COVID-19 policies in the UK and consequences for mental health.

The lockdown to “flatten the curve” of COVID-19 has caused harm to many people globally. Over the past 6 months it has been nearly impossible to discern what the UK government strategy is in relation to the virus: suppression, or following of the model used in Sweden to foster community immunity? In mid-September, things became clearer: the UK is on a course for suppression until a vaccine or effective mass testing is in place. For good measure, UK residents have all been punished by new limits to the number of people socialising together, and have been warned that further restrictions could be imposed unless their supposedly reckless social behaviour improves. Frightening graphs depicting scenarios rather than predictions have been used to terrify people about the resurgence of the virus. However, it might be years before a safe vaccine is available, and the mass testing proposal dubbed moonshot is scientifically unsound and could do more harm than good.

There is another way. One which takes account of the fact that COVID-19 does not have equal effects across age groups: for young people the risk of COVID-19 seems to be very low but the mental health of young people has been disproportionately affected during this crisis. We should allow young people to go about their lives normally and protect those who are older and more susceptible in a humane and compassionate manner; infectious diseases specialists have good ideas about implementing this suggestion. However, in late September, hundreds of healthy, young students in Scotland and Manchester, UK, have been locked down, banned from visiting home and family, and threatened that they might not be able to go home for Christmas. It is hard to see how this policy is within the bounds of human rights and I am deeply concerned about the impact of such measures on mental health and wellbeing.

Many people have highlighted the need not to medicalise natural reactions to the global crisis that the global community is facing as a mental illness. However, the global community cannot, and should not, ignore the evidence amassing to suggest that people of all ages are struggling. Increases in suicidal ideation and self-harm have been observed among young people in China before and after lockdown according to prospective studies that were able to collect cohort data. It is clear that young children have been badly affected by lockdown.

Moving forward, nations should prioritise young people. They have suffered immensely in this crisis and sacrificed a lot. Moreover, the economic devastation will have an enormous impact on young people who will bear this burden for years to come. The association between economic downturn and suicide has been shown repeatedly across the globe.

Services and support for those in distress should now be prioritised and made easily accessible, in the virtual and real world. Mental health should not be left behind in this crisis. For young people, whole-school approaches involving mental health awareness have been shown to reduce suicidal ideation and behaviour. Such evidence-based mental-health interventions should be implemented, urgently, at scale in the community.