Mental health has always been the pauper when it came to medical provision and its sufferers long stigmatised. Some well-meaning campaigns have been undertaken in recent years to break taboos and stereotypes and help alleviate the suffering of those with mental health conditions. But the fallout from coronavirus and the climate of fear which continues to trouble so many people has almost certainly undone much of this work.
Many people are – whether they are at a high risk of falling seriously ill from coronavirus or not – still terrified. People are afraid of venturing back into the outside world. Those who do keep their distance from others. Masks are everywhere, and are compulsory on public transport. The result is a reminder that this ‘new normal’ is utterly unlike what we are used to. Even to those who don’t suffer from mental health problems it’s a depressing and dispiriting sight. And I fear this ongoing state of stress and anxiety is doing profound damage to people’s psychological wellbeing.
In the distant past (pre-March) we could escape life’s trials with once-pleasurable activities. Retail therapy anyone? Shopping has now taken on all the fun of a visit to an outpatient department in hospital. A trip to the pub or barbers with no small talk allowed? No thanks. Totally silent and forgotten, an increasing number of people are simply dropping out of life as we once knew it. When, or will, they return?
Even the British Medical Association are sounding warning bells. This week they called for a massive increase in funding in an attempt to deal with the growing mental health crisis. I have had many virtual consultations with people whose neurological conditions have not deteriorated significantly. Yet when you ask about quality of life, what is there to say? Plenty of patients tell me that they are 'existing' but not much more than that.
It was widely acknowledged before the pandemic struck that mental health problems were not only increasing in number but also being seen more frequently in younger people. As a neurologist, the people I see are especially at risk from suffering from mental health problems. It’s a sad fact that in my line of work, we can cure very little. But we can try to control and mitigate the illnesses we seek to treat. Much of this relies on the patient remaining hopeful and optimistic about their prospects. But now, surrounded as we are by this 'invisible enemy', all too often hope has been substituted for fear, even terror.
Lockdown and all the other restrictions placed upon us during these extraordinary times were meant ultimately to save lives, but at what cost to so many people? Why are more people not reflecting on the importance of quality of life and whether measures in place now, when the virus appears to be on the retreat, are still justified?
There is a school of thought that to promote compliance with lockdown measures, it was necessary to make people feel worried. It clearly worked: the degree of compliance that followed surprised those in power. But what now? Some are returning to their normal lives but too many people are – and will – not.
In the discussion about coronavirus, we still hear precious little about mental health. Experts have been given plenty of airtime on television to extoll the dubious value of face coverings in preventing infection. All too often, we don’t hear about the broader impact of face masks and the message they send: that it is unsafe to go outside (it isn’t) and that by not wearing a mask you could infect someone and cause them harm (highly unlikely, unless you are symptomatic).
Of course, this isn’t to say masks are always unnecessary. Properly-fitted medical masks for people with an infection or whose immune system is compromised and who need to enter specific areas of risk, such as hospitals, is vital. But is it really necessary for healthy people to wear loosely-fitted masks in the open air? I'm not convinced.
In this time of coronavirus, I fear that too many of us have lost the ability to proportionally weigh up risks and consider the value of something basic but fundamental: our quality of life. And I fear that when this pandemic eventually recedes, we’ll be left with a dreadful psychological toll for many years to come.