Tuesday 14 April

Pensions and later life expert Baroness Ros Altmann is the latest public figure to highlight the plight of elderly people, ‘abandoned’ in care homes without the necessary level of care and care for the carers. It’s not surprising these residents could feel disturbed: those with dementia could struggle to understand why their loved ones are no longer visiting them; many are seen by carers who reportedly aren’t adhering to the required hygiene standards; doctors are reluctant to visit these homes; and a high number of care home residents are already on anti-depressants when many would prefer talking therapy. All these factors will exacerbate pre-existing mental health difficulties and create yet more.  

Care home death statistics are only updated weekly and now numerous voices are pressing for the longstanding artificial divide between NHS and social care to be erased. It sounds promising that amid the rising clamour for daily and accurate recording of COVID deaths in care homes and the community, the Care Quality Commission has stepped up to take the lead on this important work. A related, delicate and under-recognised issue has been how the cause of death is represented on a death certificate. It’s long been known but goes under the radar that doctors (and now they don’t even have to see the patient) often put the surface presenting ‘cause’ eg pneumonia, when the underlying cause is actually neglect or a combination of problems. So it follows that the COVID death toll could be much higher if older people’s deaths weren’t attributed to these other ‘causes’.

The Guardian reveals how Britain missed three opportunities to be part of an EU scheme to bulk-buy masks, gowns and gloves and has been absent from key talks about future purchases,  as pressure grows on ministers to protect NHS medics and care workers on the coronavirus frontline. A survey by the Doctors’ Association UK found that only 52% of clinicians carrying out the highest-risk procedures said they had access to the correct full-sleeve gowns. Refusing to cooperate with the EU on this is an example of doctrinaire adherence to Brexit policy, leading to damaging delay in obtaining vital supplies.

Two million more unemployed and a 35% drop in economic performance are predicted by June as a result of this crisis. A regular listener to BBC World at One tweeted: ‘It’s quite possible that lockdown is causing additional deaths. If your business is in free fall, you’re in financial meltdown, and/or whole range of mental illnesses. e.g. our Trust has seen a collapse in eating order referrals. That is storing up trouble’. It certainly is. So many facets of this COVID crisis are bringing about a mental health domino action.

Choice of language is important in every field, conveying powerful messages about the beliefs of the speaker or speakers. COVID has thrown up some good examples, eg criticism levelled at politicians and the media for using bellicose terms (‘it’s war’, ‘it’s a battle’ or about the PM ‘he’s a fighter’) and drawing comparisons with WW2 and the alleged Churchill/PM likeness.

No-one wants to hear it, but we’re going to have to make uncomfortable choices about how we pay for this.”

Psychotherapist Mark Vernon tweeted: ‘I’m wondering about the gendered nature of language around COVID. For example, military metaphors seem spontaneous, “fighting the virus” etc, plus the objection that they imply “defeat”. It sounds masculine, echoing science’s “control” of (mother) nature etc. Make any sense?’

And have you noticed how many politicians and public figures, when being grilled (or being given an easy ride) by the media use obfuscatory and diversionary phraseology like ‘What’s important now is….’ (implying the big mistake they’re being asked about is trivial) or ‘What we want to see is/what we’d very much like is….’ when wanting is just that – not actually getting something done or rectified?

Tonight’s Downing Street press briefing had several main points including the Chancellor saying   he will “have to right the ship” when we’re through this, implying cuts and some are already predicting austerity Mark 2. At tomorrow’s conference we’re promised a statement on social care – way overdue. Let’s hope it has some substance.

Published by therapistinlockdown

I'm a psychodynamic therapist in private practice, also doing some voluntary work, and I'm interested in the whole field of mental health, especially how it's faring in this unprecedented crisis we're all going through. I wanted to explore some of the psychological aspects to this crisis which, it seems to me, aren't being dealt with sufficiently by the media or policymakers, for example the mental health burden already in evidence and likely to become more severe as time goes on.

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