Mental Health

Cases of Psychosis Soared Over Past Two Years of Lockdowns

Data shows an increasing number of people suffering from hallucinations and delusional thinking over the past two years in England (and across the world) during which time our lives were plagued by the social isolation caused by numerous lockdowns. The Guardian has the story.

There was a 75% increase in the number of people referred to mental health services for their first suspected episode of psychosis between April 2019 and April 2021, NHS data shows.

The rise continued throughout the summer, with 12,655 referred in July 2021, up 53% from 8,252 in July 2019.

Much of the increase has been seen over the last year, after the first national lockdown, according to data analysed by the charity Rethink Mental Illness. More than 13,000 referrals were made in May 2021, a 70% rise on the May before when there were 7,813 referrals. …

A study earlier this month found that anxiety and depression around the world increased dramatically in 2020, with an estimated 76 million extra cases of anxiety and 53 million extra cases of major depressive disorder than would have been expected had Covid not struck. Women and young people were disproportionately affected, the researchers said.

Psychosis can involve seeing or hearing things that other people do not (hallucinations) and developing beliefs that are not based on reality (delusions), which can be highly distressing. It can be a symptom of mental illness such as schizophrenia, bipolar disorder or severe depression, but psychosis can also be a one-off, potentially triggered by a traumatic experience, extreme stress or drug and alcohol misuse.

Despite the continued pressure on mental health services, Rethink Mental Illness is highlighting the importance of rapid access to treatment to prevent further episodes of psychosis and reduce people’s risk of developing severe mental illness. …

Brian Dow, the Deputy Chief Executive of Rethink Mental Illness, said: “Psychosis can have a devastating impact on people’s lives. Swift access to treatment is vital to prevent further deterioration in people’s mental health which could take them years to recover from.

“These soaring numbers of suspected first episodes of psychosis are cause for alarm. We are now well beyond the first profound shocks of this crisis, and it’s deeply concerning that the number of referrals remains so high. As first presentations of psychosis typically occur in young adults, this steep rise raises additional concerns about the pressures the younger generation have faced during the pandemic.”

Worth reading in full.

300 People a Day Go to A&E with Depression

As patients struggle to access face-to-face appointments with their GPs, figures show that more than 300 people a day are attending A&E departments complaining of depression – a sign both of the deepening mental health crisis and the inability of the NHS to cope with it. The Telegraph has the story.

NHS Digital data show that, in the year to March, “feeling depressed” was a patient’s main complaint in 114,000 attendances at NHS emergency departments in England – an average of 312 a day.

Mind, the mental health charity, said it was “deeply concerning” that so many people across the country needed emergency care for this reason.

The data refers to chief complaints, which a clinician views during a patient’s first assessment as the main reason that led them to seek emergency care. It is not an official diagnosis.

Feeling depressed was the 28th most common reason of nearly 150 recorded for attending an emergency department nationally in the last year, coming above puncture wounds, back injuries, coughs and sore throats. …

Pennine Acute Hospitals NHS Trust, in the North West, saw the highest number of A&E attendances for people presenting with feeling depressed as their main symptom (4,785), followed by University Hospitals Birmingham NHS Foundation Trust, which recorded 3,950, and Manchester University NHS Foundation Trust, with 2,525.

Different figures show “depressive disorder” was listed as the first suspected or confirmed diagnosis in 83,500 A&E attendances at NHS trusts across the country in 2020 to this year, making it the 25th most common diagnosis of hundreds recorded.

A patient with this diagnosis may not necessarily have been listed as “feeling depressed” in their initial assessment.

Leila Reyburn, the policy and campaigns manager at Mind, said: “It is deeply concerning to see so many people feeling so mentally unwell that they need to go to A&E. This is supported by data which shows an increasing number of people, including children, being treated by the NHS in a mental health crisis.”

Worth reading in full.

