Saturday August 8, 2020

Comment: We need a national recovery plan for mental health

As the country emerges from lockdown, many Irish people are anxious, stressed or traumatised, and the cost of not helping them now could be significant

24th June, 2020
Many people who do not normally have mental health problems found it difficult to cope with the isolation and anxiety of lockdown and may suffer from post-traumatic stress

While the government has presented detailed economic plans for jobs and growth in the wake of Covid-19, there has been significantly less discussion about mental health. There is also relatively little about mental health in the new programme for government.

On June 17, the government finally published a successor to the last dedicated national mental health plan, A Vision for Change, which dates from 2006, in the form of Sharing the Vision: A Mental Health Plan for Everyone.

However, Sharing the Vision is a proposed model for a mental health service in normal times. The pandemic crisis is far from normal and, like the economic recovery plan, requires a novel and unique response.

Though many psychological professionals helped people to cope during the lockdown, even resilient well-supported individuals found the restrictions difficult, to say little of those over 70 who were forced to cocoon. Much psychological pain has been endured by many in the last three months.

In my view, we need a new mental health recovery plan rolled out quickly to support those who could not cope during the last few months and who will experience post-lockdown trauma in the future. I’d also like to suggest that the government puts such a plan in place quickly, in case we have to endure another lockdown in future.

I’m not just talking about the 10 per cent or so of the population who typically experience mental health problems at any one time. The lockdown has impinged on those who probably would have considered themselves free from mental health concerns. Many have likened what we went through to trauma.

Some talk about there being possible post-traumatic stress in the future as people remember their sense of helplessness and their inability to be with friends and love ones.

As recently as June 15, many of those participating in rolling surveys conducted for the Department of Health were still reporting the strong presence of negative emotions such as worry (29 per cent), anxiety (28 per cent), stress (29 per cent), sadness (20 per cent) and loneliness (18 per cent).

Mental health services remain the poor cousin of the health services, and continue to be underfunded. Consequently, there are long waiting lists, which further exacerbate people’s problems.

That’s what was happening before the pandemic crisis. Now add to the mix those who normally cope and don’t access mental health services.

These people don’t see themselves as needing mental health assistance. But the above figures show, and conceptual models predict, that after extreme events people experience mental health difficulties.

This is the outcome of people reflecting deeply on their lives and resolving to address core ongoing problems, or simply recognising that it was all too much. Whatever the genesis of these mental health challenges, we must recognise that many of those who held it together during lockdown may not be able to do so now.

The economic recovery plan released by the government is for economists to judge, but we need a plan for our nation’s mental health recovery. Left unchecked, these mental health problems will affect the population’s ability to cope with work, family and community participation.

We have been spiritually wounded and there needs to be a healing, a healing which can take many forms. The religious places of worship will re-open shortly, but what of those who are not religious or who aren’t members of social groups and sporting organisations?

Such people may well benefit from talking to someone qualified to listen who can help them clarify their confusion and hurt.

The provision of much greater and more extensive psychological and counselling services needs to be funded immediately, and not just through the prominent mental health charities such as Samaritans and Pieta House but also through local psychologists, psychotherapists and counsellors.

Some will benefit from a few hours of talk while others will need longer. There is a huge benefit to helping people before a mental health problem becomes too large to cope with. Early intervention is always good.

For it to be available, we need to resource it, provide it in every region and publicise it so people know where to access it. I am calling on the government to involve the main mental health professional organisations and charities in a mental health recovery plan to be drawn up quickly and to be rolled out in the next few months.

Mental health is too important an area to ignore. It should not be overlooked when we are spending billions to get our economy back on track.

Dr Joe MacDonagh is a chartered psychologist and a past president of the Psychological Society of Ireland

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