A phone call can mean a lot

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“IT might be helpful to divide people into three basic groups. Group One would be those who have significant mental health problems; serious enough to be referred to specialist services for assessment and treatment

“The second group would be people who have less severe mental health issues who might need care from their GP, a counsellor or specialist nurse. Sometimes these people have longstanding mood or anxiety problems which respond well to treatment but might recur from time to time. Usually this group of people can manage pretty well with life although sometimes they might need a bit of extra help.

“The third group is the biggest group of people who generally don’t suffer from mental health problems and cope with life’s ups and downs reasonably well. That’s not to say that they never feel down or worried or stressed - we all do at times - but usually they can manage this perhaps with some support or advice from family and friends.”

Dr Sally Bonnar is a Church of Scotland elder and retired consultant psychiatrist, having worked for the NHS for around 40 years.

She was a Consultant in Child and Adolescent psychiatry in NHS Tayside and latterly in charge of an in-patient unit for seriously ill adolescents between 12 and 18 years old.

Sally knows mental health and the things that have an impact on it – and like many professionals, she’s concerned about the long-term impact of the global pandemic.

The isolation most of us were subject to especially during the initial phase of the lockdown last year has been a concern to professionals and organisations who work with those with mental health difficulties.

Sally explains: “The evidence is clear. Isolation is a big contributor to mental health problems and indeed to mental illness. Even for people with no mental health problems, social isolation can lead to difficulties and this is well recognised eg in prisoners kept in isolation for long periods, even for their own safety. It is one of the reasons why solitary confinement is seen as a method of torture.

“Social circumstances and living conditions, as well as our own personalities, have played a huge part in how well people coped with the isolation.

“For some such as my husband and I who are both retired with no dependents, a comfortable house and garden and sufficient income, the impact has been less severe than say a young couple trying to home school children while working from home or a family who have lost their income and have no access to technology, the elderly or those living alone. For those who are happy with their own company and can occupy themselves, there has perhaps been less stress than for people who need company. I think that it would be fair to say that everyone has been impacted negatively by the seclusion to some extent. Even now with things opening up and activities returning to nearer normal, there is a wariness and the use of masks is a constant reminder that the pandemic is not over.

“I know that referrals to child and adolescent services have increased and long waiting lists have lengthened. Some scientific papers published about the early impact of the pandemic, suggest that while depression has not increased significantly; anxiety and suicidal ideation had. Rates of anxiety have almost doubled in one cohort study. Trends suggest that young people, women and those from socially disadvantaged backgrounds have borne the biggest burden.”

I ask if there are signs we could look for within ourselves – or in those we love – that might indicate a developing problem. “Poor sleep is one,” she says, “though this has been commonly reported by a large proportion of the population during the pandemic and might in part be due to disruption to normal routines and reduced exercise. Lack of appetite and poor concentration are other things to look out for. Loss of interest in things that you would normally enjoy and a disinterest in contacting people are other potential clues. Anxiety can lead to a rapid heart rate and an inability to settle to do things. A loss of interest in eating or on the other hand, over eating or comfort eating.

“Sometimes it is easier to spot these things in other people so it might be a friend or family member will point out a worry to you. Of course, anything more serious like increasing thoughts of suicide are important and should not be ignored.

“You can fight against it. Regular patterns of sleeping and eating are important especially getting a good night’s sleep.

Exercise, no matter what it is, is also a protective factor and a decent walk most days, even if you need your wellies, is a great idea. There is increasing evidence about the importance of exposure to nature. Green spaces such as parks or even your garden are great spaces to spend time. Saying good morning to people you meet, chatting with the checkout worker – any kind of positive social contact actually is a good thing. Spending time with friends and family, even on Zoom, is helpful and helps to reduce the feeling of isolation.

“Learn to relax – read a book or listen to music or watch the TV, whatever you prefer. Take a vitamin D supplement, or make the most of the sunshine. Listen to a church service or join an online bible study or prayer group. Connect to other Christians.

“There’s lots of information out there about how to protect your mental health so do look. “The internet has some reliable websites and I would recommend MIND or SAMH or for young people Young Minds.

“People have generally had raised levels of anxiety because of fear of illness either for themselves or of their loved ones. They have also been fearful of contracting other illnesses and not being able to seek help for these. Many people have lost jobs, their financial security.

“That’s increased their anxiety and prevented folks from doing some of the things that they might otherwise have done to distract themselves from problems – and in any case many of these things like cinema etc or even just going out to meet someone for a coffee were not available.

The best way to help someone whom you think is struggling is to try to talk to them,” Sally says. “If someone is struggling, keep in touch. A phone call can mean a lot.

Although many churches used technology to livestream services and other meetings for prayer and bible study, some were not able to access these. They’re not the same as communal worship where we meet and sing praises together. Christians, and those of other faiths, were cut off from many of the usual sources of support and comfort.

This was especially true for the inability to have funerals, weddings and baptisms.

These rituals which mark significant life events were missing and left many off us feeling another kind of loss. Bereavement and loss are two of the other significant risk factors for mental illness. It will be many years before we know the true cost in mental health and wellbeing of this pandemic.”

I ask if we could all do one thing, to help prevent, or help someone with, a mental health problem, what should it be?

“The best way to help someone whom you think is struggling is to try to talk to them,” Sally says. “If someone is struggling, keep in touch. A phone call can mean a lot. If you are really worried, encourage them to seek professional help from their GP or other mental health professional.” ¤