Mental health workers speak out on the challenges of the pandemic


Mental health workers Dr Nikola Leka and Sarah Ellyard spoke with Tom Eccles and Rachel Evans of Green Left about the exacerbated mental health crisis during the COVID-19 pandemic.

Were vulnerable people sufficiently supported during the pandemic?

Leka: No, they were abandoned, put in the basket too hard. There have been many stories of vulnerable people unable to obtain food and medicine.

Part of the reason is that vectors of person-to-person transmission in a pandemic will inevitably make personal care more difficult. From anecdotal accounts, the evidence across all sectors of healthcare is that we were generally unprepared.

Ellyard: The COVID-19 pandemic has exposed and exacerbated the problems that already existed for vulnerable people in our society and within the mental health system.

The rhetoric within the mental health sector is that the focus is on community care, which is the right approach. However, the funding and the resources are not there to make this feasible.

There are not enough mental health workers in the community and the support available is insufficient. In my experience, the systems and supports available are often difficult for people to navigate.

What are the main factors that cause mental health problems to emerge and develop?

Ellyard: There are many causes of mental health problems. I provide care to people with acute phases of mental health problems and am by no means an expert in all the causes of mental health problems.

Mental health issues can affect any of us, however, there are known factors associated with higher rates and exacerbation of mental health issues, including trauma, socio-economic disadvantage, and social isolation. .

What caused higher levels of mental distress during the pandemic? What impact has this had on frontline workers?

Leka: My work concerns older people with severe behavioral problems related to dementia. For this cohort, the imperative to provide practical care was stressful.

For others, delivering their mental health care entirely through electronic media is a challenge. Accessing health care through the Internet can be stressful and difficult for many people with mental distress who do not have good Internet access or secure housing.

What made it particularly difficult for the patients [during lockdowns] was their greatest reliance on social support from visitors and caregivers, who could not come to see them.

Ellyard: Social isolation has increased. The services were further extended. People have lost their jobs and their income. In the early stages of the pandemic and during the first lockdowns, people were reluctant to seek treatment for mental health issues and we have seen a drop in the number of people coming to services.

As more and more people started to seek help, we saw people whose mental health had been exacerbated by stressors such as job loss, working from home and isolation. social.

People have also come to mental health services for the first time. For those receiving inpatient mental health treatment, restrictions on visitors and waived holidays have added an additional layer of stress.

What structural and economic changes could help people in psychological distress?

Ellyard: We have to have a fairer society to start with, a society that helps people get housing, education and jobs. We need a lot more funding for community mental health services and primary health care.

We need an increase in Medicare funded sessions to see psychologists. When people need to be hospitalized, it is essential to improve the staff available to provide support and therapeutic commitment.

While psychiatric drugs will continue to be needed, the current system is too dependent on drugs as a center of treatment. It is essential that this change. I would love to see opportunities for nurses to improve their psychotherapy skills, but increased funding and endowment is essential for this.

Leka: We need safe housing and adequate income, and much higher levels of non-pharmaceutical interventions. We must also take into account that most people are aware of the climate catastrophe that is enveloping us.

Psychiatric drugs are of course necessary to improve acute symptoms. But there are not enough resources for health workers using other modalities such as counseling and the arts.

Professionals working as psychologists or in allied health care or nursing often have a rather unimaginative approach to treatment. But the financing of the imagination simply does not exist – and there is no tolerance for the risks that such approaches can entail.

Capitalism exploits the majority and has a disproportionate impact on vulnerable communities. What are the management strategies?

Leka: The best approach is to support what can be done through local community networks. There is much more that local councils can do. Small local initiatives emerged during the pandemic as residents of the neighborhoods decided to protect each other.

A conscious focus on fostering acceptance and good neighborliness would benefit everyone, not just those who may be labeled or diagnosed as “different”. Some of the approaches taken to health and education during Hugo Chavez’s time as a leader in Venezuela are worth exploring.

Ellyard: It is clear that an inequitable society exacerbates health inequalities and leads to poorer mental health outcomes. This highlights the need for a more just society and for universal access to services that include minority and marginalized groups.

What can COVID-19 teach us about treating mental health in the future?

Leka: The main thing is to ensure that we act locally, to tackle the causes of the major problems we are facing, in particular the degradation of human rights and of the planet. We must learn to live in relation to one another, rather than existing as “consumers”.

Ellyard: COVID-19 has increased the need for funding and funding of the mental health system. We must continue to de-stigmatize mental health problems and ensure universal access to mental health care.

We need to tackle social inequalities which we know contribute to poorer mental health outcomes. The challenges will continue to test all aspects of our health care system. Most importantly, we need to prepare the health system for the impact of the climate crisis which will have a huge impact on mental health.

[Dr Nikola Leka has been enrolled as a mental health nurse since 1982 and has a PhD in Health Social Science. Sarah Ellyard is a registered nurse working in mental health.]


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