Keeping well in a COVID-19 crisis: a qualitative study formulating the perspectives of mental health service users and carers

Abstract

Background: People with existing mental health conditions may be particularly vulnerable to the psychological effect of the COVID-19 pandemic. But their positive and negative appraisals, and coping behaviour could prevent or ameliorate future problems. Objective: To explore the emotional experiences, thought processes and coping behaviours of people with existing mental health problems and carers living through the pandemic. Methods: UK participants who identified as a mental health service user (N18), a carer (N5) or both (N8) participated in 30-minute semi-structured remote interviews (31 March 2020 to 9 April 2020). The interviews investigated the effects of social distancing and self-isolation on mental health and the ways in which people were coping. Data were analysed using a framework analysis. Three service user researchers charted data into a framework matrix (consisting of three broad categories: "emotional responses", "thoughts" and "behaviours") and then used an inductive process to capture other contextual themes. Results: Common emotional responses were fear, sadness and anger but despite negative emotions and uncertainty appraisals, participants described efforts to cope and maintain their mental wellbeing. This emphasised an increased reliance on technology, which enabled social contact and occupational or leisure activities. Participants also spoke about the importance of continued and adapted mental health service provision, and the advantages and disadvantages associated with changes in their living environment, life schedule and social interactions. Conclusion:This study builds on a growing number of qualitative accounts of how mental health service users and carers experienced and coped with extreme social distancing measures early in the COVID-19 pandemic. Rather than a state of helplessness this study contains a clear message of resourcefulness and resilience in the context of fear and uncertainty.

Social connections at work and mental health during the first wave of the COVID-19 pandemic: Evidence from employees in Germany

“…This study is one of the first to measure employees' needs for and supplies of social connections during COVID-19 and to call attention to a significant lack of social interaction and social support in the workplace. This result is in concordance with other studies that have found, more generally, high levels of social isolation and loneliness [3,42], as well as changes in social life and social connections [4,43,44], during the pandemic. Furthermore, our response surface analysis (RSA) challenges the assumption of a fit effect, which is common in previous studies [22].…”

The Impact of the COVID-19 Pandemic on Those Supported in the Community with Long-Term Mental Health Problems: A Qualitative Analysis of Power, Threat, Meaning and Survival

“…Finally, as found in other studies (e.g. Dejonckheere et al, 2021 ; Simblett et al, 2021 ), many participants were remarkably resilient and resourceful, drawing on their experience of managing pre-existing difficulties, despite the new threats posed by the pandemic. As service users have noted elsewhere (Gillard et al, 2021 ), there may be limits on the sustainability of some self-management strategies without access to formal support.…”

“…Similarly, detailed time series case analyses of daily emotional trajectories for four women with depression and anxiety-related mental health problems demonstrated variation in coping, resilience and emotional response as lockdown restrictions were introduced in Belgium (Dejonckheere et al, 2021 ). There has been limited in-depth exploration of the particular situations and experiences that may produce these differences, though three qualitative studies with people living with or recovering from mental health problems during the pandemic are particularly helpful—two in the UK (Gillard et al, 2021 ; Simblett et al, 2021 ) and one in Australia (Honey et al, 2021 ). Despite some accounts of coping and resilience, many participants across all three studies had clearly struggled with the pandemic restrictions, describing responses of sadness, fear and anger, negative self-appraisals, worsening mental health and a detrimental impact on wellbeing.…”

What have we learned about what works in sustaining mental health care and support services during a pandemic? Transferable insights from the COVID-19 response

“…The unprecedented challenges and uncertainties associated with have reportedly led to substantial mental health deteriorations, both among healthy individuals and those with pre-existing mental health problems (Banks & Xu, 2020;Cullen et al, 2020;McElory et al, 2020;Simblett et al, 2021;Vindegaard & Benros, 2020;Willis & Chalder, 2021). COVID-19 restrictions have resulted in prolonged waiting lists, concerns surrounding how to provide safe and adequate care remotely and MHWs struggling to maintain their own mental wellbeing (Rosenberg et al, 2020).…”