The Duke and Duchess of Cambridge have lent their support to a Public Health England initiative to boost the nation’s mental health during the coronavirus pandemic.

On Sunday PHE launched new guidance on how to look after your own wellbeing as well as that of children and other dependants during the shutdown.

At the same time they updated the guidance on what you should do if you have coronavirus symptoms.

The wellbeing guidance, which can be found on its website, offers tips on staying in touch with loved ones using video calls and social media, as well as establishing a healthy sleep pattern or starting a new hobby.

Mental health minister Nadine Dorries, who was herself diagnosed with Covid-19, also announced an additional £5 million in funding to leading mental health charities to expand their services.

The Duke and Duchess of Cambridge said: “The last few weeks have been anxious and unsettling for everyone.

“We have to take time to support each other and find ways to look after our mental health.

“It is great to see the mental health sector working together with the NHS to help people keep on top of their mental wellbeing.

“By pulling together and taking simple steps each day, we can all be better prepared for the times ahead.”

The guidance, which was developed with the input of mental health charities and clinically assured by the NHS, also has points on how to help children manage stress.

There is also support for those who are already living with a serious mental health problem, such as how to access help from mental health professionals.

PHE said it is issuing guidance to trusts on prioritisation of services and how to maximise use of digital and virtual channels to keep delivering support to patients.

It said NHS mental health providers are also establishing 24/7 helplines.

Ms Dorries said: “When I discovered I had coronavirus I felt anxious and scared.

“For those who already suffer with anxiety or other mental health issues this may present new and difficult challenges.

“It’s imperative that we stay home if we are to beat coronavirus and save lives.

“I know how important it is that people have support to look after their mental health and this guidance will be of huge value.”

Mind is one of a consortium of charities preparing to adapt and increase their services.

They are reaching out to vulnerable groups including older adults and people with underlying health conditions, and also anyone experiencing unstable employment and housing conditions.

Paul Farmer, chief executive of Mind, said: “Reaching out to friends and family is critical, as well as paying attention to the impact our physical health can have on our mental health – from diet and exercise to getting enough natural light and a little fresh air.”

He added: “Whether we have an existing mental health problem or not, we are all going to need extra help to deal with the consequences of this unprecedented set of circumstances.”

Latest PHE guidance on Covid-19

The advice for anyone in any setting is to follow these main guidelines.

  1. The most common symptoms of coronavirus (COVID-19) are recent onset of a new continuous cough and/or high temperature. If you have these symptoms, however mild, stay at home and do not leave your house for 7 days from when your symptoms started (if you live alone), or 14 days (if you live with someone who has symptoms). You do not need to call NHS 111 to go into self-isolation. If your symptoms worsen during home isolation or are no better after 7 days, contact NHS 111 online. If you have no internet access, you should call NHS 111. For a medical emergency dial 999.

  2. Wash your hands more often than usual, for 20 seconds using soap and hot water, particularly after coughing, sneezing and blowing your nose, or after being in public areas where other people are doing so. Use hand sanitiser if that’s all you have access to.

  3. To reduce the spread of germs when you cough or sneeze, cover your mouth and nose with a tissue, or your sleeve (not your hands) if you don’t have a tissue, and throw the tissue in a bin immediately. Then wash your hands or use a hand sanitising gel.

  4. Clean and disinfect regularly touched objects and surfaces using your regular cleaning products to reduce the risk of passing the infection on to other people.

At the current time and based on our understanding of what is known of COVID-19 and other similar respiratory viruses, it is likely that older people and those with chronic medical conditions may be vulnerable to severe disease. As more information emerges, recommendations may change.

PHE guidance on mental health and wellbeing in full

The coronavirus (COVID19) outbreak is going to have an impact on everyone’s daily lives, as the government and the NHS take necessary steps to manage the outbreak, reduce transmission and treat those who need medical attention.

It may be difficult, but by following guidance on social distancing, or staying at home, you are helping to protect yourself, your family, the NHS and your community.

During this time, you may be bored, frustrated or lonely. You may also feel low, worried, anxious, or be concerned about your health or that of those close to you. Everyone reacts differently to events and changes in the way that we think, feel and behave vary between different people and over time. It’s important that you take care of your mind as well as your body and to get further support if you need it.

Background

This guide provides advice on how to look after your mental health and wellbeing during the coronavirus (COVID-19) outbreak.