Record Numbers of Children Seeking Access to Mental Health Services

A new analysis by the Royal College of Psychiatrists has underlined the damaging impact of long months of school closures and general lockdowns on children’s mental health, showing that record numbers of young people are seeking – and are having to wait for – access to mental health services. The Guardian has the story.

In just three months, nearly 200,000 young people have been referred to mental health services – almost double pre-pandemic levels, according to the report by the Royal College of Psychiatrists.

Experts say the figures show the true scale of the impact of the last 18 months on children and young people across the country.

“These alarming figures reflect what I and many other frontline psychiatrists are seeing in our clinics on a daily basis,” said Dr. Elaine Lockhart, the college’s Child and Adolescent Faculty Chair. “The pandemic has had a devastating effect on the nation’s mental health, but it’s becoming increasingly clear that children and young people are suffering terribly.”

The college analysed NHS Digital data on mental health referrals for children and young people aged 18 and under. It found that between April and June this year, 190,271 children aged 18 and under were referred to children and young people’s mental health services – almost twice the number (97,342) referred during the same period in 2019.

Urgent referrals had also risen steeply. From April to June in 2019, 5,219 children and young people were referred for urgent care. This rose to 8,552 in 2021, the college said.

At the end of June, 340,694 people were in contact with children and young people’s mental health services, up from 225,480 in June 2019. …

Eating disorder treatment services were seeing more patients than ever, the college said, but it also warned of an “unprecedented” number of children still waiting for care.

Worth reading in full.

More than 50% Increase in Number of Children Going to A&E with Serious Mental Health Issues since Start of Lockdowns

We are told that healthy children should be vaccinated against Covid to benefit their mental health. If only our leaders had taken an interest in this before imposing school closures and wider lockdowns which have helped to bring about a more than 50% increase in the number of children going to A&E with serious mental health issues. The Telegraph has the story.

More than 2,243 children in England were referred for specialist mental health care from emergency departments in May this year, compared with just 1,428 in May 2019.

Experts say children have struggled with schools being closed and without face-to-face interaction with their peers.

Robert Halfon, the Conservative MP and the Chair of the Education Select Committee, called for schools to remain open to stave off a mental health “catastrophe”.

NHS data reveal that nearly 27,000 children are being prescribed antidepressants each month, up more than 8% from 2019. While most are teenagers, 25 a month are aged six or under, and more than 1,000 are aged seven to 11.

Waiting lists for Child and Adolescent Mental Health Services (CAMHS) have jumped by more than a third in some regions, according to NHS England Trusts.

The number of children admitted to acute wards with eating disorders more than doubled in the three months to June 2021, when compared with the same period in 2019.

Dr. Anna Conway Morris, a consultant child and adolescent psychiatrist, said the increase in A&E referrals “shows that the things that are likely to need CAMHS input, like eating disorders, or like more serious self-harm or suicidal thoughts, have increased”.

Paul Farmer, the Chief Executive of the mental health charity Mind, has written to the Health Secretary, Sajid Javid, calling for extra funding in order not to “betray the next generation”.

An NHS England spokesman said its mental health services were looking after record numbers of children “with over 420,000 treated since April last year”.

Worth reading in full.

Number of Children Referred for Foster Care Increased by More Than a Third Over the Past Year of Lockdowns

There was a time when commentators seemed obsessed with telling their readers that they rather enjoyed being locked down – avoiding lengthy commutes, spending time with family in the garden and rediscovering forgotten hobbies. Needless to say, this joy was not universal. Others (likely those without the gardens or without the funds for hobbies) found lockdown to be particularly difficult, as is reflected by figures showing that family breakdowns led to a surge in the number of children referred for foster care in the year up until July 31st, 2021. The Telegraph has the story.

The 36% increase in referrals to Barnardo’s, from 14,130 to 19,144 in the 12 months to July 31st, 2021, prompted an urgent appeal by the charity for foster parents.

Barnardo’s is targeting foster parents who would be willing to care for siblings left without a family after a 31% increase in their numbers.

