Written Statement: Mental health and the Coronavirus Pandemic

The coronavirus pandemic continues to have an impact on all aspects of our lives, particularly on our mental health and wellbeing.

This statement outlines the actions we have taken to respond to the immediate mental health-related effects of coronavirus and how we will support people and communities through the autumn and winter months ahead.

We have carefully analysed a range of data to understand how coronavirus and the national response has affected people’s general mental health and wellbeing. People have commonly reported feeling raised levels of anxiety since before lockdown started in March. This has eased as the restrictions were lifted through the summer months, but there is a real risk we could see population anxiety levels increase again as we respond to a new wave of coronavirus this winter.

A number of surveys carried out over the course of the lockdown reveal some of the potential causes of this increased anxiety, including concern about personal health and the health of loved ones; concern about personal finances; worry about the wellbeing of children and feelings of loneliness and isolation.

The pandemic has had a disproportionate impact on particular groups in society, particularly those on a low income; people with an existing mental health condition; children and young adults and people from Black, Asian and Minority Ethnic (BAME) communities.

There is no single response to these issues – they require multifaceted and multi-agency approaches, developed through collaboration across sectors, across government departments and across services.  Preventing and supporting the mental health and wellbeing needs of the population is not something the NHS can – or should – do alone.

We have focused our response to the mental health impact of the pandemic on three key areas:

• Maintaining mental health services and responding to immediate mental health needs;
• Strengthening protective factors and reducing the socioeconomic impacts of the pandemic on mental health and wellbeing;
• Supporting the NHS to meet the changing mental health needs in their areas, while planning for a second wave and ensuring mental health services can stabilise and recover for the long term.

Mental health services were classified as an ‘essential service’ during the early stages of the pandemic. They have remained accessible and able to respond throughout the pandemic and lockdown.

At the onset of the pandemic, we released the planned mental health service improvement funding of £3.5m to health boards to support the maintenance of essential mental health services while responding to the immediate pandemic pressures. We also provided an additional £2.2m for inpatient surge capacity to ensure mental health units had flexibility to manage additional demands and to deal with any outbreaks of the virus.

We also expanded the CALL mental health helpline and worked with Public Health Wales to provide tailored online information to support people to manage their mental health during the lockdown period.

Building on this, we have provided £1.3m to support the rollout of Silvercloud, an online cognitive behavioural therapy pilot; MIND Cymru’s Active Monitoring; the Young Person’s Mental Health Toolkit and BEAT’s Eating Disorders helpline are also available. These tier 0 services do not replace specialist services but provide easy access to support and aim to reduce demand on local primary mental health services. We have also provided funding for a range of regional approaches to reduce suicide and self-harm including bereavement support, training and awareness raising.

The NHS and social services have a very important role to play in responding to the changing mental health needs of our communities, it has become clear the areas we need to strengthen lie in areas outside health – for example, employment support, homelessness prevention and debt support. This can only be achieved through an effective cross-government and multi-agency approach. The Health Minister has written to all Cabinet Ministers to highlight the evidence underpinning this approach and officials have been working across departments to strengthen actions to respond to the wider socioeconomic and other societal harms.

These new actions are set out set in a refreshed version of our Together for Mental Health Delivery Plan 2019-22. The plan has been updated to ensure the actions respond to the pandemic. We have accelerated a number of actions to respond to the immediate mental health needs. These include extending tier 0 support, the Wales Traumatic Stress Quality Improvement Initiative and the rollout of Health for Health Professionals to support NHS staff. 

The refreshed plan sets out significant new actions in those areas that are important protective factors to support mental health and wellbeing. Support and resilience in these areas is a critical part of a system wide response to lessening the socio-economic impact of the pandemic on well-being and reduce the need to access mental health services. This includes, but is not exclusive of, education, employment, financial inclusion and homelessness support. 

I will continue to work jointly with the Minister for Education on our Whole School Approach to emotional well-being. We recently announced an extra £5m for mental health in schools. Alongside £450,000 to go towards supporting mental health and well-being of the school workforce, funding is also provided for developing further provision for schools counselling and mental and emotional support to children younger than year 6. We have also developed the Youth Mental Health Toolkit, which launched in June and is hosted on HwB.

In July, the Minister for Transport, Economy and North Wales announced a £40m investment in the Covid Commitment to support jobs and skills. This will be targeted to help those most affected by covid-19, including young people. The new funding will extend existing support through our In Work and Out of Work Support Services.

The work the Minister for Housing and Local Government has led to support the homeless population during the pandemic has provided an opportunity for us to deliver on our commitment to provide better mental health and substance misuse wrap-around support for some of the most vulnerable people in our communities.

Through the hard work of partners in local authority housing teams, mental health and substance misuse services we have seen a much better integration of health and social services support with some vulnerable individuals being reached for the first time with the help and support that they need. The refreshed delivery plan also includes new actions to support tenants who are struggling with rent arrears and will include signposting/referral to other advice services or support where necessary. We are also further extending notice periods for eviction from assured and assured short hold tenancies to six months recognising the devastating mental health impact of home insecurity.

We are concerned about the disproportionate impact the pandemic has had on particular groups in society, particularly those who may be financially vulnerable, on low incomes and from BAME communities. 

The refreshed delivery plan reflects new actions on the Single Advice Fund and the further investment of £1.4m links with mental health support to help reduce the impact of debt on mental health. Despite improvements we are making to the scale and availability of mental health services and support, not all groups access such provision in an equitable way. I am particularly concerned about higher levels of anxiety among BAME communities and evidence of lower levels of take up of mental health support. 

To address this, additional funding is being provided to Diverse Cymru to further embed the BAME Mental Health Workplace Good Practice Certification Scheme in Wales. We will continue to work with Diverse Cymru and other key stakeholders to ensure mental health services are accessible and culturally appropriate. We are also strengthening our engagement with third sector agencies to ensure all have a voice in policy decisions going forward.

The Winter Protection Plan was published last month, setting out our overarching plan and priorities for health and social care until March 2021. It reinforces the need to continue to position mental health as an ‘essential service’ and we encourage people to access mental health services when they need them.

A set of high-level principles to guide the delivery of mental health services are currently being co-produced with the third sector, service users and other partners. This will help guide service planning and ensure there is clearer communication and understanding of what service users find important and what services will be able to deliver over the coming months.

There are a number of changes many service users have welcomed – particularly the increased opportunities to engage digitally. Even if everything went back to the “old normal” tomorrow, we would collectively decide that some of the rapid changes we have put in place to manage the coronavirus pressures have been positive and should remain.  Working together to plan for the coming winter conditions and ongoing coronavirus response will also help us to establish service principles that inform the longer term.

We also continue working across the NHS and its partners as part of our recovery approach to enable us to meet the changing mental health needs of the population. This will include access to additional investment for tier 0 services, lower level mental health support as well as a commitment to the priority areas set out in the 2019-22 Mental Health Delivery Plan, including increased access to psychological therapies, CAMHS services, eating Disorders support and perinatal services.

We invest around £700m every year in NHS mental health services and protect that investment through the mental health ring-fence. In 2020-21, we provided £3.5m of planned service improvement funding at the start of the pandemic to support mental health services and we are currently releasing the remaining £3.5m service improvement funding to invest in line with the priorities of the delivery plan.

Additional investment supporting mental health services this year amounts to £8.5m, which comprises:

• £5m for the whole school approach
• £1.3mto accelerate tier 0/1 support
• £2.2m for surge capacity

We are unable to predict exactly how the pandemic will impact on mental health, what is clear is that a collaborative and partnership approach is needed to respond to the nation’s mental health and wellbeing needs – and we all have a role to play in this.