For wider guidance on how to protect yourself and others, and actions to take if you think you may have contracted the virus please see the guidance on this page.

This guidance will be updated in line with the changing situation.

What can help your mental health and wellbeing

Consider how to connect with others: Maintaining relationships with people you trust is important for your mental wellbeing. Think about how you can stay in touch with friends and family via telephone, video calls or social media instead of meeting in person – whether it’s people you normally see often or connecting with old friends.

Help and support others: Think about how you could help those around you – it could make a big difference to them and can make you feel better too. Could you message a friend or family member nearby? Are there community groups that you could join to support others locally? Remember it’s important to do this in line with guidance on coronavirus (COVID-19) to keep yourself and everyone safe. And try to be accepting of other people’s concerns, worries or behaviours.

Talk about your worries: It is quite common to feel worried, scared or helpless about the current situation. Remember that this is a difficult time for everyone and sharing how you are feeling and the things you are doing to cope with family and friends can help them too. If you don’t feel able to do that, there are people you can speak to via NHS recommended helplines or you could find support groups online to connect with.

Look after your physical wellbeing: Your physical health has a big impact on how you are feeling emotionally and mentally. At times like these, it can be easy to fall into unhealthy patterns of behaviour which in turn can make you feel worse. Try to eat healthy, well-balanced meals, drink enough water, exercise inside where possible and outside once a day, and try to avoid smoking, alcohol and drugs.

If you are able to go outside, consider walking or gardening (keeping the recommended 2 metres from others as outlined in the social distancing guidance). If you are staying at home, you can find free easy 10 minute work outs from Public Health England or other exercise videos to try at home on the NHS Fitness Studio. Sport England also has good tips for keeping active at home.

Look after your sleep: Feeling anxious or worried can make it harder to get a good night’s sleep. Good-quality sleep makes a big difference to how you feel mentally and physically, so it’s important to get enough.

Try to maintain regular sleeping patterns and keep good sleep hygiene practices – like avoiding screens before bed, cutting back on caffeine and creating a restful environment. The Every Mind Matters sleep page provides practical advice on how to improve your sleep.

Try to manage difficult feelings: Many people find the news about coronavirus (COVID-19) concerning. However, some people may experience such intense anxiety that it becomes a problem. Try to focus on the things you can control, including where you get information from and actions to make yourself feel better prepared.

It is okay to acknowledge some things that are outside of your control right now but constant repetitive thoughts about the situation which lead you to feel anxious or overwhelmed are not helpful. The Every Mind Matters page on anxiety and NHS mental wellbeing audio guides provide further information on how to manage anxiety.

Manage your media and information intake: 24-hour news and constant social media updates can make you more worried. If it is affecting you, try to limit the time you spend watching, reading, or listening to media coverage of the outbreak. It may help to only check the news at set times or limiting to a couple of checks a day.

Get the facts: Gather high-quality information that will help you to accurately determine your own or other people’s risk of contracting coronavirus (COVID-19) so that you can take reasonable precautions. Find a credible source you can trust such as GOV.UK, or the NHS website, and fact check information that you get from newsfeeds, social media or from other people.

Think about how possibly inaccurate information could affect others too. Try not to share information without fact-checking against credible sources.

Think about your new daily routine: Life is changing for us all for a while. Whether you are staying at home or social distancing, you are likely to see some disruption to your normal routine.

Think about how you can adapt and create positive new routines – try to engage in useful activities (such as cleaning, cooking or exercise) or meaningful activities (such as reading or calling a friend). You might find it helpful to write a plan for your day or your week.

Do things you enjoy: When you are anxious, lonely or low you may do things that you usually enjoy less often, or not at all. Focussing on your favourite hobby, learning something new or simply taking time to relax indoors should give you some relief from anxious thoughts and feelings and can boost your mood.

If you can’t do the things you normally enjoy because you are staying at home, try to think about how you could adapt them, or try something new. There are lots of free tutorials and courses online and people are coming up with innovative online solutions like online pub quizzes and streamed live music concerts.

Set goals: Setting goals and achieving them gives a sense of control and purpose – think about things you want or need to do that you can still do at home. It could be watching a film, reading a book or learning something online.

Keep your mind active: Read, write, play games, do crossword puzzles, sudokus, jigsaws or drawing and painting. Find something that works for you.

