EXPERT EYE: Imagine Independence

It is no shock to learn that the COVID-19 pandemic has had a significant impact on the mental health of millions of people in the UK.

And the anecdotal stories, what is often called qualitative research, are backed up by hard data, what we call quantitative research. According to Public Health England (PHE) “multiple” studies have shown how mental wellness deteriorated significantly during the pandemic, particularly during periods of lockdown.

Analysis of data by PHE from the UK Household Longitudinal Study (UKHLS) has tracked changes in levels of psychological distress during the pandemic. It suggests the proportion of adults aged 18 and above reporting a clinically significant level of psychological distress rocketed from 20.8% in 2019 to 29.5% in April 2020.

It fell back to 21.3% by September 2020, as restrictions were eased and there was a feeling of some kind of normality. But by January 2021, at the height of another COVID wave and subsequent lockdown, this figure shot back up to 27.1%.

Another large study of adults aged 18 and over found that 26.1% of respondents reported self-harm thoughts and 7.9% self-harm behaviours at least once between March 2020 and May 2021. This study does not have a pre-pandemic comparison.

Antony Dowell and his colleagues at mental health charity Imagine Independence see the reality behind those abstract figures. The Liverpool-based organisation employs around 250 people delivering mental health support services for local authorities and the NHS across the North West as well as in south west London.

According to Antony, who is the campaigns and partnerships officer for the charity, levels of mental wellness have not returned to pre-pandemic levels, suggesting a net change. He said: “The good news about mental health issues, which are distinct from mental illness, is that many of us will recover. But a significant number will suffer life-changing effects.

“When it comes to mental health, you can divide things into two factors – protective factors and risk factors. So protective factors are things such as having a job, financial security, family, friends, a support network and access to health services.

“During the pandemic many of those protective factors have turned into risk factors. People have lost job security, creating more worry and uncertainty around finances. Lockdowns have led to periods of isolation, being cut off from friends and family leading to loneliness.

“The pandemic has also impacted on the provision of mental health services. According to the World Health Organisation, there has been disruption to mental health services in 93% of countries around the world. The NHS has reported a massive increase in the number of calls it has received.

“It is also important to point out the link between mental and physical health. Not being able to exercise or having difficulty accessing health services can manifest as physical ill-health in many people.

“For example, with the number of people working from home there is evidence that has resulted in some musculoskeletal disorders as people have been using computers while not sitting on proper office chairs and at desks.”

Imagine Independence offers a range of services. It is a provider of supported living services, it cares for people in their homes, it offers one-to-one support to gain and retain paid employment, a peer support service for people who want to join support groups as well as a befriending service for people in the community.

It’s team offers a specialist service for ex-offenders between the ages of 18 an 65, providing one-to-one short-term intervention, advice and guidance. In Salford it offers a service for women who are experiencing complex mental health needs and who want to take back control of their lives.

“While our focus is mental health we also deal with social exclusion as the two often intertwine and one can be the cause of the other,” explained Antony. “People with mental health issues can often find themselves excluded from society and from employment, which then adds to their problems.”

One of Antony’s main roles is to deliver mental health first aid training to companies and organisations. He sees this work as critical as our workplaces, where so many of us spend so much time, are often on the front line of dealing with mental health issues.

The good news is that he believes companies large and small have become more aware of mental health in the workplace in recent years and that the pandemic has accelerated that process. He added: “Many more companies now have HR policies in place. Even if it is just lip service it is an improvement on before.

“There has been a growing realisation that the mental wellbeing of the people within a business can have a direct effect on company performance and the bottom line. Since the start of the pandemic many firms have become more proactive. They are saying ‘ok, we do have a duty of care’.”

Research by an organisation called the Centre for Mental Health calculated the annual cost of dealing with mental health problems to UK employers was £35bn. This is up from £26bn a decade ago and represents a cost of £1,300 for every employee in the UK economy.

“Our workplaces have always been equipped with well-trained first-aiders to deal with physical injuries and illnesses,” said Antony. “I believe firms big and small, as a bare minimum, need to have trained mental health first-aiders in their teams as well.

“We run a number of mental health first aid courses – two days, one day, half a day and a refresher for people who want to keep their skills up to date. We know first-hand how they can make a real difference in the workplace, enabling people to spot problems early on.

“One of our key aims is to challenge the stigma around mental health. We run a session where we split people up into two groups. We ask one group to list the negative words associated with mental health and the other group to list positive words.

“It is always the group that has to come up with positive words that struggle. The other group has no problem filling their list. The reason is we have so many derogatory words or terms for mental health. We need to change those mindsets and encourage people to spot the signs of mental health issues in their colleagues and be able to reach out.”

Antony says he’s encouraged by how many employers are now taking mental health in the workplace seriously but adds there is still so much more can be done. He explained: “There are some great resources companies can access.

“For example ACAS offers some excellent guidance on its website with both practical advice for the workplace day to day and an overview of the legal responsibilities and duty of care of employers.

“I think we need to make more progress in more male-dominated environments, sectors such as construction, engineering and manufacturing. We know that traditionally women are more prepared to talk about their mental health than men. Around 75% of suicides are among men. That is a very telling statistic.

“I also recommended employers use external employee assistance programmes. Yes, there will be a monetary cost to that but they need to think of it as an investment into their business and their teams that will pay dividends in the form of a happier and more productive workforce.

“When we deliver the mental health first aid course it is amazing to see how the awareness levels of those taking part rises over the course of a couple of days. Myths are shattered right before their eyes. It gives them hope and that is a very powerful message.”

For more information contact Imagine Independence