Friday 1 May

As the 6th week in lockdown draws to a close, it seems that daily revelations of delay and incompetence in handling this crisis are adding to general anxiety. This is because we need to trust and believe in our leaders, authority figures who act as proxies for the early parental figures whose job it was to take care of us. When this psychological ‘holding’ is missing, anxiety can increase.

This obsession with the macho and arbitrary target of test numbers (which experts tell us this is meaningless without a broader approach including contact tracing) detracts from energy which could be better expended on other things. Further complications are that people can be carriers but without symptoms, meaning they would have no reason to seek a test, and ‘false negatives’, eg the unreliability of tests, all of which means we need a coordinated and nuanced approach, not the simplistic and uncoordinated one which has characterised strategy so far.

Reaching the 100,000 a day (with a bit of statistical massaging, which doesn’t equate to tests actually done) is being presented as a great success despite the terrible death toll. ‘By hook or by crook we will get it to 100,000 tests per day. But mainly by crook’, tweeted a BBCPM listener. Top bioscientist Sir Paul Nurse was impressive on Question Time last night re the government’s response to Covid-19, cutting very smoothly through the obfuscation of Transport Minister Grant Shapps:  “We could be doing better”, “We were totally underprepared for it”, “We should’ve prepared for it” “we’re “playing catch up”.

A Today Programme listener tweeted: ‘Continuous long-standing lack of transparency with govt actions/policies has led to lack of trust in what they tell us. So with testing … Is 100K tests carried out, or simply tests booked online + ordered home test kits? It probably doesn’t really matter, but trust does’.

One of the most daunting aspects of this crisis has to be the extensive collateral damage already being inflicted: business failures, mental health crises, struggling councils, closure of yet more care homes, and so on. There was already a social care crisis and now we learn that more care homes will be forced to close, due to COVID-related costs (eg the hugely increased cost of nursing care). It always seemed wrong to me and a risky business model for social care to be largely in the private sector. If you can overlook the irony, ADASS (Association of Directors of Adult Social Services in England) did capture a key realisation earlier, tweeting: ‘Important to hear Jeremy Hunt at the Commons Health & Social Care Committee, saying ‘If there is one thing we have learnt from this crisis it’s the importance of social care to our society. The challenge now and post Covid-19 is to prioritise, protect and re-imagine social care for the future.’

Local government isn’t in a position to make much headway, having had its central government grant severely cut for years, yet today housing and local government minister Robert Jenrick told journalists ‘’I’ve been very clear to local government that we will be standing behind them’. This coincided with the news that Liverpool City Council declared it was on the brink of bankruptcy and looking to file a Section 114 notice. [Part of the 1988 Local Government Finance Act, a 114 order bans all new expenditure, with the exception of safeguarding vulnerable people and statutory services. It is only issued ‘in the gravest of circumstances’]. There are so many services communities rely on their council for that they cannot be allowed to collapse – lack of trust in national government could then be coupled with a similar lack in local government.

Rob Whiteman, CEO of CIPFA (Chartered Institute of Public Finance and Accountancy) said: ‘This may require a temporary or new set of rules for local government finance. Councils may need to borrow in order to fund services – government should be underwriting what is needed to keep councils solvent as it is already doing for businesses and the NHS’.

Worsening mental health has manifested in the number of people seeking help, suicides and charity Rethink’s survey of more than 800 people living with mental illness showing that 80% felt their mental health was worse due to the impact of the coronavirus, 28% saying it was ‘much worse’. In a letter to the Guardian (30 April), pleading the case for sustained mental health investment, Danielle Hamm (Associate director of campaigns and policy) pointed out:

‘While necessary to prevent the spread of this highly contagious virus, lockdown is depriving people of the things that they need to stay well, from peer support groups to the routine of work and social engagements. We’re hearing from people who are not just feeling a lack of motivation or purpose but experiencing an increase in suicidal thoughts, or deterioration in their health to the point they require urgent intervention to manage paranoid delusions or psychosis’. This reinforces the debate as to whether lockdown could be as damaging to people’s health as the risk of the virus.

One of the most interesting COVID news items must be Cambridge statistician David Spiegelhalter’s, effectively about the rise in risk aversion. He suggests people are over-anxious, as 60 % of those surveyed by IPSOS Mori said they’d feel ‘uncomfortable’ about going to bars, restaurants and on public transport and two thirds would about attending a large public event like a concert or sports fixture. The academic said Britain will need a public information campaign to persuade people to ‘start living again’ because the government’s stay-at-home message has been “slightly too successful”. There’s an interesting debate to be had about personal risk management: some risk aversion is obviously sensible but too much (and there is often too much) curtails the capacity to grow and develop. 

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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