Lyn Perry, Joint Chief Executive of Barnardo’s, said job losses caused by the pandemic combined with mental ill health had contributed to the sharp rise.

“The pandemic and lockdown measures have piled pressure onto struggling families with job losses, deepening poverty and worsening mental health, contributing to family breakdown,” she said. …

In England the rise in the total number of children referred to Barnardo’s fostering services was 40%, in Wales it was 5% and in Northern Ireland it was 20%. In Scotland, however, there was a decrease of 17% in total referrals.

Worth reading in full.

Victoria Playgrounds Were Closed to Stop Parents Meeting, Not to Stop Covid Spreading Among Children

Much has been written on the damage of playground closures on young children during lockdowns. To add insult to injury, a Victoria health official has admitted that playgrounds in the state weren’t closed because children were spreading Covid – for which there was (and still is) no evidence – but to stop parents from being able to meet. The Mail Australia has the story.

Victorian children who have spent months living in fear of becoming infected at their local playground have finally been told there was no real evidence they were going to catch Covid playing on the swings. 

In a stunning admission sure to enrage Melbourne families, Victoria’s Chief Health Officer Professor Brett Sutton admitted  on Wednesday the parks were banned for the last month to get at parents. 

It is not the first time Professor Sutton has taped-up Victorian playgrounds because of their supposed threat to children. 

Last year he closed them for months during Victoria’s second deadly wave, which killed more than 800 after leaking out of his own bungled hotel quarantine scheme. 

On Wednesday, the Professor told long suffering Melbourne parents the actual reason he closed playgrounds in the first place was because of them. 

“My advice on playgrounds originally was because we saw that people were using it as a loophole to have de facto meetings across households, neighbourhoods, families,” he said. 

“In allowing playgrounds to open again, absolutely with the wellbeing and considerations of kids in mind, but we’re going to have QR codes as a mandated requirement.”

Melbourne parents had pleaded with Premier Daniel Andrews to introduce such a scheme back on August 16th, when he announced for the second time the only avenue of enjoyment many kids had would be banned. 

Their calls had fallen on deaf ears at the time as Professor Sutton claimed he was acting on evidence that playgrounds were a serious transmission risk to children who played at them. 

“We are investigating a potential transmission in a playground,” he claimed.

“It is not definitive and maybe we will not be able to make it definitive but it looks like there has been transmission in a playground.”

He backed-up the cruel plan with news the Delta variant of Covid had been spread between children walking home from school.  

The next day, playgrounds across Melbourne were taped off under threat of serious fines if children attempted to use them. 

On Wednesday, Professor Sutton said he would allow just one parent or guardian to attend playgrounds with their kids. 

He warned those parents not to even contemplate removing their masks while there. 

“You will not be removing your mask to eat or drink because that’s when transmission occurs, It’s been said across Australia this virus moves with people. If we don’t have those human interactions, we can’t infect others'”

When pressed again for any scrap of evidence to support transmission of the virus at playgrounds, Professor Sutton could provide none. 

“We have suspicions about transmission maybe occuring at playgrounds, but you don’t have to jump to specific instances to know how transmissions have occured [sic] indoors and outdoors between adults, between kids round the world,” he said.

Worth reading in full.

Almost a Quarter of a Million Children Prescribed Antidepressants in 2020

In case there was any doubt about the impact of numerous long-lasting lockdowns on the youngest in society, new NHS figures have revealed that record numbers of antidepressants are being prescribed to children, with 231,791 prescribed to children aged between five and 16 in 2020 alone. Long waiting lists for mental health services, caused in part by lockdowns, have certainly added to the problem. And as we have previously reported, many people who have been able to receive ‘treatment’ over the course of the lockdowns still feel as though they missed out on proper care due to the loss of face-to-face appointments. For some, video calls made matters worse. The Times has the story.

Health service guidance says that they should be offered to under-18s only in cases of moderate or severe depression alongside talking therapies.

