The coronavirus crisis has resulted in a corresponding global crisis of mental health as the ongoing impacts of the pandemic affect communities across the world. Bereavements, isolation, job insecurity and a loss of income are just a few of the things which are resulting in an increase in demand for mental health support at a time when the services addressing these issues have been severely disrupted by the pandemic.
A survey carried out by the World Health Organisation last year showed that 93% of countries (out of 130 who took part in the survey) had disrupted or halted critical mental health services even as the need for these services has gone up. In the UK analysis by the Health Foundation showed there will be potentially 11% more referrals for mental health services over the next 3 years.
It has been well documented that COVID-19 has exacerbated existing inequalities of wealth, health, race, class and gender and these same factors are resulting in the mental health impacts of the pandemic particularly affecting certain communities. Individuals from ethnic minorities have experienced greater levels of anxiety and depression and the gendered dynamics of childcare, home-schooling and family responsibilities are resulting in women being more likely to experience a negative impact on their mental health. There has also been a disproportionate impact on young people and those living on their own have been particular affected. Research carried out by the charity, Rethink, has found that over three quarters of people with pre-existing mental illnesses reported that their mental health has deteriorated as a result of the pandemic.
As we head out of the second wave, uncertainty continues with the prospect of looming unemployment and the mental health consequences this entails; recent work from the Health Foundation estimating that around 800,000 people may be affected.
Social enterprises have often been at the forefront of delivering mental health services, with 15% citing improving mental health and wellbeing as their primary social mission.  Mental health support is however an area in which many other social enterprises work as they deal with the impacts of structural inequality across economy and society.
P3 are a social enterprise working in 20 counties across the UK working across sectors including in homelessness prevention, street outreach, youth services, supported housing and mental health support.
In January last year, they began working alongside the Derbyshire Healthcare NHS Foundation Trust (DHCFT) at the Police Headquarters in Ripley, taking low level calls from the police, East Midlands Ambulance Service (EMAS) and NHS 111 to provide telephone support for those living in Derbyshire & Derby City.
Three month later, this changed dramatically.
The demand placed on the service by COVID resulted in it being transformed into a 24/7 helpline directly open to the public. Staff numbers running the helpline went from one to a team of 14.
As the mental health implications of the pandemic became apparent the service became busier and busier. P3 worked in partnership with the NHS to transform the service into the Derbyshire Mental Health Helpline and Support Service which now runs out of Chesterfield Royal Hospital.
The helpline works by taking initial calls from people need support or advice with their mental health, escalating to an NHS clinician if necessary. Clinicians sit in the same room as frontline staff so are on hand if a person is in crisis or needs specialist intervention. Derbyshire Federation for Mental Health have also joined the partnership, providing support and advice to children and young people on the helpline.
Frontline staff first explore non-medical, community-based and self-help alternatives with callers, to avoid escalating calls where this is not needed. Over the last month, P3 have managed to de-escalate around 70 percent of the calls made to the helpline, which has made more time for the NHS team to concentrate on the triage aspect and deal with more serious cases where people need a clinical intervention. Where a person experiencing mental ill-health might otherwise have had no choice but to call an ambulance or other emergency service the phoneline has been able to deliver support there and then for a lot of people with low to medium needs, who actually just need someone to talk to and listen to them. Staff always provide follow-ups to callers to see how they are doing and if any further support is needed, ensuring the service is as personalised as possible.
Currently, the team takes around 70 calls per day and from September 2020 to January 2021, the number of calls has risen from just over 1500 a month to well over 2000.
One of the people staffing the helpline is Bianca Alton who had this to say about the impact the helpline is having:
“I feel that the helpline has been an invaluable source of support for people in Derbyshire during the Covid crisis. From those with health anxiety, to those who are in financial difficulty, those who are missing loved ones to those who are unsure about how support bubbles work, we have provided a listening ear, clarified the do’s and don’ts and signposted to appropriate specialised support.
“By far the biggest issue has been the isolation and loneliness faced by those that are vulnerable and shielding or simply living in a different area to loved ones, unable to have that all important face to face contact. The effect that this has had on the mental health of callers has been phenomenal. For these people, it’s been extremely important just to have a chat with someone friendly on the phone, to gain some perspective and to feel somehow part of the world again.”
The importance of being listened to with someone who cares about your situation was reflected in this comment from a person who used the helpline last October:
“In the past I’ve been told by other so-called ‘caring’ professional people that they’ll do something for me or when I was opening up to them about very personal things, I could tell that they weren’t even half-listening to me.
“When I told [the helpline staff member] how I was feeling, the mess that my mental health was in, the number of stress/psychologically induced seizures I was having a day, she was genuinely concerned about what I was telling her. When she told me that she was going to chase my referrals up, I actually believed that she was going to do it.”
NHS staff on the helpline also take professional calls from police officers who may need to potentially section someone who is experiencing severe mental distress. Between December and January at least 90% of these calls were deescalated by helpline staff with no section needed.
P3’s work supporting communities over the last year has been extensive. Last year it helped house nearly 1,000 people who were sleeping on the streets when the pandemic hit, as part of the Government’s ‘Everyone In’ scheme. They worked to support people into emergency accommodation during the height of the first wave and provided ongoing, wrap-around support to help people find long-term solutions. In Derbyshire, working with local authorities, GPs, drug/alcohol support and other services, P3 helped support people move into temporary accommodation with 213 people being moved into longer-term housing.
From Gloucestershire to Warwickshire to the West Midlands, P3 adapted their supported housing and community-based support services to continue supporting people throughout the Covid-19 crisis, providing phone and video support, socially-distanced doorstep visits, liaising with local services to organise thousands of food parcels, wellbeing packages and essential supplies and modifying their community hubs to make them Covid-safe when lockdown eased.
Over the last year P3 has shown how a social enterprise can adapt its services to deal with the escalating impact of the pandemic and the Derbyshire Mental Health helpline has been a lifeline for thousands of people, offering much needed support at a time when access to mental health services is under severe strain. As Bianca says:
“To know that often you are helping someone to hold onto hope and to face another day is incredibly humbling. I am extremely proud to be a part of a service that makes such a huge difference for so very many.”