Was on a panel about the #mentalhelath effects of Covid-19 at the NHS Providers annual conference yesterday. I suggested a few things about what we might need to do to ensure that people's mental health can be as OK as possible over the immediate future (see below)

First thing I suggested was people who live with mental ill-health, distress and trauma and have done for ages do not have same needs as people experiencing their first ever period of distress as a result of lockdown and Covid-19 and it won't help anyone lumping them together

A stepped care model may be appropriate for those seeking help for mental ill-health for the first time as a result of the pandemic, but it probably won't be for people who know their own distress. People who need help need help *now*, but what that help is won't be uniform

Second thing I said was that people with longer term #mentalhealth difficulties didn't just lose access to the NHS during lockdown; they lost access to community, charity, social care, loved ones and the stuff of life. The hole in their being well is larger than the NHS

The third thing I said was I don't think the NHS has the relationships with communities needed to reach people with informal or practical support for #mentalhealth , and that I didn't think it was prepared to work with actual small community groups on non-medical support

I said that I don't think the NHS is able to flow support, funding and practical making-life-better-stuff to communities that have already felt isolated, with even further isolated people within them, and if it tried it wouldn't accept the risk required to do so.

The fourth thing I said was that I feel like our current response to Covid-19 is based on hedging that 'things will go back to normal' so we are clinging onto not spending in response to Covid-19 related change - "What the point of mending the fence if we're going to move house?"

In relation to Covid-19 and #mentalhealth , I said I feel we are avoiding making significant Covid-19 related changes to how we do mental health because we are scared of looking silly if it all blows over. I don't think it will and I think we are stacking up future problems

The fifth thing was in response to Simon Wessely saying he felt face to face consultations were important. I agreed, but I said we are doing nothing and spending nothing to make them possible. We aren't preparing for a Covid world, just lamenting the loss of the pre Covid one

If the most important thing for people's #mentalhealth is seeing each other, we should be using government spending to make that possible. We are doing nothing to make public spaces covid-resistant. All spending on that has been private businesses. This is a government failure

The government could give every public space a supply of face masks, sanitiser stations, other protections. It could certify levels of covid safety. The government could spend to make public spaces safer but it won't. It instead is individualising the risk of covid-prevention

I got to trot out my favourite line about spending around #mentalhealth being a political decision and spending around covid-19 and mental health being same. We are betting on savings from it 'going back to normal' while storing up costs from not taking action now for the future

It says a lot to me that our government assumed it could not make spending decisions to support practical covid-19 related safety possible and that the easiest route was to modify public behaviour and then wait it out. While we are waiting it out, the problems are growing

So my main points around Covid-19 and #mentalhealth were: accept things have changed; take practical actions to make face to face meeting and involvement in community possible with government funds; don't lump all #mentalhealth need into a stepped care model; spend now, not later

It's not impossible to design and build temporary covid-19 safe meeting places. It's not impossible to support community groups to support their communities: been working with @NSUNnews and we did a Covid fund that did just that: https://www.nsun.org.uk/news/nsun-covid-19-fund-update

My main point around Covid-19 and #mentalhealth was: a novel factor has been introduced into what we can and should do to support mental health. It's not helping just to say how much we need to get back to before Covid-19 happened. Covid, brexit and more mean now is *different*

Right now there are people who get a lot of air time basically saying 'we need to get back to how life was in 2019'. 2019 wasn't great for a lot of people anyway and stating obvious things that can't happen right now isn't heroic: aking it possible for things to happen now is

Getting back to 'normal life' where people can do the things they need to do to make their #mentalhealth the best it can be is going to require government spending. The market is not going to solve that problem if the market is collapsing.

Said some other stuff, too. I'd not really had chance to discuss this stuff in public. As I've said before, and as Simon Wessely also said, problem of Covid-19 is it takes away things that we would usually do to deal with a problem like Covid-19. Just winging it won't solve that

Anyway, morning! I don't know if @NHSProviders are going to stick a video of the discussion up online anywhere. I got to virtually meet @SamiraAhmedUK, which was nice.