Abstract
PurposeWe sought to understand how the experiences of people in the UK with pre-existing mental health conditions had developed during the course of the COVID-19 pandemic.MethodsIn September–October 2020, we interviewed adults with mental health conditions pre-dating the pandemic, whom we had previously interviewed 3 months earlier. Participants had been recruited through online advertising and voluntary sector community organisations. Semi-structured qualitative interviews were conducted by telephone or video-conference by researchers with lived experience of mental health difficulties, and, following principles of thematic analysis, were analysed to explore changes over time in people’s experience of the pandemic.ResultsWe interviewed 44 people, achieving diversity of demographic characteristics (73% female, 54% White British, aged 18–75) and a range of mental health conditions and service use among our sample. Three overarching themes were derived from interviews. The first theme “spectrum of adaptation” describes how participants reacted to reduced access to formal and informal support through personal coping responses or seeking new sources of help, with varying degrees of success. The second theme describes “accumulating pressures” from pandemic-related anxieties and sustained disruption to social contact and support, and to mental health treatment. The third theme “feeling overlooked” reflects participants’ feeling of people with mental health conditions being ignored during the pandemic by policy-makers at all levels, which was compounded for people from ethnic minority communities or with physical health problems.ConclusionIn line with previous research, our study highlights the need to support marginalised groups who are at risk of increased inequalities, and to maintain crucial mental and physical healthcare and social care for people with existing mental health conditions, notwithstanding challenges of the pandemic.
Highlights
Since the World Health Organization declared COVID-19 a pandemic in 2020, the consequences for human health and society continue to be experienced globally
Our work shows that policy-makers and service planners need to prioritise maintaining and optimising access to mental and physical health care for people with existing mental health conditions, as this was a concern expressed by our interviewees
Despite being forced to find ways to adapt to COVID-19 restrictions, both during lockdown and in the period after this, many participants in our study reported struggling to cope and a deterioration in psychiatric symptoms
Summary
Since the World Health Organization declared COVID-19 a pandemic in 2020, the consequences for human health and society continue to be experienced globally. Two large UK national surveys [10, 11] reported conflicting findings about whether anxiety and depression increased for people with existing mental health conditions during the early months of national lockdown. These surveys suggest that the impact of the pandemic on people with mental health conditions may not be uniform and is not yet fully understood: qualitative exploration of people’s experiences is needed. Unequal impacts of the pandemic were identified among people with existing mental health conditions [12], with additional hardships amongst Black, Asian, and minority ethnic (BAME) communities, those with physical health conditions and socioeconomic disadvantages [12] These hardships are likely to persist with ongoing restrictions. Changes to mental health service delivery, including transition to remote technologies [15], have remained in place and may continue to influence the experiences of people with mental health conditions
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