Take time to relax and focus on the present: This can help with difficult emotions, worries about the future, and can improve wellbeing. Relaxation techniques can also help some people to deal with feelings of anxiety. For useful resources see Every Mind Matters and NHS’ mindfulness page.

If you can, once a day get outside, or bring nature in: Spending time in green spaces can benefit both your mental and physical wellbeing. If you can’t get outside much you can try to still get these positive effects by spending time with the windows open to let in fresh air, arranging space to sit and see a nice view (if possible) and get some natural sunlight, or get out into the garden if you can.

Remember that social distancing guidelines enable you to go outside to exercise once a day as long as you keep 2 metres apart from others who are not members of your household group.

Staying at home

Recent guidance is clear about the need for people to stay at home. If you are feeling anxious it might help to think about potential challenges and make a plan for them.

Practical issues

Supplies: Think about how you can get any supplies you need – either from a neighbour, family friends or a delivery service so you don’t worry about running out. Try to pick healthy food, especially as you might not get as much exercise as normal.

Financial concerns: You may be worried about work and money if you have to stay home – these issues can have a big impact on your mental health. For guidance on what your rights are at work, what benefits you are entitled and what further support is available please see our guidance for employees or advice from citizens advice or the National Debt line.

If you care for other people: You may be worried about how to ensure care for those who rely on you – either your dependants at home or others that you regularly visit. Let your local authority know if you provide care, or support someone you don’t live with. Further advice on creating a contingency plan is available from Carers UK.

If you are being treated or taking medication for existing conditions

Continue accessing treatment and support where possible: Let relevant services know that you are staying at home, and work out how to continue receiving support during this time:

Keep taking your medication: You might be able to order repeat prescriptions by phone, or online using an app or website if your doctor’s surgery offers this.

Where to get further support

Managing physical symptoms that are triggered by stress and anxiety

It is quite common to experience short-lived physical symptoms when your mood is low or anxious, for example:

It can be difficult to know what is causing these symptoms, but often people who experience them due to stress, anxiety or low mood find that they get worse when they focus on them. See advice from the NHS on managing the physical symptoms.

If you are concerned about your physical symptoms, then do contact NHS 111 online.

For advice on coronavirus (COVID-19) and any symptoms see the NHS website.

If you are experiencing stress, feelings of anxiety or low mood, you can use the NHS mental health and wellbeing advice website for self-assessment, audio guides and practical tools Every Mind Matters also provides simple tips and advice to start taking better care of your mental health. If you are still struggling after several weeks and it is affecting your daily life, please contact NHS 111 online. If you have no internet access, you should call NHS 111.

In a medical emergency call 999. This is when someone is seriously ill or injured and their life is at risk. A mental health emergency should be taken as seriously as a physical health emergency.

Additional advice for groups with specific mental health needs

Existing mental health problems

If you already have a mental health problem, then you may be finding the coronavirus (COVID-19) outbreak particularly challenging. The advice above should help, but here are a few extra things that you may want to think about. This advice is part of comprehensive guidance provided by Mind.

Managing difficult feelings or behaviours to do with hygiene, washing or fears of infection

Some mental health problems can cause difficult feelings or behaviours to do with washing or hygiene. If you experience this, you might find it hard to hear advice about washing your hands.

It is important to follow government advice on helping to avoid the spread of coronavirus (COVID-19), but if you find you are going beyond the recommendations, if this is making you feel stressed or anxious, or if you are having intrusive thoughts here are some things you could try:

Speaking to your mental health team

If you are already receiving mental health care, contact your mental health team to discuss how care will continue, and to update safety/care plans.

Managing panic and anxiety

If you have panic attacks or flashbacks, it might help to plan a ‘safe space’ in your home that you’ll go to.

You can also find ways to comfort yourself if you’re feeling anxious. For example, Mind has games and puzzles you can use to distract yourself, and breathing exercises which may help.

Managing feelings of being trapped or claustrophobia

You are probably spending more time than usual at home so try to get outside if you can, once a day. You could also open the windows to let in fresh air, find a place to sit with a view outside, or sit on your doorstep or in your garden if you have one. It can also help to regularly change the rooms you spend time in (if possible). This can help to give you a sense of space.

