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Pandemic Destabilised Support Structure of Those With Mental Health Issues

Researchers have shown how those with long-term mental health issues experienced threats that left their support structures damaged, or removed, during the COVID-19 pandemic.

In the small study, published in the Community Mental Health Journal, researchers from the University of Huddersfield set out to explore the impact of pandemic restrictions on the experience and challenges for people living with long-term mental health problems who, prior to the pandemic, had accessed support from community-based third sector providers of psychosocial support.

The authors explained how their research focussed on participants’ experiences of lockdown and periods of reduced social contact, with particular attention paid to the impact of the pandemic on recovery and how participants managed their mental health difficulties.

"The question often being asked was 'Does the pandemic lead to people becoming more depressed or anxious?'," said Dr Dawn Leeming from the Department of Psychology, School of Human and Health Sciences, University of Huddersfield. "We were interested more in the people who were already depressed or anxious, and who were in a routine of accessing community services."

She explained how she and her colleagues were not necessarily thinking about availability of psychiatric services, crisis, or therapy services as they were moved online, but were more interested in the services that help people to maintain a stability to their lives, a routine and connections with other people.

Pandemic Related Restrictions Threaten Mental Wellbeing

The authors commented how "prolonged periods of enforced isolation have been shown in previous pandemics to have a significant impact on mental health". They explained how the current pandemic had also posed other challenges known to impact mental health, including unemployment, workplace stresses, financial strain, relationship discord, severe and chronic illness, and health anxieties.

Their new research involved semi-structured phone interviews with 15 people (11 women and 4 men) all of whom had, or were in recovery from, mental health difficulties and who had received support from a community organisation that focussed on mental health. Participants were an average age of 54 years (45-65), of White British nationality, and from West Yorkshire. All had experienced mental health problems for at least 2 years, with most experiencing difficulties for several years. 

Their findings suggested that study participants had experienced significant threats to their mental wellbeing and recovery due to the pandemic and related restrictions.

"These threats were exacerbated by situations of current or previous powerlessness and inequality," the authors said. However, they continued, "many participants were remarkably resilient and resourceful, drawing on their past experience to manage mental wellbeing actively, though sometimes self-soothing involved a return of behaviours that had contributed to the original difficulties".

Threads of Recovery Pulled Apart

The researchers found that the pandemic could exacerbate inequalities related to employment, education, and housing for people with long-term mental health issues. 

Lockdowns had wide ranging effects and threatened the ways in which participants were managing their mental health problems and trying to stay well, said the authors. Specifically, they found that lockdowns and measures to restrict the spread of the virus took vital communications and support away from those struggling with long-term mental health difficulties.

"One participant referred to the 'threats' of recovery being pulled apart by the pandemic. It was a meta threat, not just difficult but actually destabilising," said Dr Leeming. She said some participants already had a recovery structure and had learned to manage their difficulties, but the "whole thing was threatened by COVID".

COVID presented as a threat, said the authors, "as understood by the concept of 'Power, Threat, Meaning' – the idea that what is often viewed as a mental health disorder is actually a threat response".

"Threats often arrive through the negative operation of power, in relation to economic inequalities, social strata, physical disability and various other ways people might be disempowered," Dr Leeming said. If people feel that they have limited control, then they are far more likely to experience mental health difficulties.

"What is seen as a symptom of illness is often an attempt to survive in the face of threat."

The authors acknowledged some limitations of their study. The sample being restricted to one local authority area meant the sample was small and not diverse, and that difficult pandemic-related circumstances made it hard to engage other organisations.

People’s vulnerabilities are often misinterpreted as 'they are ill', the authors said.

"That’s not quite right - the vulnerability may be that they are part of marginalised groups, that experience inequalities, and their recovery structure has been taken away by the pandemic."

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