Saturday 12 December

Whereas just one of these would be more than enough to contend with, this week has seen ‘V-Day’ jingoism, Christmas and Brexit dominating the news agenda, some media outlets generally assuming that everyone has a fairly middle class lifestyle. A letter to the Daily Telegraph demonstrated this, quoting SAGE advice as to how to manage the Christmas dinner with more households involved. ‘Have drinks or Christmas dinner outside by a fire pit; have two tables so you can socially distance; and if you’re a visitor, take your own plates and put them in the dishwasher yourself’. Said the letter writer: ‘These guidelines certainly tell us something about the lifestyles of SAGE members and their understanding of how most people live’.

Another example is, in relation to an Observer piece which estimated that 1.67m, mostly over 65s, will be on their own this Christmas, Radio 4 Broadcasting House’s take, featuring celebrity chef Prue Leith bullishly advising how to prepare a turkey drumstick for one. Whoopee. The article on loneliness quoted a survey showing the usual figure of 4% alone at this time was expected to be 8% this year, attributed to the disruption and fragmentation inflicted by the pandemic. Among the over 65s, the figure is predicted to rise from 7% to 14%. ‘The survey results follow a growing body of research raising concerns about the impact of loneliness during the pandemic. Similar polling for the British Red Cross in the autumn found that 39% of UK adults had not had a meaningful conversation with someone in the preceding fortnight and 32% worried that should something happen to them, no one would notice. Zoe Abrams, the executive director of communications and advocacy at the charity, said the seasonal impact of loneliness on top of the pandemic could not be underestimated.’ The article goes on to point out that loneliness is a public health issue, technology is a help but not the answer and many older people have no access to it – none of which were covered by the BH piece.

Meanwhile, some commentators have suggested that people are starting earlier and ‘going bigger’ on Christmas this year in an effort to compensate for the restrictions and lack of levity this year. One manifestation of this is thought to be the size of Christmas trees and wreaths and it does seem some of the wreaths already on display are bigger than usual. Who’d have thought the size of your wreath (assuming you’ve even got a front door to put one on) would become a target for oneupmanship? But now perhaps some plans for gatherings won’t be activated, following scientists’ and advisers’ exhortations to rethink Christmas amid fears of rising COVID cases in many areas. Already a third wave and a third lockdown in January are widely predicted. Professor Chris Whitty, the Chief Medical Officer for England, is on a sticky wicket, wanting to appear not to depart from the government’s stance but clearly worried, resulting in a mixed message some will find confusing. ‘The country needs to accept that Christmas is a period when we can do things, that’s the reason why the rules are being relaxed – but that doesn’t mean we should do things’.

Remember the promise, after months on end when family members weren’t allowed to visit care home residents, that measures would be introduced to facilitate this? Not surprisingly, charity Age UK has now revealed that this is unlikely to happen for anticipated Christmas reunions because there’s still no detail on when the lateral flow tests will be delivered. While one helpline, the Relatives and Residents Association, said most of their calls were about banned or restricted visits, the head of Age UK, Caroline Abrahams, said: ‘As one barrier is overcome another always seems to take its place, whether it’s the pronounced risk aversion of some care home chains and their insurers, or a lack of confidence in lateral flow tests among some local authorities’. Of 2,732 people Age UK surveyed, 70% had not been able to visit or see their relative since the start of the pandemic and a third said they hadn’t been offered an alternative eg videocall. Such a situation can lead to despair on both sides, the frustration and undeserved guilt of families and the lonely confusion of the residents. One respondent poignantly captured this painful experience: ‘My grandad was going to die, we knew that it was only a matter of time. But the fact that he might have died thinking we abandoned him kills all of my family. And it probably will do for the rest of our lives.’