If you are reducing your drinking significantly

If you are reducing your drinking, remember it can be dangerous to stop too quickly without proper support. If you have physical withdrawal symptoms (like shaking, sweating or feeling anxious until you have your first drink of the day) you should seek medical advice. For further advice available in your area (including remote services) see NHS advice.

People with a learning disability

You may be finding the coronavirus (COVID-19) outbreak stressful. You may be worried about changes that might happen because of it, including having to stay at home. You may also be worried about your family or those close to you.

Public Health England has easy read guidance on coronavirus (COVID-19) and how it may affect you. There is also other information available about coronavirus (COVID-19) from Mencap and how to manage difficult feelings you are having.

There are ways you can take care of yourself and prevent spreading the virus:

While it is important to be aware of coronavirus (COVID-19), it is important not to forget about any other health conditions you might have. Make sure you take any medication you have been prescribed, keep any hospital appointments you have (unless you have been told otherwise by the hospital) and tell people if you can’t attend appointments.

Autistic people

You may be finding the coronavirus (COVID-19) outbreak stressful and be worried about getting the virus or changes that might happen because of it, including having to stay at home. There are ways you can take care of yourself and prevent spreading the virus:

Understand what is happening

Keep up to date with information about Coronavirus (COVID-19) from sources you can trust, such as the NHS website.

Help to stop the virus from spreading

There are 4 easy steps you can take to reduce the risk of getting coronavirus or spreading it to others:

Plan to keep mentally well

Do the things you would usually do to keep well, like eating food you enjoy and taking exercise, once a day outside if you can. If you have support from others, plan with them how you can remain well and relaxed. There are also other things you can do to help to manage your emotions if you feel you are losing control, such as:

You know what strategies have helped in the past, so use them again now. The National Autistic Society guidance on managing anxiety might also be helpful.

Get help if you are struggling

Hearing about coronavirus (COVID-19), and the changes it causes in your daily life, might make you feel like you don’t have control, or make you worried or scared about your health. These feelings are common. Try to speak to someone you trust such as a friend, family member or supporter.

If you do become unwell and need medical treatment, share your hospital passport or autism diagnosis so staff know the best way to support you.

If you are still feeling worried and want more help. You can call the Autism Helpline on 0808 800 4104.

Older people

Government guidance is that older people are at increased risk of severe illness and need to be particularly stringent in following social distancing measures and staying at home. Given this, it is natural for older people, particularly those with pre-existing medical conditions, to feel concerned or affected by changes you have to make to your daily life. The following suggestions may help with any difficult feelings and look after your mental health:

Stay connected

Draw on support you might have through your friends, family and other networks. Try to stay in touch with those around you, this might be over the phone, by post, or online. If you have been advised to stay at home, let people know how you would like to stay in touch and build that into your routine.

Get practical help

If you need help, for example with shopping or running errands, ask for it and let those around you know what they can do. If you need help but you’re not sure who to contact, Age UK runs an advice line (0800 678 1602 – lines are open every day 8am-7pm) that can put you in touch with local services.

People living with dementia

You may feel concerned about coronavirus how it could affect you. Alzheimer’s Society have published information on coronavirus for people affected by dementia.

If you’d like to connect and talk with other people affected by dementia, you can visit the Alzheimer’s Society online community Talking Point.

A range of information on information on dementia is also available from Alzheimer’s Research UK

If you are still feeling worried and want more help you can call the Alzheimer’s Society Helpline on 0300 222 11 22

You can also speak to a dementia specialist Admiral Nurse on Dementia UK’s Helpline, on 0800 888 6687.

Dealing with a mental health crisis or emergency

You may find that the added stress of the current situation could have a big impact on your mental health. In some cases, you may feel that you are having a mental health crisis as you no longer feel able to cope or be in control of your situation.

You may: feel great emotional distress or anxiety, feel that you cannot cope with day-to-day life or work, think about self-harm or even suicide, or experience or hear voices (hallucinations).

If this sort of situation happens, you should get immediate expert assessment and advice to identify the best course of action:

See further advice from the NHS on dealing with a mental health crisis.

PHE guidance for parents and carers supporting children and young adults

The coronavirus (COVID-19) outbreak is going to affect everyone’s daily lives, as the government and the NHS take necessary steps to manage the outbreak, reduce transmission and treat those who need medical attention.

Regardless of their age, this may be a difficult time for children and young people. Some may react right away, while others may show signs of difficulty later on.

