Helping mental health services rise to the challenge of COVID-19
It’s clear that the UK’s COVID-19 pandemic has had a significant impact on people’s mental as well as physical health. Researchers from NIHR Greater Manchester Patient Safety Translational Research Centre are studying how mental health services can best help people to get the care that they need during these difficult times.
For some people the disruption of the COVID-19 lockdown has had a considerable impact on their mental health. Social isolation, shielding, loneliness, reduced access to support networks and services, economic uncertainties (including loss of livelihood), sudden changes in routine and increased exposure to triggering messages all present challenges to wellbeing.
Focusing on suicide prevention
The COVID-19 pandemic may have triggered a new episode of mental illness or exacerbated existing mental health problems for some people. There is evidence that deaths by suicide increased in the USA during the 1918–19 influenza pandemic and among older people in Hong Kong during the 2003 severe acute respiratory syndrome (SARS) epidemic. Suicide and self-harm rates may in time increase in the UK due to the long-term effects of the current pandemic on the UK population, economy, and health services.
But although COVID-19 has the potential to cause significant detrimental impact on people’s lives, an increase in the number of people who die by suicide is not an inevitable consequence of the crisis. At the NIHR Greater Manchester Patient Safety Translational Research Centre (NIHR GM PSTRC), we are building on over 20 years of applied research in the Centre for Mental Health and Safety to address the major issues in mental health services - including the impact of the COVID-19 pandemic.
At the NIHR GM PSTRC, we undertake translational research to improve patient safety in mental health services and contribute to suicide prevention strategies, in areas such as:
- Access to psychosocial assessments and psychological therapies
- Family involvement in crisis services
- Inpatient discharge and service use
- Cross-sector clinical management of self-harm
- Implementation interventions for the NICE guidelines
Throughout all our research we work closely with patients, carers, and clinicians to ensure that our findings impact on clinical practice.
When it comes to COVID-related research at the PSTRC, the Manchester Self-Harm Project has been monitoring self-harm in the city for two decades and is now collecting real time data on the impact of the COVID-19 pandemic on suicide and self-harm. Similarly the UK-wide National Confidential Inquiry into Suicide and Safety in Mental Health, which undertakes studies into suicide prevention in the general population, is now collecting data on probable suicide deaths by mental health patients during COVID-19.
We hope that our research can help understand the impact the current crisis has had on people experiencing mental health problems. By understanding how and when people access services and the experiences they have of the care that they receive, we hope to be able to develop and test interventions to help patients, carers and health care professionals in promoting and improving safety and safer self-management for people experiencing self-harm or mental health crisis.
Engaging people with lived experience of mental health problems and self-harm in research
Engaging with the public on the significance of applied research is more important than ever. As many mental health services were reconfigured in response to the pandemic, we need to ensure that our research examines the impact of these changes on patients, carers, and healthcare staff. By working with people with lived experience, we can ensure that we continue our research in a way that reflects the current situation and is meaningful to patients and carers.
In support of World Suicide Prevention Day (10 September 2020), we co-designed a public engagement event with our patient and carer panel on what hope means during the COVID-19 pandemic. The event was a great success and opened up discussions on self-harm and suicide prevention research, involving patients and the public in research, and the importance of sharing hope during these challenging times.
One of our panel contributors, David, said of his involvement in the event: “Being part of the group gives me an insight into the theory and practice of the research and development of future care in the medical environment. It’s invaluable that people with lived experience are contributing to these studies to further enable targeted best practice. Above all though, I genuinely believe that our collective voices are heard and those people genuinely listen”.
“Hope is a way forward”
The COVID-19 pandemic has affected all of us in our daily lives, but little things can provide us with hope and support our wellbeing. Our patient and carer public contributors told us how important small glimmers of hope are to them when faced with mental health challenges during the pandemic, from baking to finding symbols of hope during daily health walks. You can see their comments and artwork in our virtual exhibition developed as part of our public engagement event.
The theme of hope runs through all our research and patient and public engagement. On World Mental Health Day 2020, what does hope during the COVID-19 pandemic mean to you?
By Dr Louise Gorman, Research Associate, Dr Leah Quinlivan, Research Fellow, Professor Roger Webb and Professor Nav Kapur, NIHR Greater Manchester Patient Safety Translational Research Centre.
Helpful resources on mental health services and the COVID-19 pandemic
- National academic response to COVID-19-related suicide prevention
- National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH)
- Suicide Prevention National Transformation Programme
- Royal College of Psychiatrists COVID-19 Mental Health Improvement Network Webinars
The views and opinions expressed in this blog are those of the authors and do not necessarily reflect those of the NIHR or the Department of Health and Social Care.