Increase in demand for lockdown mental health services

New research commissioned by BASW England and the Department of Health and Social Care (DHSC) reveals a significant increase in people accessing mental health services during the first lockdown.

Three-quarters of England’s local authorities took part in the Impact of Covid-19 on Approved Mental Health Professionals (AMHP) Services survey, with 60% saying demand for mental health services has risen above pre lockdown levels.

BASW said 96% of respondents reported an increase in the number of first-time presentations of people suffering mental distress/ill-health who had not been previously known to mental health services.

While feedback from more than 100 AMHPs revealed an increase in Mental Health Act (MHA) assessments taking place during the lockdown period and into the post-lockdown period in summer.

There was a significant level of concern expressed from AMHP respondents that withdrawal of face-to-face visits and monitoring by community services, and reduction of contact to telephone only, led to requests for MHA assessments which would not otherwise have been made and which did not warrant consideration of detention in hospital.

The author of the report, Steve Chamberlain, chair of AMHP Leads Network and BASW England member, said: ‘The reality is that AMHPs only see people who are in a mental health crisis, most people don’t reach that point.

‘Therefore, the increase in those numbers strongly suggests that this is just the tip of the iceberg and that the pandemic has caused considerable mental distress for a great many people.

‘AMHPs have continued to see people face to face throughout the pandemic, often in situations where distancing is difficult or impossible.

‘Add to that the intense nature of the work and the fact that many people they see are in acute distress, creates a particularly taxing environment in which they are working.

‘It is vital that specific consideration is given to issues of health and safety to enable them to continue to fulfil their role to the best of their ability.’

Among many recommendations for the ongoing handling of the pandemic and any future virus-related pandemics is better understanding of the AMHP role, especially regarding PPE.

Many respondents highlighted the ineffectiveness of wearing masks in a role working with people potentially suffering from a range of serious mental illnesses, where face to face communication is vital.

The use of see-through face masks or reusable face shields was mentioned to address the concerns over the impact of PPE on the assessment process.

Maris Stratulis, BASW England national director said it is important to consider if and why AMHP services were having to undertaking work normally done by community mental health services

‘AMHPs have played a pivotal role throughout the pandemic and have worked incredibly hard to maintain and deliver essential services to people experiencing distress and mental health crisis.

‘The research findings have highlighted an increase in the number of people presenting for the first time to AMHP services, withdrawal of ‘mainstream’ mental health services from face-to-face contact and increase in requests to AMHP service which did not lead to Mental Health Act Assessments.

‘We need to consider if and why AMHP services were fulfilling a function normally undertaken by community mental health services and question inequalities of access to support services and the impact of PPE and health and safety of the workforce.

‘We look forward to working in partnership with AMHPs, people with lived experience, DHSC and other key partners in taking forward the report recommendations.’

 Joint-chief social worker for England, Mark Harvey said the report will help government, local authorities and NHS colleagues to work together to improve support for AMHP services

‘We really welcome this new report on AMHP services and COVID-19.

‘The Chief Social Worker’s office commissioned this research because we were very aware of how hard AMHP services, emergency duty teams and mental health crisis support services have been working during the pandemic and we wanted to understand how it has affected professionals and people using services.

‘The report illustrates how individual AMHPs and AMHP services have adjusted and stepped up to deal with the additional pressures.

‘AMHPs have carried on with face to face interactions with people in mental health crisis and they have adapted to the challenges experienced by partner agencies while also dealing with a rise in requests for mental health act assessments, including people new to mental health services.

‘This report will help the government, local authorities and NHS colleagues to work together to improve support for AMHP services and implement lessons learnt from the pandemic.’

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