How a child or young person reacts can vary according to their age, how they understand information and communicate, their previous experiences, and how they typically cope with stress. Negative reactions may include worrying thoughts about their health or that of family and friends, fear, avoidance, problems sleeping, or physical symptoms such as stomach ache.

During this time, it’s important that you take care of your family’s mental health – there are lots of things you can do, and support is available if you need it.

Background

This advice is to help adults with caring responsibilities look after the mental health and wellbeing of children or young people, including those with additional needs and disabilities, during the coronavirus (COVID-19) outbreak.

For wider information on how to protect yourself and others please see Coronavirus (COVID-19): what you need to do

This guidance will be updated in line with the changing situation.

Looking after your own mental health

As well as thinking about the children or young people in your care, it is important to take care of your own mental health and wellbeing. Children and young people react, in part, to what they see from the adults around them. When parents and caregivers deal with a situation calmly and confidently, they can provide the best support for their children and young people. Parents and caregivers can be more supportive to others around them, especially children, if they are better prepared.

Please see advice on how to look after your mental health and wellbeing during the coronavirus (COVID-19) outbreak or visit Every Mind Matters for clear advice and actions to take care of your mental health and wellbeing.

Helping children and young people cope with stress

Here are some key points to consider about how you can support your child or young person:

Listen and acknowledge: Children and young people may respond to stress in different ways. Signs may be emotional (for example, they may be upset, distressed, anxious, angry or agitated), behavioural (for example, they may become more clingy or more withdrawn, they may wet the bed), or physical (for example, they may experience stomach aches). Look out for any changes in their behaviour.

Children and young people may feel less anxious if they are able to express and communicate their feelings in a safe and supportive environment. Children and young people who communicate differently to their peers may rely on you to interpret their feelings. Listen to them, acknowledge their concerns, and give them extra love and attention if they need it.

Provide clear information about the situation: All children and young people want to feel that their parents and caregivers can keep them safe. The best way to achieve this is by talking openly about what is happening and providing honest answers to any questions they have. Explain what is being done to keep them and their loved ones safe, including any actions they can take to help, such as washing their hands regularly.

Use words and explanations that they can understand and make sure you use reliable sources of information such as the GOV.UK or NHS website – there is a lot of misleading information from other sources that will create stress for you and your family.

It will not always be possible to provide answers to all the questions children and young people may ask, or to allay all their concerns, so focus on listening and acknowledging their feelings to help them feel supported.

Be aware of your own reactions: Remember that children and young people often take their emotional cues from the important adults in their lives, so how you respond to the situation is very important. It is important to manage your own emotions and remain calm, listen to and acknowledge children and young people’s concerns, speak kindly to them, and answer any questions they have honestly.

See further guidance on how to look after your own mental wellbeing during the outbreak.

Connect regularly: If it is necessary for you or your children to be in a different location to normal (for example, staying at home in different locations or hospitalisation) make sure you still have regular and frequent contact via the phone or video calls with them. Try to help your child understand what arrangements are being made for them and why in simple terms.

Create a new routine: Life is changing for all of us for a while. Routine gives children and young people an increased feeling of safety in the context of uncertainty, so think about how to develop a new routine – especially if they are not at school:

Limit exposure to media and talk about what they have seen and heard: Children and young people, like adults, may become more distressed if they see repeated coverage of the outbreak in the media. A complete news blackout is also rarely helpful as they are likely to find out from other sources, such as online or through friends.

Try to avoid turning the television off or closing web pages when children or young people come into the room. This can peak their interest to find out what is going on – and their imagination can take over. Instead, consider limiting the amount of exposure you and your family get to troubling media coverage.

Young people will also hear things from friends and get information from social media. Talk to them about what is going on and ask them what they have heard about. Try to answer their questions and reassure them in an age appropriate manner, avoiding too much detail.

How children and young people of different ages may react

All children and young people are different, but there are some common ways in which different age groups may react to a situation like the coronavirus (COVID-19) outbreak. Understanding these may help you to know how to support your family. The common reactions to distress will fade over time for most children and young people, though could return if they see or hear reminders of what happened.

For infants to 2-year olds

Infants may become more easily distressed. They may cry more than usual or want to be held and cuddled more.

For 3 to 6-year olds

Preschool and kindergarten children may return to behaviours they have outgrown. For example, toileting accidents, bed-wetting, or being frightened about being separated from their parents or caregivers. They may also have tantrums or difficulty sleeping.

