What has changed in the experiences of people with mental health problems during the COVID-19 pandemic: a coproduced, qualitative interview study

Abstract

Purpose We sought to understand how the experiences of people in the UK with pre-existing mental health conditions had developed during the course of the COVID-19 pandemic. Methods In September–October 2020, we interviewed adults with mental health conditions pre-dating the pandemic, whom we had previously interviewed 3 months earlier. Participants had been recruited through online advertising and voluntary sector community organisations. Semi-structured qualitative interviews were conducted by telephone or video-conference by researchers with lived experience of mental health difficulties, and, following principles of thematic analysis, were analysed to explore changes over time in people’s experience of the pandemic. Results We interviewed 44 people, achieving diversity of demographic characteristics (73% female, 54% White British, aged 18–75) and a range of mental health conditions and service use among our sample. Three overarching themes were derived from interviews. The first theme “spectrum of adaptation” describes how participants reacted to reduced access to formal and informal support through personal coping responses or seeking new sources of help, with varying degrees of success. The second theme describes “accumulating pressures” from pandemic-related anxieties and sustained disruption to social contact and support, and to mental health treatment. The third theme “feeling overlooked” reflects participants’ feeling of people with mental health conditions being ignored during the pandemic by policy-makers at all levels, which was compounded for people from ethnic minority communities or with physical health problems. Conclusion In line with previous research, our study highlights the need to support marginalised groups who are at risk of increased inequalities, and to maintain crucial mental and physical healthcare and social care for people with existing mental health conditions, notwithstanding challenges of the pandemic.

Experiences of the COVID-19 pandemic amongst individuals with severe mental health conditions and caregivers in South Africa: a qualitative study

“…Behavioural responses (e.g. wearing masks, sanitizing) to prevent illness, cognitive processes (understanding the illness) and strategies for managing emotional responses to the pandemic have been required for coping and thriving during this period [39,42,52,63] and the current study indicates that people with schizophrenia in South African (and potentially other LMIC) may have demonstrated resilience during the course of the pandemic.…”

“…These barriers to care may have an ongoing contribution to delayed health seeking behaviour, with the potential to further entrench health inequalities in this vulnerable group [20,56]. Although important disruptions to access to services were also present in HIC [47], many services in these settings implemented some form of telephonic or virtual support and 'checking in' [34,39,40,52]. The absence of such alternative support in LMIC such as South Africa may have contributed to the negative impacts of the pandemic.…”

“…Although most service users in this study felt their degree of social isolation was already high and largely unchanged by the pandemic, which has likewise been reported in some HIC settings [39], opportunities for social interaction and relationships (including via casual social contacts in neighbourhoods) became further restricted. This is concerning as social connection is an important part of recovery in both HIC and LMIC [21,39,47,[52][53][54]. The reported existence of social isolation even before the pandemic indicates an important gap in care in South Africa, and suggests the current biomedical orientation fails to meet needs for social connection [11,54].…”

Exploring the experiences of loneliness in adults with mental health problems: A participatory qualitative interview study

“…The majority of interviews were conducted during the COVID-19 pandemic, and we have reported baseline [ 23 ] and follow-up [ 26 ] findings elsewhere, but the pandemic context may have influenced accounts of loneliness, even though participants were encouraged to talk about experiences of loneliness in general rather than specifically in a pandemic context, and appeared for the most part to be doing so.…”

“…In this paper we report only on findings relevant to the original question regarding experiences of loneliness and their relationship with mental health. Findings relevant to the pandemic are reported in three other papers [ 23 , 25 , 26 ].…”