There are almost no words for what’s been going on with the Brexit negotiations, the PM, ministers and UK negotiators causing more embarrassment for the UK by the day. It’s almost as if they don’t realise that their blustering and antics are being beamed into households all over the world. The week began with Michael Gove repeating Brexit fibs in the House of Commons, the last place you’d have thought he’d get away with chestnuts like the ‘Australia-like deal’. We hear that the UK has had to allow the EU to have an office in Northern Ireland: it sounds like they also need one in the House in order to counter the many misrepresentations still being trotted out there. Asked by Channel 4’s Krishnan Guru-Murthy ‘How would you rate the current government?’, veteran broadcaster David Dimbleby said: “Very, very low… the lowest… the lowest since I was born in 1938… it’s not a government one would be proud of…”

Guardian sketch writer John Crace broadened his repertoire this week, giving Matt Hancock a rest and focusing on other ministers including James Cleverly. On the alleged ‘oven ready deal’ (this week disingenuously conflated with the Withdrawal Agreement), Crace observed: ‘You can sometimes tell how much of a state No 10 is in by its choice of minister for the morning media rounds. And sending out the junior Foreign Office minister James Cleverly – living proof of the fallibility of nominative determinism – rather proved that Downing Street was in full panic mode over the progress of its Brexit trade talks. At a time like this, only a minister too dim to sense the danger he was in would do. Cleverly may have his talents, but the only one that he doesn’t keep hidden – apart from to himself; in his own world he is one of life’s winners – is his inability not to make a bad situation worse’.

Focusing on an exchange with Labour’s Rachel Reeves, Penny Mordaunt fared only marginally better. ‘She sounded like a presenter on a 24-hour news channel trying to fill dead air by reading out the same headlines over and over again, telling nobody anything that they didn’t know already. The talks were at a critical stage. She couldn’t say how they were progressing. The sticking points were the level playing field, fishing and governance. And that was about it. Thanks for that, Penny…. Unlike Cleverly, she has the self-awareness to realise when she’s out of her depth. And right now, she was drowning’.

In a move which could have felt humiliating for the Brexit negotiators, it was decided the fountain heads should meet over dinner, our PM having had the nerve to suggest that perhaps ‘sweet reason’ might prevail – his own, of course. Off went a more tousled than usual Boris to Brussels, immediately getting into an idiotic exchange with Ursula von der Leyen about mask wearing. Having already felt the need to remind the PM about distancing, she said he should remove his mask. “Then we have to put it back on…You have to put it back on immediately.” “You run a tight ship here, Ursula, and quite right too,” Johnson responded’. We can only imagine what the EC president thought of the Boris Johnson ‘ship’.

We also have to wonder about the cost of this exercise, including the travel, lost time and the three-course meal of scallops, turbot and pavlova, when the outcome of ‘significant differences remaining’ could have been predicted from the start. We were then told the deadline is Sunday, but no one will be surprised if the negotiations drag on for another week or beyond, as the parliamentary recess could be delayed beyond 21 December in order to pass a Brexit bill.

One of the untruths peddled by ministers and others about Brexit is that of an ‘Australia type deal’, aka No Deal, but dressed up to sound more than it is and managing to convince the gullible that the emperor is wearing some clothes. Anyone who hasn’t yet seen or heard former Australian PM Malcolm Turnbull on BBC’s Question Time last night might like to catch up: a genius bit of programming during which Turnbull firmly deconstructed ‘the Australia type deal’, thereby demolishing this Tory fib. The clip was replayed on Friday’s Today programme and it seems as if this had some effect, because when the PM spoke to journalists during his visit to Blyth (Northumberland) he didn’t trot out the usual misrepresentation.

‘It obviously would be different from what we’d set out to achieve but I have no doubt this country can get ready and, as I say, come out on World Trade terms’.

You’d think his tactical and diplomatic blunders couldn’t get any worse, but they reached an all time low on Friday, with reports that at this 11th hour, he tried to divide and undermine the EU side by seeking separate audiences with German and French leaders Merkel and Macron. The EU turned down his request. When asked about these reports, a Downing Street spokesman said: ‘I would point you to the PM’s words yesterday where he said he would go the extra mile to reach a fair deal, including going to Brussels, Paris or to Berlin’. So there we have it: this isn’t an embarrassing blunder or a desperate last minute measure due to pressure from senior Tories, but an indication of the lengths our illustrious PM is prepared to go to get these errant Europeans to see sense.   