For 7 to 10-year olds

Older children may feel sad, angry, or afraid. Peers may share false information but parents or caregivers can correct the misinformation. Older children may focus on details of the situation and want to talk about it all the time, or not want to talk about it at all. They may have trouble concentrating.

For preteens and teenagers

Some preteens and teenagers respond to worrying situations by acting out. This could include reckless driving, and alcohol or drug use. Others may become afraid to leave the home. They may cut back on how much time they connect with their friends. They can feel overwhelmed by their intense emotions and feel unable to talk about them. Their emotions may lead to increased arguing and even fighting with siblings, parents, caregivers or other adults. They may have concerns about how the school closures and exam cancellations will affect them.

Children and young people who are accessing mental health services

Children and young people with an existing mental health problem may find the current uncertainty around the coronavirus (COVID-19) outbreak particularly difficult. Their increased stress may lead to a change in their behaviours and their mental health needs. If you are concerned about how to access support if they need to stay at home, you may want to think about the following actions:

Speak to your child or young person’s mental health team

Contact your child or young person’s mental health team to discuss any concerns and check how care will continue to be accessed while you are at home. Update any safety and care plans as agreed.

Identify how the support your child or young person normally receives can be maintained

Ask about having appointments by phone, text or online, and how their health professional can offer extra support if your child or young person needs it.

If you usually have support in your home, check who you would need to contact in your local authority to let them know you’re staying at home. Make sure it is clear if support is still needed for your child or young person.

If your child or young person has been admitted to an inpatient mental health unit, talk to the staff about their policies on access to cell phones and think about how you can stay in contact, particularly if you have to stay at home. Ask the unit if you could participate in a ‘virtual ward round’ so you can keep in touch with your child and/or young person’s mental health team. If you need to stay at home this will also impact on whether your child or young person can come home on leave, so talk to your child or young person about what might happen so they are fully informed.

If your child or young person becomes affected by coronavirus (COVID-19) they will need to be cared for appropriately, so talk to the unit about what plans are in place should this happen and how best to communicate these to your child or young person.

Plan how you will access medication

You might be able to order repeat prescriptions by phone. Or you may be able to do this online using an app or website, if your doctor’s surgery offers this.

Ask your pharmacy about getting medication delivered or think about who you could ask to collect it for you. The NHS website has more information about getting prescriptions for someone else and checking if you have to pay for prescriptions.

Continue to order repeat prescriptions in your usual timeframe. There is no need to order for a longer duration or larger quantities.

Your GP might convert your child or young person’s repeat prescription to one that is supplied under the repeat dispensing arrangements, this means you can go back to the pharmacy for a certain number of repeats without having to get a repeat prescription from the practice.

Be careful about buying medication online. You should only buy from registered pharmacies. You can check if a pharmacy is registered on the General Pharmaceutical Council website.

You might also want to make arrangements for your child or young person if you become unwell, for example making sure a partner, friend, family member or neighbour is aware of important information including their care plan, medications and emergency numbers.

Children and young people with learning disabilities

Children and young people with learning disabilities can feel a loss of control in times of uncertainty such as the coronavirus (COVID-19) outbreak. They may need extra words of reassurance, more explanations or adapted explanations about the event, and more comfort and other positive physical contact from loved ones.

A good way to help them is by supporting their decisions, representing choices visually through written words, pictures, symbol systems or objects if helpful, supporting them to express their emotions and letting them know they are not alone. While listening, take their feelings seriously and don’t judge their emotions. They may feel anxious about big changes, such as going to new places or the possibilities of having to stay at home for a long period.

Where possible, it can be helpful to explain any upcoming changes to routine and circumstances before they happen and help them to plan and come up with solutions, such as finding a hobby or doing exercises to relax and cope with anxiety.

For useful tips for talking about feelings, see Skills for Care advice. For further guidance on coronavirus (COVID19) for those with learning disabilities please see the Mencap website (includes easy read materials)

Autistic children and young people

Irrespective of cognitive ability and language, autistic children and young people may struggle to identify any physical symptoms of coronavirus (COVID-19), as well as having difficulty talking about the emotions the situation will create. Keep an eye out for changes in behaviour which may help you to identify their emotional state, as well as physical symptoms.

