression, and psychotic episodes. These have been triggered by significant stress and life events associated with the pandemic and the lockdown.
“I and other colleagues have seen people presenting for the first time in emergency situations, often triggered by significant life events such as losing a job, a bereavement, significant illness in a family member or concerns that their business, or the one they work for, is about to go under.”
Lovett, a community psychiatrist in Devon, added: “Of the people I am seeing, many are extremely unwell with symptoms of severe mental illness: serious changes in their moods, belief system and hallucinations. Life events associated with Covid-19 have triggered this or led to a relapse for almost all of them. Relationships are now all feeling lockdown pressures. Routines have disappeared.”
The chief executive of one mental health trust said: “We are definitely seeing ‘people not known to services’ who are acutely unwell. They are mainly young men aged 18-25 who require admission. Misuse of alcohol and drugs is a factor – people who normally smoke a bit of weed smoking more than usual in their rooms. People not working is also an issue.
“One woman rang us recently and said her partner was walking around their house like a zombie because he wasn’t working and couldn’t provide for the family and had just snapped.”
Psychiatrists are also concerned about stress linked to the fear of contracting Covid-19. Being cut off from family and friends, and disruption to normal NHS services, are also exacerbating existing mental health problems. Some now refer to the emergence of “lockdown anxiety”.
One mental health nurse said that she and her colleagues were seeing people with a set of symptoms they had christened “corona-psychosis”. Such patients have typically lost their job and are having trouble sleeping, becoming anxious from watching the news on TV and no longer getting social support through their normal networks.
The royal college’s findings are contained in a survey of 1,369 psychiatrists carried out between 1 and 6 May. In it 45% of psychiatrists said that they had seen a fall in the number of patients attending routine appointments during the pandemic, which could see services facing a “tsunami” of people needing treatment once restrictions on people’s movements have eased.
One participant said: “Many of our patients have deteriorated or developed mental disorders as a direct result of the coronavirus disruption, for example social isolation, increased stress [or that they have] run out of meds.”
The findings follow the UN’s warning this week that the pandemic could lead to an “upsurge” in the number of people needing mental health care and the severity of their illness.
Earlier this month, Claire Murdoch, NHS England’s national clinical director for mental health, told the Commons health and social care committee that demand for mental healthcare would increase “significantly” once the lockdown ended and would see people needing treatment for trauma for years to come, just as they did after the Grenfell fire in London in 2017.
Trauma and post-traumatic stress disorder was likely in people who had lost a relative to Covid-19 or been in intensive care, she added.
One psychiatrist told the college that “lockdown has exacerbated behavioural difficulties in children” and another that they had seen “patients having severe psychotic symptoms which incorporate Covid-related themes”.
A specialist in the psychiatric care of children and young people said they had seen more under-18s with autism having to be admitted for inpatient care because they were “not coping with changes re Covid” and others “with deteriorating mental health state and increase in significant self-harm and increase in completed suicides”.
An NHS spokesperson said: “Although there can of course be no reliable data as yet on any medium- or long-term impact of the coronavirus pandemic on mental health, the NHS has been adapting our services to ensure people can still get care like talking therapy or counselling with their clinician, even while still adhering to government guidance.”
In the UK, Samaritans can be contacted on 116 123 or email jo@samaritans.org. You can contact the mental health charity Mind by calling 0300 123 3393 or visiting mind.org.uk