Meanwhile, The Times spells out what a No Deal Brexit will mean, effects having been masked by the transition period. The alarming catalogue of prohibitions, price rises and shortages will create even more anxiety in an already anxious population. One example, as the UK is now officially ‘a third country’, is that UK holidaymakers will be barred from EU after 1 Jan under COVID rules. It will come as a shock to some that Brits will be lumped together with ‘other non-EU countries such as Albania and Turkey’…… Researchers based in Britain would lose access to European research funding programmes and students would no longer be able to take part in the Erasmus exchange programme. It is unclear on what terms British travellers would be allowed to drive and access healthcare in the EU and take their pets with them’. It will clearly involve a lot more paperwork for activities we’ve long taken for granted.

Interestingly, the article also describes the effects of Brexit on the EU bloc and some member countries – it would be interesting to know how many of these are anticipated by the residents. While the EU is predicted to lose at least €33 billion in lost annual exports, France will lose E3.6 billion and its fishermen prevented from entering British waters, Germany could lose E60 billion in exports and up to 400,000 jobs and Italy could find a big dent in its E21 billion of exports to the UK, its wine trade already suffering (half of all the exported prosecco comes to the UK).

V Day jingoism is now somewhat tempered by the not surprising news, despite Matt Hancock’s bullish assurance that he had every faith in the NHS, that dozens of GP practices won’t be taking part in the vaccination programme due to lack of capacity, so what happens to their patients? Surely they could end up waiting quite some time because those practices taking part will be prioritising their own patients. Two key deterrents for GPs are the contractual obligation to run vaccine clinics from 8 am till 8 pm, 7 days a week, and the need to monitor all vaccine recipients for 15 minutes afterwards, to check for adverse reactions. One GP seems to have captured the doubts of many colleagues, citing the “inflexible” contract and NHS England’s ability to unilaterally impose new conditions during the rollout, believing that these “pose a real risk to the safe and essential general medical services we provide to our patients, to the wellbeing of our colleagues, and to the financial stability of the GP practices”. How typical that Health Secretary Matt Hancock ‘tasked’ the NHS with this massive additional programme (‘I know they can do it’ aka ‘I’ll make them do it whatever the cost to their wellbeing’) without thinking through the implications of these barriers to participation.

As rising numbers of cases make it likely that London will be placed in Tier 3 next week, we’re told the not surprising news that Track and Trace, the cost of which has now rocketed to £22bn, is only managing to test 68% of its capacity and is still fails to trace a significant number of contacts. This is seriously worrying after all this time, but at least local public health departments are now much more involved in the process. Pubs in Tier 2 are taking good advantage of the ruling that a Scotch egg counts as a ‘substantial meal’, the necessity of which is the condition for customers buying alcoholic drinks. Some producers have seen Scotch egg sales rocket by 200%. Who’d have thought a year ago that the humble Scotch egg would become so newsworthy?

This week has seen yet more evidence of the development of a mental health crisis to match that of the pandemic. Demand for Young Minds’ parents services have risen significantly as children and young people across the UK continue to contend with the uncertainty and trauma of living through COVID and its consequences, including lengthy school closures, cancelled exams, the confusion over university places, compulsory isolation in student accommodation and poor prospects for the future including employment opportunities. Even one of these factors could lead to compromised mental health, but taken together, it’s hardly surprising that many young people and their parents have experienced anxiety, depression and grief. We are all, to some extent, susceptible to feelings of bereavement because of all the pressures and losses of this last year, one of the less acknowledged ones being the loss of spontaneity. Now, instead of just doing something, going somewhere or hugging a friend, so many factors have to be weighed up, including the likely stance of others on risk adversity and on compliance. Said one helpline volunteer: ‘The issues that parents are bringing tend to be more complex and more severe. The mention of suicide is definitely more common’. A report by the National Child Mortality Database said children’s deaths by suicide increased during the first lockdown, and since then the same factors continue to contribute, such as fragmented or suspended support services, tensions at home and isolation. While it’s very positive that such charities can be so helpful, it also reflects a failure of cash-strapped statutory services to meet these needs.