There is going to be disruption for all of us during the outbreak, for example they may not be able to follow their normal routines, or visit older family members, so help them to manage these changes using the typical strategies you know work for your family.

It is important to be clear when communicating about the situation, how to stay safe and the symptoms of the virus. Try to avoid giving definitive statements about the future - this is a rapidly developing situation and your child or young person may be more distressed if things change when they were told they would not. Keep up to date with reliable information about coronavirus (COVID-19).

If your child or young person becomes ill, they may struggle to manage the physical experience. You know what works with your family, so help to manage this situation knowing what helps your child or young person.

You should continue to access support of local autism groups online or via the telephone. The National Autistic Society guidance on managing anxiety might also be helpful - you can call the Autism Helpline on 0808 800 4104 for further advice.

Children or young people with physical health issues

Children or young people with long term physical health issues, such as those who need continuous use of a breathing machine or are confined to a wheelchair or bed, may have stronger reactions to the coronavirus (COVID-19) outbreak. They might have more intense distress, worry or anger than children without these issues because they have less control over day-to-day wellbeing than other people. Support them by listening to their concerns, providing open and honest explanations about the situation, and giving them information about what is being done to protect them.

You may also be concerned about how you will continue their care if you have to stay at home, or you may be worried about infecting them. If you usually have support in your home, check who you would need to contact in your local authority to let them know you’re staying at home. Make sure it is clear if support is still needed for your child or young person.

For further information about the conditions that put children and young people at risk please see the guidance on shielding and protecting people defined on medical grounds as extremely vulnerable.

Children and young people who care for others

Some children and young people also have existing caring responsibilities for adults or siblings. They may be anxious about what will happen if the person they care for becomes unwell, or what will happen if they themselves become unwell and unable to support the person they care for. Even if they don’t currently act as a carer, it is possible that they may become one if they are in a household with one adult.

Planning with your child or young person what will happen if you or another member of the family they care for or may need to care for becomes unwell, including contact details for others who can step in and support them, will help to reduce anxiety.

Bullying

Unfortunately, the coronavirus (COVID-19) outbreak has led to some individuals experiencing discrimination and harassment, often because of their ethnicity or nationality. It is important to check that your children and young people are not experiencing bullying or bullying others.

Explain that coronavirus (COVID-19) has affected and is likely to affect people from many countries, in many geographical locations. Emphasise that your child or young person should be empathetic to anyone who has been affected, whatever country or area they are from.

Remind your children and young people that everyone deserves to be safe at school, online and at home. Bullying is always wrong, and we should each do our part to spread kindness and support each other. If they have been called names or bullied at school, they should feel comfortable telling an adult whom they trust.

For more help and advice resources, please see the Anti-Bullying Alliance website.

Money worries

You may be worried about supporting your family if you have to stay home – this can have a big impact on your mental health. For guidance on what your rights are at work, what benefits you are entitled and what further support is available please see our guidance for employees or advice from citizens advice or the National Debt line.

Where to get further support

If you are worried about your or your child/ or young person’s symptoms. Please visit the NHS self-isolation advice website for information. If you are still worried, call NHS 111.

If you are worried about your child or young person’s mental health. Seek help from a professional. You may have services attached to your child or young person’s school or college who can help, contact your GP, or look up information on children and young people’s mental health services on your local CCG website or on the NHS website.

In a medical emergency call 999. This phone line should be used when someone is seriously ill or injured and their life is at risk. A mental health emergency should be taken as seriously as a physical health emergency. For more advice on where to get support for a mental health crisis please see this NHS page.

For support as a parent or carer

Young Minds for Parents and Carers provides advice about mental health and behaviour problems in children and young people up to the age of 25. You can call the parents’ and carers’ helpline on 0808 802 5544. Please be aware Young Minds do not provide any direct psychological services and cannot make referrals to the NHS or Children and Young People’s Mental Health Services (CYPMHS).

Helplines and websites for your child and or young person

If your child or young person would like to speak to someone anonymously, they could try calling a helpline or visiting websites such as ChildLine and The Mix.

Shout provides free, confidential support, 24/7 via text for anyone at crisis anytime, anywhere.

You can:

ChildLine provides a confidential telephone counselling service for any child with a problem. It comforts, advises and protects.

You can:

The Mix provides a free confidential telephone helpline and online service that aims to find young people the best help, whatever the problem.

You can: