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

Abstract

Research suggests that the COVID-19 pandemic has had a significant impact on those already living with mental health problems, though there is also evidence of resilience. However, to date there has been limited in-depth qualitative investigation. We interviewed 15 people living with long-term mental health problems who, before the pandemic, were being supported by third sector organisations, to explore how they experienced lockdowns and accessing services remotely. Template analysis was informed by the Power Threat Meaning Framework and suggested that participants experienced significant threats to their mental wellbeing and recovery which were exacerbated by current or previous powerlessness and inequality. Although participants described positive coping strategies, several described a return of unhelpful behaviours that had contributed to the original difficulties. The findings illustrate the wider contributions of social and economic context to mental health problems and the importance of ensuring that people do not feel abandoned and are proactively supported.

Using an Intersectional Lens on Vulnerability and Resilience in Minority and/or Marginalized Groups During the COVID-19 Pandemic: A Narrative Review

“…Some identities might be connected to an increased risk of vulnerability: gender and sexual identity minorities, BIPOC, refugees or having a migration background, and individuals with lower income or living in poverty reported worse mental health in China, the United States, and the United Kingdom ( Bhaskar et al, 2020 ; Gibson et al, 2021 ). Particularly, restricted access to (non-emergency) healthcare and isolation increased experiencing threats during the pandemic in psychiatric patients in the United Kingdom and the United States ( Diaz et al, 2021 ; Leeming et al, 2022 ). Similarly, in the United States, gender-diverse individuals experienced more distress and less resilience ( Salerno et al, 2020 ; Hunt et al, 2021 ), and more social isolation and interpersonal problems in terms of not being able to live their authentic self ( Mitchell et al, 2022 ).…”

Suicide numbers during the first 9-15 months of the COVID-19 pandemic compared with pre-existing trends: An interrupted time series analysis in 33 countries

“…There may also be long-term impacts of COVID-19 on people with pre-existing mental disorders. 11 Studies of other pandemics/epidemics suggest that if increases in suicide do occur, they may be delayed. 12 …”

“…There may also be long-term impacts of COVID-19 on people with pre-existing mental disorders. 11 Studies of other pandemics/epidemics suggest that if increases in suicide do occur, they may be delayed. 12 The aim of this study was to provide an updated, more granular picture of the impact of COVID-19 on suicides globally to inform pandemic-related suicide prevention activities.…”

Clinical Outcome in Persons with Severe Mental Disorders Attending a Mental Health Day Center during the COVID-19 Pandemic

“…However, the exploration of psychological responses to the pandemic, such as fear and worry, as well as the assessment of patients’ well-being, was beyond the scope of the study. Indeed, some studies on psychiatric patients, including those receiving community-based support, recorded increased distress, loneliness, fear and anxiety, and perceived risk to mental health and well-being, even in the absence of any exacerbation of psychiatric symptoms [ 67 , 68 , 69 , 70 ]. Whether these psychological effects would contribute to an eventual deterioration of patients’ mental health in the long term remains to be studied [ 69 ].…”