Analysis

COVID-19 and mental health: why nurses will have a key role in people’s recovery and support

An estimated 10 million people in England alone will need support for depression, anxiety and other mental health issues, and nurse-community partnerships will be vital in helping to provide this

An estimated 10 million people in England alone will need support for depression, anxiety and other mental health issues, and nurse-community partnerships will be vital in helping to provide this

  • People at greater risk of mental health issues include those treated for COVID-19 in intensive care and NHS workers
  • Mental health teams are stretched to breaking point
  • Health organisations raise concerns over the UK’s economic readiness to respond post-pandemic
Picture shows worried man with woman standing behind with her hand on his shoulder
Picture: iStock

Is it possible to calculate the effect of the COVID-19 pandemic on the nation’s mental health?

Researchers in several campaigning organisations have tried, such as those at the Centre for Mental Health (CMH), which seeks to drive change in policy and practice.

Using international research into previous epidemics and a ‘demand model’ developed with NHS experts, the CMH estimates 10 million people in England alone will require support for depression, anxiety and other mental health issues in the coming months.

Two thirds of these will have existing mental health problems and may be known to services. The remainder will need help and support for the first time.

Mental health support is urgently needed to avert a crisis

People treated for COVID-19 in intensive care, the bereaved and those affected by unemployment – as well as NHS workers – are at greater risk.

CMH chief economist Nick O’Shea says the numbers are stark and wants to see urgent government action so unresolved needs do not become a crisis.

‘We cannot afford to wait and see or to leave it until after the pandemic has subsided. That means putting in place plans to identify people who need mental health support and ensure they receive the right care quickly’

Nick O’Shea, chief economist for the Centre for Mental Health

‘COVID-19 is a disaster for every country that has been badly affected and the consequences for our mental health are just as severe,’ he says.

‘We cannot afford to wait and see or to leave it until after the pandemic has subsided.

‘That means putting in place plans to identify people who need mental health support and ensure they receive the right care quickly.’

The CMH is not alone in its bleak forecast.

COVID-19 survivors likely to be at greater risk of developing mental health problems

Analysis by researchers in Oxford, based on more than 62,000 cases of COVID-19 in the United States, found that one in five of people with coronavirus received a psychiatric diagnosis within three months. One quarter of these had no previous mental health diagnosis.

University of Oxford professor of psychiatry Paul Harrison says: ‘People have been worried that COVID-19 survivors will be at greater risk of mental health problems and our findings show this to be likely.

‘Services need to be ready to provide care, especially since our results are likely to be underestimates of the actual number of cases.’

Elsewhere, Mind and the University of Glasgow are among other organisations to publish studies demonstrating the serious effect of the pandemic on mental health.

Picture shows fed up man looking at his mobile phone. Social distancing has helped contain the pandemic, but isolation will affect mental health
Social distancing has helped contain the pandemic, but isolation will affect mental health. Picture: iStock

With evidence mounting of increased demand, there are concerns about services’ readiness to respond, especially if investment is squeezed as the UK struggles to balance the books post-pandemic.

A Trades Union Congress report highlighted how one in ten NHS mental health posts was unfilled, with net recruitment of nurses ‘getting worse’.

A nurse psychotherapist quoted in the report said teams were stretched to breaking point.

Treasury pledges extra £500 million for mental health services in England

In 2019, the King’s Fund highlighted the urgent action required to plug workforce gaps, in particular the shortage of mental health nurses.

There are, however, some successes.

Chancellor Rishi Sunak announced an extra £500 million for mental health services in England as part of the recent autumn spending review.

And the Improving Access to Psychological Therapies (IAPT) programme in England has offered a quick route in to support for many with problems, such as anxiety.

But with waiting times rising in some areas, IAPT may come under more strain.

Nurses’ skills and expertise often go unrecognised

Catherine Gamble, former RCN professional lead for mental health and now head of nursing education, practice and research, South West London and St George’s Mental Health NHS Trust, is not confident services can cope with increased demand.

Catherine Gamble, head of nursing education, practice and research, South West London and St George’s Mental Health NHS Trust
Catherine Gamble. Picture: David Gee

Despite renewed interest in mental health nursing as a career option, she believes that a lot of money and effort is being invested in mental health roles outside the profession, while nurses’ skills and expertise go unrecognised.

‘Why are we not investing in the existing professions?’ she asks.

Looking ahead six months to a year, Ms Gamble predicts much of the burden of supporting people with mental health needs will fall on families and communities.

Community cohesion has been one of few bright spots in a grim year, from doorstep gatherings to ‘clap for carers’ to hyperlocal WhatsApp groups offering help to neighbours.

Is it reasonable to expect this civic unity can be harnessed to complement overstretched mental health nursing teams?

Plans for ‘listening campaign’ to support and protect people’s mental health

An event organised by a coalition of statutory services and community organisations in London suggests a vast resource is waiting to be tapped.

The online summit brought together 450 individuals and alliances representing professionals, volunteers, experts by experience, support groups, faith groups and charities. The aim was to shape local initiatives to safeguard those at risk of pandemic-related mental ill health and follows two similar events earlier in the year.

These events have seen the ambition emerge to launch a major ‘listening campaign’ to support and protect people’s mental health while a full action plan is to be launched in the spring.

Access all areas: community resources for nurses

Community: picture shows various people looking outside various windows of a building
Picture: iStock

A blog by Public Health England examines community responses to COVID-19 and includes links to resources mental health nurses may find useful in building partnerships to meet rising demand, including:

Nurse-community partnerships will play ‘crucial role’ in preventing mental ill health

Sir Norman Lamb, chair of the South London and Maudsley NHS Foundation Trust and former care minister who led the summits, says nurses will play ‘an absolutely crucial role in this endeavour’.

Sir Norman Lamb. Picture: UK Parliament

‘The whole idea of this is, rather than the trust sitting back and waiting for demand to hit, which is the traditional way in which mental health trusts operate, we seek to prevent mental ill health.

‘This is a new approach where we actively go out and say we’ve got a responsibility to work with partners, to be an asset in the community, supporting the work of others – to help communities be more resilient, to give them the ability to support more effectively people falling into distress for various reasons.

‘This is a moment to be creative and think about how we can use our expertise as professionals to support communities through this difficult time.’

For some mental health nurses and services, this approach is not new.

‘This is a moment to be creative and think about how we can use our expertise as professionals to support communities through this difficult time’

Sir Norman Lamb, South London and Maudsley NHS Foundation Trust chair

Five years ago, Public Health England published guidance on community-centred approaches to health and well-being.

Ramp up health services in preparation of future pandemics?

And many nurses have long experience of facilitating support groups in community settings and co-producing service responses in partnership with community groups.

But predicted rises in pandemic-related demand suggest the scale of such approaches needs to be ramped up if NHS services are not to be overwhelmed.

A panel of international experts say that now is the time to put in place targeted and effective provision that promotes new practices, expands access and which can be scaled up. Such approaches ‘could even turn the COVID-19 pandemic into an opportunity to improve mental healthcare for everyone’, they claim.

Six key areas to prevent COVID-related mental health crisis

South London Listens, a campaign by the South London Mental Health and Community Partnership, is producing an action plan to identify and address issues affecting local communities.

It targets six key areas to help prevent a COVID-related mental health crisis:

  1. Social isolation
  2. People at risk of losing their jobs
  3. Housing insecurity
  4. Communities experiencing disadvantage
  5. Families, children and young people
  6. Developing a long-term, joined-up approach to preventing mental ill health

View our COVID-19 resources centre

Find out more


Jobs