Covid-19: a looming mental health crisis

Sam Gleaden , mental health worker , Unison steward (personal capacity)

From a psychological perspective, the Covid-19 crisis looks like something from the pages of a dark dystopian novel or an episode of the TV series Black Mirror. Society is being asked to separate from each other in either complete, or near-complete isolation to slow the spread of the disease. Although it is clearly necessary for there to be far-reaching measures that can slow and halt the spread of the virus - the full effects of these extreme social distancing measures are unprecedented, and will be felt for years, if not decades to come.



World Capitalism was already in the middle of a mental health crisis pre-coronavirus. The World Health Organisation ( WHO) has recently reported that depression is the fastest growing form of disease in the world. Against multiple measures, the world's mental health was already in steep decline.


Loneliness, job dissatisfaction, stress, as well as statistics for more serious conditions such Anorexia or Schizophrenia all pointed towards a society which was producing mental distress at an alarming level. Years of austerity, the housing crisis and general economic decline, combined with a largely toxic individualistic consumer culture, have left many people’s mental health in tatters.


Covid-19, and capitalism’s failure to deal with it, is going to massively exacerbate these underlying issues.


Need for human contact


Humans beings need to have consistent contact with other people to help regulate our emotions, feel a sense of purpose and even to keep physically healthy. Many studies suggest that the impact of isolation and loneliness on health and mortality are of the same order of magnitude as such risk factors as high blood pressure, obesity, and smoking.


Although the scale of the Covid-19 crisis is unprecedented, there is research coming from Wuhan, as well as from previous epidemics, as to the potential consequences of a long-term lockdown . For example, a study from Emerging Infectious Diseases Journal into the effects of Quarantine during the SARS epidemic of the early 2000s found disturbing results. It showed that 31.2% of the total respondents who had spent a period in isolation had symptoms of Depression and Post traumatic Stress disorder ( PTSD). To put that into some context, PTSD is caused by terrible emotional trauma and is often seen after extreme acts of abuse or warfare. The participants made clear that it was both the isolation from family member as well as the fear of disease itself which combined to cause them such distress.


We are now seeing similar reports coming from Wuhan after their 6 week quarantine, this time on much larger scale. A report from Emerging Infectious Diseases Journal has shown that the brutal quarantine has caused a massive spike in psychological distress. China's poor mental health system is hopelessly ill-equipped to deal with the nature and scale of a crisis like this. Unfortunately, there are clear parallels with the inadequacies of our own under-funded mental health services which are likely to face a similar battle in the coming months.


Added to this, The Lancet has published data showing the likely psychological damage that health workers will suffer from the aftermath of this based on previous epidemics. Health workers can be susceptible to PTSD and depression up to three years after a period of isolation of only 10 days. This is without taking into account the already traumatic experience of dealing with making life and death decisions in hospitals cut to shreds by years of austerity. Hospitals already regularly run at 100-105% bed capacity in winter, with a similar pattern across global health systems. Tragically, we have already seen a suicide of an Italian doctor traumatised by the fear of spreading the coronavirus to her patients due to a lack of Personal protective equipment (PPE).


For most of us social distancing will be a matter of dealing with periods of extreme boredom , anxiety, loneliness and low-level depression. A recent Ipsos-MORI poll found 62 per cent of Britons are finding it harder to stay positive about the future, while 55 per cent found it harder to stay positive day-to-day since Covid-19.


For others, lockdown will have much worse consequences. The vulnerable and elderly who will have to remain in complete isolation are at risk of developing traumatic symptoms. Pre-existing mental health conditions are also much more likely to be triggered by social distancing measures and economic hardship. For example, there was a harrowing report in the media this week on a young woman with mental health issues driven to suicide because of her fears over social distancing measures. Finally, there is the added pressure on relationships and, at the same time, there has already been a massive spike in domestic violence cases across the world.


Need for Socialist system


Overall, when we take into account the full multifaceted nature of the overwhelming economic and psychological consequences of Covid-19 lockdown, it’s clear that total lockdown is not a long-term solution. Although social distancing measures are undoubtedly necessary to act as a stop gap for our heath service, a plan is needed to get on top of the virus and its consequences. Crucial in doing this is the rolling out of widespread testing to the whole of society, not just the rich elite, the nationalisation of the pharmaceutical companies to end destructive competition and accelerate the development of a vaccine, and a massive injection of the necessary resources into our NHS.


Very importantly, it should be working-class people, including the key-workers on the front lines, rather than the callous Tories who have full democratic control of what measures are taken and for how long. Workers have already shown the way by taking strike action to shut down non-essential workplaces, such as recently by ASOS factory workers. And it should be working-class people, who unlike the bosses' politicians instinctively prioritise the needs of people over profit, who democratically decide when and how things can reopen.


The reaction to this crisis of capitalist governments around the world has already shown how completely incapable their system is of acting in the interests of the majority, or of the long-term planning required to solve the problems created by it.


Mass testing for the whole population, as advised by the WHO - especially if it were able to accurately establish immunity - could potentially allow for some people to safely return to work and come out of isolation. Meanwhile a fully public, properly-funded health service, including mental health provision, could not only much better treat the direct victims of the virus, but could also make prioritising people's mental health a priority, with innovative methods use to maximise support available for those suffereing as a result of isolation.


Even before this crisis, a massive expansion of mental health services, including to have parity with physical health, was already urgently needed. We also need to end the exploitative practices that many workers live under with insecure contracts, low wages , cramped expensive housing and bullying bosses - which all contribute to mental distress.


This would require a complete restructuring of the economy, in which the major monopolies that currently dominate are brought under public ownership and run democratically by and for the working class.This would lay the basis for democratic planning of the economy to create a system which provides for the needs of all. The fact that testing has not even been made available to all NHS staff yet gives an indication of just how derisory the government's reaction to this virus has been.


Finally, as much as the world under Covid-19 seems like a bleak picture, there are clear signs for hope and positivity. We have already seen a huge growth community spirit and altruism. The 500,000 volunteers that signed up for NHS support in just 48 hours, mass trade union action to defend workers safety, hundreds of mutual aid groups that have been created, and finally, the moving scenes on Thursday evening as millions applauded from their window to show support for the NHS workers. These all display the growing sense of solidarity and community which will be the bedrock for supporting each other through this incredibly difficult time.


The reaction of workers also goes against the toxic and false idea that human nature is fundamentally self-interested. Both culturally and politically, Covid-19 will be remembered as a momentous historical turning point. It will become clear through this crisis that it is not human nature which incapable of the selflessness, ingenuity and heroism required. But instead it is the creaking capitalist system which benefits a ruling elite at the expense of the rest of us, which ultimately sees profit as the most pressing of all needs. It’s this system and its representatives which need to be replaced.

Times of extreme crisis such as wars or economic collapse have produced massive social upheaval often with massive revolutionary ramifications. For example, the aftermath of the second world war brought with it huge revolutionary potential and immense desire for fundamental change. In Britain, capitalism as a system was forced to make huge concessions to the working class in order to stave off the threat of social revolution. The Labour government of 1945 created welfare state, including the NHS, carried out a programme of massive investment in public housing on a scale not seen before and more. However, these changes only happened because the working population used its power, acting collectively to force political change.


This is the opportunity we have today, to fight for a socialist society which can provide for all our needs – both psychological and economic.