Still on mental health, the new chief executive of Samaritans, Julie Bentley, has spoken about the impact of COVID on mental health and why it’s important not to wait until someone becomes suicidal. She believes Samaritans have been crucial during the pandemic and she’s so right to say ‘being listened to without judgment is an extraordinarily powerful thing’, not least because volunteers (who are emotional support workers, not counsellors, usually) are at the end of a telephone, unlike (unless you seek help privately) regular mental health services, which are increasingly subject to long waiting lists, threshold criteria and limited hours of operation. ‘Just because somebody considers taking their own life, it is not inevitable that they will take their own life. That’s why it’s important that there are services like Samaritans where people can phone; not just because they’re feeling suicidal, but if they’re feeling troubled, distressed or concerned, they will find somebody who will listen, in a very real and meaningful way without judgment’.

A survey among Samaritans volunteers ‘offers a window into the impact of Covid on the national psyche: one in five calls over the past six months were from people who were specifically concerned about Covid, though volunteers surveyed suggest that the pandemic has affected every caller to some extent, with worries about isolation, mental ill-health, family and unemployment the most common concerns’. (This reminded me that one of the regular questions on the University College London Covid survey was about what caused respondents anxiety and the level of that anxiety – besides the expected categories like employment and relationships, etc, one was ‘future plans’.) Julie reminds us that suicide tends to rise during recessions and of course this is already happening, due to the pandemic and Brexit. She gets to the nub of it here – underinvestment in statutory services. ‘So we need to be mindful of where we’re at in the country … particularly as a result of coronavirus and the financial impact..We need to be concerned about the numbers of people feeling high levels of distress and to keep pushing to ensure there is a good provision of service…One of the things that is a worry is that of those people who do take their lives, many of them were not in touch with any mental health services. And we know that people are waiting too long to access services. So, mental health concerns are significant’.

Set up in 1953, Samaritans now has 201 branches in the UK and Ireland and there can’t be anyone who hasn’t heard of them. That’s not to be underestimated as often people don’t where to go to get help. We’re told that since March, staff have been “entirely focused” on addressing difficulties emanating from the pandemic. Between March and September they supported 1.2 million people – a colossal achievement, in my view, especially as many wouldn’t have been able to get help from statutory services when they acutely needed it. There’s a little CV of Julie Bentley at the end and it was good to see her interests reflect some of my own – ‘walking, reading, movies, long dinners and wine with loved ones’. Let’s hope she enjoys her new role and is able to continue conveying to government the need for mental health support.

Finally, there’s been quite a bit of coverage this week of light pollution and the need for more work on increasing visibility of ‘dark sky’. ‘Supported by the astronomer royal, a cross-party group urged the government to designate a “minister for the dark sky” and to establish a statutory commission to regulate excess lighting’. Light pollution is thought to be detrimental to mental health (eg disrupting hormone levels) and the environment, for example by interfering with breeding cycles and activity patterns, linking with the broader issue of climate change. Astronomer Royal (first time I knew we had such a thing) Martin Rees said: ‘Throughout history, people have looked up at the stars and tried to make sense of their place in the universe. It is a deprivation if people, especially, young people, can’t see that. Just as you don’t have to be an ornithologist to miss birds in your garden, you don’t have to be an astronomer to miss the night sky’. In a report launched this week and to be debated on 14 December, the All-party Parliamentary Group for Dark Skies made a number of recommendations, including the appointment of a minister for dark skies. Let’s just hope, if this comes to pass, it’s not Chris Grayling.

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.

One thought on “Saturday 12 December

  1. Pithy and apposite as ever, but I wonder if your estimates for mental illness are on the low side and will also be exacerbated by the ill-effects of Brexit which, as you say, have been woefully understated, if not deliberately denied by the cabinet who simply do not understand how all this is affecting anyone who isn’t white, affluent and middle class? Mathew Parris in yesterday’s Times was particularly scathing about this.


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