Not long ago, a young woman sat in my NHS outpatient clinic and asked me to take away her children. She was calm and at first I thought she was joking. Why? I asked. She simply couldn’t cope any more, she said.
Then, as she began to sob, she confessed she was worried that she would end up killing them and then herself. ‘I love them so much,’ she repeated as she begged me to take them into care.
You have to be pretty desperate to try to give away your children.
This woman had one young child with autism, the other with behavioural problems and developmental delay. Day in and day out, she sat at home while her children screamed and wailed. The neighbours had complained. She was truly at the end of her tether, and could see no way out.
Dr Max Pemberton argues social services and mental health services should be open across the UK (file image)
I sat blinking at her, literally speechless. There were no day centres where she could take the children, no drop-ins for a little help — all had been sacrificed in the rush to lock down.
This poor woman told me she hadn’t seen her social worker for months. In the pandemonium of the pandemic, her community mental health team had effectively shut up shop and abandoned her for months on end.
Some services, such as drop-in centres, have closed entirely or now offer only phone calls — little use to a struggling single mother desperate for a break.
In many areas, community mental health teams are operating a skeleton service. Staff are either working from home or have been redeployed to fill gaps on inpatient wards where staff are off sick with Covid.
What this means in real terms is that precious few mental health patients are seen — with only those deemed the most unwell making the grade.
Part of the problem with mental health, though, is that the sickest people are often the hardest to reach. They don’t ask for help and it’s all too easy for them to fall through the gaps. Particularly now. How this woman lasted so long without support I have no idea.
While most of us know the Covid crisis has led to gaps in diagnosis and treatment of diseases such as cancer, many are unaware of the hidden mental health tragedy.
Working on the front line in London as I do, I see the heartbreaking reality of what lockdown means for so many, especially mothers struggling to hold it together without vital support.
My colleagues and I are always asking: when will this be over? It’s all we talk about, and not just because we long for an end for ourselves, but because of the misery and despair it is causing our patients.
Yes, we have to keep Covid at bay, but if we can keep supermarkets open, why on earth can’t we keep social services and mental health services open? Doctors and other health and social care professionals need to see people face to face. Phone calls simply are not adequate in assessing someone’s mental health, their social situation or the risks to them or their children. The people who are in real trouble don’t necessarily have internet access or a quiet, safe place to talk.
Dr Max (pictured) believes too many health and social care professionals have been happy to embrace the working from home culture
What’s more, while the virus appears to be more deadly in men, lockdown has disproportionately affected women. This is because it is women who tend to take on the lion’s share of managing the home. It is women who are most often carers or single parents. Generally they are the ones having to carry the burden of lockdown.
I wonder how often the plight of struggling mothers is considered by the scientists, government advisers and ministers — most of whom are men, you’ll note — who insist on tougher restrictions?
We must wake up to the fact that, while lockdowns may save lives, they will undoubtedly cost others. Yes, there are missed cancer diagnoses, untreated heart attacks and so on, but there will also be many lives lost to suicide and blighted by severe mental health problems.
My colleagues who work privately are doing a roaring trade, because those who can are paying for treatments while the NHS is paralysed by the virus. But that’s not an option for most. This disease has exposed the yawning gap between the haves and the have-nots.
I have been shocked by the utter misery that people have endured as a result of the pandemic and it is in eye-wateringly sharp contrast to the comfort enjoyed by a significant cohort of the largely professional classes. Doctors — the archetypal middle-class profession — have been largely silent about this. We have secure jobs and income protection. We tend to be drawn from middle-class families a world away from the poorest patients we serve.
I’ve been saddened at the lack of imagination and empathy that many of my colleagues have demonstrated when confronted by draconian lockdown measures. Too many health and social care professionals have been happy to embrace the working from home culture.
We’ve allowed the panic and the hysteria to spread and failed to call for calm and to champion the needs of the most vulnerable.
When all this is over, I hope we don’t look back and view with horror the trail of misery and death caused not by the virus, but by our attempts to contain it.
Dr Max says America’s former First Lady (pictured) missed an opportunity for some 'gratitude therapy' when she didn't write her own thank-you cards
Try some gratitude therapy, Melania
I’ll admit I’ve been rather remiss this year with writing my thank-you cards, and have only just got round to it, nearly a month after Christmas. I’m horrified, as I’m a great believer in the importance of thank-yous.
But while I have the excuse of covering colleagues at work who are off with Covid, which has meant I’ve hardly had a spare minute, I wonder what Melania Trump’s excuse is? According to a source, America’s former First Lady didn’t write her own thank-you cards to the staff who have looked after her family for the past four years. For shame!
If true, not only is that incredibly bad manners, but she’s also missed an opportunity for some ‘gratitude therapy’. Focusing on the positive encourages us to give thanks for the things and people around us. Countless studies have shown a robust association between high levels of gratitude and long-term mental wellbeing. It helps to reduce toxic emotions such as anger, frustration, envy and regret. So if you haven’t written your Christmas thank-yous yet, it’s time to put pen to paper.
Illegal drug use among youngsters is double official estimates, according to research published last week by Bristol University. A third of people aged 16 to 24 admitted to using drugs including cannabis, cocaine and amphetamines last year. We’ve basically decriminalised drug use in this country by the back door. It’s the worst of both worlds — we’re in a situation where people openly smoke cannabis on the street with the police turning a blind eye, and yet no tax is paid that could offset the cost of caring for people when they experience mental health problems as a result of these drugs. I’ve spent years working in drug services and have always felt these substances are dangerous and should remain illegal. However, in recent years my view has changed slightly. Drug use is here to stay, and I think it would make much more sense to allow certain drugs to be legalised, so they are regulated and taxes are paid. What is clear is that we can’t allow criminal gangs who wreck and destroy lives and communities to profit from our wariness to properly address the issue.
Dr Max prescribes...
Every mind matters
Public Health England’s Every Mind Matters campaign aims to improve mental wellbeing during the lockdown. There are a host of useful resources on the website, including a tool that helps you build a ‘mind plan’ — a personalised action plan with practical tips to help you deal with stress and anxiety, boost your mood, sleep better and feel more in control.