Mr Ahmed is a 72-year old man and a regular patient at the pharmacy. He calls one morning and asks to speak to the pharmacist.
He has barely left home since the start of the COVID-19 lockdown, other than for exercise, and he is apprehensive about collecting his prescription from the pharmacy. He asks that his prescription be delivered to his home instead.
What advice should you give him?
Statistics on mental health during lockdown
Lockdown has been an unprecedented and challenging time for everyone, and statistics have shown that it has had a significant effect on mental health.
The Office of National Statistics published data from an Opinions and Lifestyle survey between April 3 and May 10 2020, showing that over 33% of adults in the Great Britain said the pandemic has affected their wellbeing.(1) High levels of anxiety have been seen throughout lockdown and are associated factors such as loneliness, feeling safe at home, age, sex, marital status and how COVID-19 is affecting daily life such as work, financial status and relationships.
Similarly, a survey conducted by Superdrug with over 3,000 participants found that:
- 65% of people are concerned about the further impact on their mental health as social distancing measures and lockdown are eased.
- 80% of people believe that social distancing and lockdown has negatively impacted mental health in the UK.
- 22% have spent so much time in one place that they are anxious to go into more crowded environments.
- 21% feel insecure about being sociable again after spending the lockdown being less social.
- 43% are nervous about lockdown being eased because they are unsure they’ll be safely protected from coronavirus.
- 12% are worried to leave the safety of their home.(2)
Who is most vulnerable to mental health issues in lockdown?
The probability of reporting high anxiety has been the greatest in those aged over 75 years, showing a stark difference prior to the pandemic. Those aged 75 years and over were almost twice as likely as those aged 16 to 24 years to report high anxiety during lockdown. This has been linked to extensive media coverage and the higher risks of mortality from COVID-19 in those over 70.(1) Some of those aged over 70 have also been asked to shield under government guidelines – contributing to feelings of isolation and anxiety about health and wellbeing.
Those with pre-existing mental health conditions are likely to have worsened mental health issues during the lockdown.
Additionally, young people who have not been in school since early March may be struggling with their mental health. Action Mental Health is a charity which works to empower parents and carers.
They have recommended that parents and carers be aware of the following signs of deteriorating mental health in their family members:(3)
- Persistent sadness
- Withdrawing from or avoiding social interactions
- Hurting or talking about hurting yourself
- Talking about death or suicide
- Outbursts of anger or extreme irritability
- Excessive worrying or fear
- Confused thinking or problems concentrating
- Extreme mood changes
Easing of lockdown restrictions
Unfortunately, some of those affected by anxiety during the lockdown period may experience a worsening in their mental health and may concurrently suffer from other conditions such as depression or they may even have suicidal thoughts.
It is unclear what the long-term mental health effects of easing lockdown will be. It is anticipated many people will feel more anxious and afraid with the easing of restrictions.(4)
The pharmacy team can play a key role in identifying patients who may be suffering from mental health issues due to lockdown – making an effort to ask patients how they are doing, providing advice and support and referring them to their GP if there are concerns for their wellbeing.(4)
Pharmacy teams can encourage self-care tips to help manage anxieties when coming out of lockdown. Simple measures such as finding new routines to adjust to the ‘new normal’, staying connected, eating well and regular exercise should be advised for mental wellbeing.
How can pharmacy teams advise patients and reassure patients with concerns?
Patients can be advised that government measures are being put in place to help prevent the transmission of the virus. As of June 15, it is now mandatory to wear face coverings on public transport. All hospital visitors and outpatients are also advised to wear face coverings. It is hoped these measures will reduce the risk of transmission.
In Scotland, it is now compulsory from July 10 to wear a face covering in all shops, including pharmacies. In Wales, the use of non-medical face coverings is recommended in situations where it is difficult to maintain the two-metre social distance. The Department of Health and Social Care in England is advising people to wear a face covering when they visit a pharmacy. However, while wearing a face covering is compulsory for patients and visitors at hospitals in England, it has not been made a requirement in primary care, including pharmacy.
Permitting a restricted numbers of patients into the pharmacy, can help reduce the risk of transmission which can be used to comfort patients coming in to collect their medication.(4)
Public Health England posters can be displayed in community pharmacies to encourage social distancing measures and re-enforce government guidance.
The NHS App includes a new area where patients can view or change their EPS pharmacy nomination. This means that patients no longer need to collect prescriptions from GP practices to drop them off at pharmacies, which supports the public to observe social distancing and may ease anxieties about the easing of lockdown measures.(5)
Where can patients find information on the easing of lockdown?
Patients can be referred to mind.org.uk for practical advice on maintaining wellbeing. The Mental Health Foundation also has tips for looking after mental health. Further advice and support can be found on the NI Direct government services website.
- Office for National Statistics (2020) Coronavirus and anxiety, Great Britain: 3 April 2020 to 10 May 2020
- Soffer D (2020) Research reveals mental health impact of lockdown: 3,293 Superdrug customer respondents; research conducted 24-29 June 2020
- Action Mental Health (2020) Spot the signs – empowering parents and carers to spot mental health issues
- Mental Health Foundation (2020) Looking after your mental health as we come out of lockdown
- Pharmaceutical Services Negotiating Committee (2020) Public messaging
- Gov.uk (2020) Coronavirus (COVID-19)
- NHS Volunteer Responders (2020) Need help from a volunteer responder?