OPINION: Keeping the UK’s mental health together feels like mission impossible

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OPINION: Keeping the UK’s mental health together feels like mission impossible

Consultant Psychiatrist Dr Mark Silvert reflects on the impact of the lockdown on people's mental wellbeing

Dr Mark Silvert

I am staring out the window after I finish another day of virtual consultations, the park nearby is sunny and yet uninviting.

Fear seems to be whistling through the trees, the air no longer a welcome refreshment but a possible source of contagion. 

Especially if you have health anxiety.

I find myself thinking of Tom Hanks and it takes me a while to work out why. 

The obvious answer would be that he has been in the news all week as the most notable celebrity index case that has tested positive for coronavirus (COVID-19). 

But it’s not that, it’s a memory of one of my favourite films, Apollo 13.

I can hear the voice of Ed Harris playing flight director Gene Krantz, as he turns to his leading rocket scientists at NASA.

“So you’re telling me you can only give our guys 45 hours. It brings them to about there,” he points halfway between the moon and Earth.

Dr Mark Silvert

“Gentlemen, that’s not acceptable. I suggest you invent a way to put a square peg in a round hole. Rapidly.”

In order to enter the atmosphere safely, the crew must aim for a corridor just two and a half degrees wide. If they’re too steep, they will incinerate in the steadily thickening air, if they’re too shallow, they’ll ricochet off the atmosphere like a rock skipping off a pond.

Hanks who played astronaut Jim Lovell, fires up their lunar module to launch them thousands of miles to the moon and slingshots them safely back to Earth. 

My point is they had to get the burn just right against all the odds. I think this is the reason it has been bouncing around my brain all day. It feels strangely familiar.

How is it any different to our Chief Medical Officer, Prof Chris Whitty’s comments throughout this pandemic about our response?

Timing as ever, is everything.  

This is the most serious threat humanity has faced in most of our lifetimes. While this is not an existential threat, the threat to public health and the world economy looks to be devastating. 

If we had locked down the country down too soon we risk public fatigue, loneliness, poor mental health outcomes and a potentially higher economic toll. Lock down too late and we enter a potential pandemic abyss, with millions that could fall ill.

Neither bring any comfort.

For those with OCD and health anxiety, or any generalised anxiety disorder, this outbreak is basically their very worst nightmare coming true. With one in three of us suffering from one of the above diagnoses, it goes without saying that’s a lot of people who are struggling at the moment. 

I treat many people who will have to isolate alone who already struggle with social interaction, whether it’s due to a chronic psychotic illness or an array of many others. 

Keeping the mental health of the nation together feels a bit like mission impossible right now, but that does not mean we should not give it a bloody good British go. 

One of the best things about my job as a mental health professional is that I don’t need to be in the same room as my patient to do my job. I can connect with my patients virtually and continue to see as many as possible.

So let’s use the technology we have and a bit of creativity – we can continue to provide your medications, I sent dozens of prescriptions today to pharmacies around London.

Mental health treatment, even with the best team (of which I feel lucky to be a part) takes time. Therapists and psychologists: stand ready to listen and absorb the mental health burden from this pandemic that is to come. This is going to be a marathon not a sprint.

Since February we have witnessed the Kubler-Ross model (aka the five stages of grief) and Maslow’s hierarchy of needs in action on an unprecedented level since the Second World War. 

Society and the individual are currently going through shock, denial, frustration and depression, but then will come experimentation, decision making and integration. 

Maslow’s hierarchy basically argues that humans have a series of needs, some of which must be met before they can turn their attention toward others. 

Even as a fairly seasoned psychiatrist, I never would have guessed the need for toilet paper would slot into the hierarchy pyramid during a pandemic!

The odds of getting that NASA crew back were probably a hundred million to one; a crippled spacecraft drifted thousands of miles away from our planet while hundreds of the world’s smartest (literal rocket scientists) worked around the clock for weeks without sleep to find a way. 

That’s exactly what we need to do to now to overcome this  – play for time, and let our brightest scientists and brave medics find a way to bring us all back to the planet we miss. 

The world is uniting in healthy competition as Israel pioneers multiple trials for treatments and a vaccine.

Let’s work hard to support each other; we each need to do our bit. Let’s give ourselves the badly needed time to ’work the problem’. 

At The Blue Tree Clinic we are doing as much pro bono work as we can for those in our community that find themselves in need at this time for their mental health. 

  • By Dr Mark Silvert MBBS MRCPsych Msc (Consultant Psychiatrist), Medical Director and Clinical Lead of Mental Health, The Blue Tree Clinic (Working From Home)


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