Campaigners fear that long waits for specialist mental health services aimed at children and young people are driving higher rates of prescription from GPs, who feel powerless to offer anything else.

Studies suggest that lockdowns and missed schooling, as well as the pressure of social media, may be behind higher rates of mental distress. The number of prescriptions issued to primary school children has increased by 20% in the past five years; those for secondary school pupils rose 23% in the same period. …

Catherine Knibbs, a child psychotherapist and online harm adviser, said that she often saw antidepressants handed out for mild cases of anxiety or depression. “Children’s mental health and wellbeing is complex, however pharmacology ought to be a last rather than first resort as their brains and bodies are still developing and maturing,” she said. …

A recent Unicef survey ranked the U.K. in the bottom third of wealthy nations when it came to assessing the quality of children’s mental health. Its report stated that problems with children’s mental health were only likely to get worse. “The existing children’s mental health crisis will probably intensify,” it stated.

“The experiences of lockdown, bereavement and ongoing strains on family relationships of economic uncertainty can damage many children’s mental wellbeing. Children may feel anxious, insecure and fearful for the future.”

Worth reading in full.

Students Need Help Addressing “Socialisation Issues” Following More Than a Year of Lockdowns, Says University Official

Having been cooped up in their bedrooms for much of the past 18 months, teenagers who are about to begin university need help addressing “socialisation issues”, according to an English university official. Universities will also have to give catch-up sessions to help make up for the amount of learning lost during school closures. The i has the story.

Last month, the London School of Economics and the University of Exeter estimated that pupils lost nearly a third of their learning time between March 2020 and April 2021 because of school closures and coronavirus disruption.  

With many schools unable to complete the full A-level curriculum, students were only assessed this summer on the topics they had covered. 

To make sure students will be able to complete their undergraduate courses, universities are therefore having to step in to bridge the learning gaps. 

The elite Russell Group of universities has teamed up with the Open University to launch ‘Jumpstart University’ – a free resource designed to help students settle into university. 

The platform – which is open to students in all universities – has subject-specific courses, and modules on study skills, student life, wellbeing and mental health. …

An official working for a university in the South of England told i that they were expecting to deliver “remedial work with a lot of students”.

“They cannot help but have had some of their intellectual and other development hindered by being at home for two years at such a critical part of their education. 

“We certainly noticed at the start of last year, some students had problems typical entrants didn’t have.” 

With the 2021 cohort experiencing disruption over two school years, catch-up would have to be provided “across the whole year” to make up for the amount of learning lost, they said. 

The source said universities would have to address “socialisation issues” as well as academic study. “If you’re locked away from age 16 to 18… if we’re back to normal by October, you’ve gone from a period of being locked down for almost two years, to something like as much freedom as you’re ever likely to get.” …

With student unions planning traditional freshers’ week activities for the first time since 2019, there are also concerns some students may over-indulge after two school years in which socialising was strictly limited.

Worth reading in full.

The Dubious Ethics of ‘Nudging’ the Public to Comply With Covid Restrictions

by Dr. Gary Sidley

A middle-aged woman, walking along a pavement in the afternoon sunshine, sees a young family approaching and instantly becomes stricken with terror at the prospect of contracting a deadly infection. A man in a queue in a garage kiosk leans into the face of another and screams, “You selfish idiot! Hundreds of people will die because you don’t wear a mask.” The aggressor is oblivious to the fact that his victim suffers a history of asthma and anxiety problems. A neighbour puts on a face covering and plastic gloves before wheeling her dustbin to the end of her drive. These are three recent examples of many similar events I’ve observed or read. What could be the main reason for such extraordinary behaviour? Has the emergence of the SARS-COV-2 virus magically re-wired our brains, transforming many of us into vindictive germaphobes?

No, of course not. These extreme human reactions are, I believe, primarily the result of the Government’s deployment of covert psychological ‘nudges’, introduced as a means of increasing people’s compliance with the Covid restrictions.

In an article in the Critic, I discussed the remit of the Government’s behavioural scientists in the Scientific Pandemic Insights Group on Behaviours (SPI-B), a subgroup of SAGE which offers advice to the Government about how to maximise the impact of its Covid communications strategy. The methods of influence recommended by the SPI-B are drawn from a range of ‘nudges’ described in the Institute of Government document, MINDSPACE: Influencing behaviour through public policy, several of which primarily act on the subconscious of their targets – the British people – achieving a covert influence on their behaviour. The three ‘nudges’ to have evoked the most controversy, among both psychological practitioners and the general public, are: the strategic use of fear (inflating perceived threat levels); shame (conflating compliance with virtue); and peer pressure (portraying non-compliers as a deviant minority) – or ‘affect’, ‘ego’ and ‘norms’, to use the language of behavioural science. (Specific examples of how each of these covert strategies have been used throughout the Covid crisis are described here).

The British Psychological Society (BPS) is the leading professional body for psychologists in the U.K. According to their website, a central role of the BPS is: “To promote excellence and ethical practice in the science, education and application of the discipline.” In light of this remit, I – together with 46 other psychologists and therapists – wrote a letter to the BPS on January 6th, 2021, expressing our ethical concerns about the use of covert psychological strategies as a means of securing compliance with Covid restrictions. In particular, our alarm centred on three areas: the recommendation of ‘nudges’ that exploit heightened emotional discomfort as a means of securing compliance; implementing potent covert psychological strategies without any effort to gain the informed consent of the British public; and harnessing these interventions for the purpose of achieving adherence to contentious and unevidenced restrictions that infringe basic human rights.  

Responses from the BPS to our initial letter were slow and circuitous. However, on July 1st we received an email from Dr. Roger Paxton, the Chair of the Ethics Committee, which clarified the BPS’s position: in the Committee’s view, there is nothing ethically questionable about deploying covert psychological strategies on the British people as a means of increasing compliance with public health restrictions. 

An in-depth inspection of Dr. Paxton’s defence of the BPS reveals that it is evasive, disingenuous and wholly unconvincing. 

First, he quibbles about the use of the word “covert”, arguing that the compliance techniques under scrutiny are more appropriately described as “indirect”. Behavioural-science documents routinely refer to the psychological strategies underpinning Government communication campaigns as evoking responses from people that are “unconscious”, “subconscious” or “automatic”. The crucial point is that the human targets of these ‘nudges’ are often unaware that the intention of the SPI-B psychologists is to scare, shame them and socially pressure them to conform. The MINDSPACE publication – co-authored by Professor David Halpern, an SPI-B and SAGE member – seems to concur: “Citizens may not fully realise that their behaviour is being changed… Clearly, this opens Government up to charges of manipulation… [as] it may offer little opportunity for citizens to opt-out.” (p. 66)

Second, Dr. Paxton rejects the idea that it would be ethical to offer citizens an opportunity to opt-out by asserting that the application of covert psychological strategies to shape people’s behaviour falls outside the realm of individual consent. The BPS appears to be claiming that an appeal to some nebulous, ideologically-driven concept of social decision-making exempts psychologists from the fundamental requirement to seek a person’s informed agreement before delivering an intervention. So according to the BPS – the formal guardians of ethical practice in the U.K. – the Covid communications strategy, aimed at achieving mass behavioural change, was intended to influence some anonymous collective rather than the actions of as many individuals as possible. 

Again, the BPS stance is at odds with Professor Halpern’s position. In his 2019 book, Inside the Nudge Unit, he states: “If Governments… wish to use behavioural insights, they must seek and maintain the permission of the public. Ultimately, you – the public, the citizen – need to decide what the objectives, and limits, of nudging and empirical testing should be.” (p. 375)

Third, Dr. Paxton’s claim that the levels of fear throughout the Covid pandemic were proportionate to the viral threat is ill-informed and does not stand up to scrutiny. The minutes of the SPI-B meeting of March 22nd, 2020, demonstrate that its endorsement of a covert psychological strategy was a calculated decision to scare the British people, recommending that: “The perceived level of personal threat needs to be increased among those who are complacent… using hard-hitting emotional messaging.” In her book, A State of Fear, Laura Dodsworth interviewed members of SPI-B who confirmed that there had been a concerted effort to elevate the fear levels of the general public. One committee member, Educational Psychologist Dr. Gavin Morgan, admitted: “They went overboard with the scary message to get compliance.” Another SPI-B member – who wished to remain anonymous – was even more forthright: “The way we have used fear is dystopian… The use of fear has definitely been ethically questionable. It’s been like a weird experiment. Ultimately, it backfired because people became too scared.”

The mission to indiscriminately instil fear in the British public has been highly effective. An opinion poll prior to ‘Freedom Day’ suggested most people were worried about the prospect of lifting the remaining Covid restrictions. Even now, when all the vulnerable groups have been offered vaccination, many of our citizens remain tormented by ‘Covid Anxiety Syndrome’ – a disabling combination of fear and maladaptive coping strategies – with 20% of the population ‘markedly affected’. And this psychology-assisted fear inflation will be responsible for a substantial proportion of the extensive collateral damage associated with the restrictions, including excess non-Covid deaths and mental health problems.

Fourth, Dr. Paxton’s response makes no reference to the use of shame and scapegoating, and whether these are acceptable strategies for a civilised society to use. One can only assume that the BPS either views these tactics as acceptable, or that they seek to avoid acknowledging that psychologists have recommended practices that, in some respects, resemble the methods used by totalitarian regimes such as China, where the state inflicts pain on a subset of its population in an attempt to eliminate beliefs and behaviour they perceive to be deviant.

The dismissal of our ethical concerns by the BPS was predictable: a cursory glance at the scientists comprising the SPI-B shows that several of its members are also influential figures in the BPS; a major conflict of interest that renders the impartiality of their views highly questionable. What was surprising was the strident tone of Dr. Paxton’s rejoinder, as exemplified by his assertion that the psychologists’ role in the pandemic response demonstrated “social responsibility and the competent and responsible employment of psychological expertise”. I suspect the lady trembling on the pavement, the young man being verbally abused in the garage, and the neighbour donning mask and gloves to wheel out her dustbin – along with the many others in similar positions – might all beg to differ.

Dr. Gary Sidley is a retired NHS Consultant Clinical Psychologist.

Man Taking Legal Action Over Prison-Like Conditions at Government-Approved Quarantine Hotel

A man from Southampton is taking legal action over the prison-like conditions at a quarantine hotel which he says left him “traumatised” and suffering from depression. He was forced to stay at a Government-approved hotel for ten days (costing him £1,750) after visiting a sick relative in India, which was on the Red List at the time, and claims to have been treated like a “Covid prisoner”. BBC News has the story.

Pritheepal Singh… stayed at Park Plaza Waterloo, London, after visiting a sick relative in India.

He said the experience was like prison, with restricted exercise and food that was inappropriate for his religion.

The Department of Health and Social Care said its “robust border regime” protected the U.K. from Covid.

The hotel said it did its best to make guests feel welcome.

Mr Singh said his stay left him “traumatised” and suffering from depression.

He said: “It was pure fear. I had to go and speak to my doctors. I couldn’t sleep at night.

“I didn’t know that I was going to be treated like a Covid prisoner. It is despicable behaviour – just not acceptable.”

He said security guards stayed by his room to stop him leaving and allocated restricted fresh air breaks on the hotel roof.

Mr Singh added that he was served halal meat, which was not appropriate for his religion. …

On August 12th, the Government raised the price of hotel quarantine per adult from £1,750 to £2,285.

He isn’t the first to complain of poor conditions at a quarantine hotel. Earlier this month, one Brit staying in a Heathrow hotel said he had to move room twice due to a rodent infestation.

The BBC News report is worth reading in full.