Personal reflection of the impact of COVID on mental health and will there ever be parity?

When your sanctuary becomes your office, where do you escape? Sophie Ford from the Lincolnshire Partnership NHS Foundation Trust shares their honest reflections on working from home.  

In my life before COVID-19, I was a work hard and play hard person. I gave my heart and soul to my job – it was a huge passion of mine. Whilst it was always a very busy and stressful job I always counteracted and coped with the effects of that by having an active social and exercise schedule, oh and always a variety of holidays and events on the planner that got me through. Having things to look forward to and then enjoy them was my brain’s way of coping with stress. My home was my safe place and sanctuary, where, when things got too much, an evening at home alone to rest and restore would always perk me back up and give me the right energy boost. I’ve worked hard over the years to achieve these coping strategies, knowing they supported maintaining my mental health, managing the stresses of work and life, and generally keeping life balanced.

So, what happens when lockdown takes effect and everything that maintained your mental health is now gone from your life? No meals out in the evening, no hosting dinner parties and drinks with friends and family, no partying and dancing the night away without a care in the world, no having a giggle with friends about funny things that we’d done that day or seen. And more importantly not going out to work everyday, but instead when work is now full time in your safe space of home.

Like anything, there is no one singular factor that makes up who we are, how we cope and manage our lives and our mental health. I am an outwardly helpful, smiley and happy-go-lucky kind of a person. That is my natural state. But when you feel like your smile has been erased from existence and that there is a never ending sense of when it might return it can be a dark place to exist.

When you once looked around your surroundings at home and felt joy, but all you now feel is dread at seeing the work laptop, screen, and keyboard screaming stress and despair at you. Every day you had to open that laptop and just sob at the fact that you are in what was your happy place, but feel so sad that all the stress and sadness of work is around you 24/7.

In the first few weeks of lockdown, where all communications at work were via the telephone, I couldn’t understand why it was such a struggle. Then I realised just how much communication is non-verbal and how much I relied on those non-verbal cues to support my mental health and keep paranoia at bay. My brain took on every pause and silence after I spoke, as a thought that no one was interested in what I was saying and that I had nothing of any worth to contribute. I became very quiet and subdued on calls. I was only contributing if directly asked something, even though I had many thoughts and ideas going round in my head. I had concluded that my opinions were worthless.

Then we got a video conferencing platform. But this then lead to working days with call after call after call on screen, discussing tough and difficult issues. Pulling down the laptop screen that evening knowing you can’t escape the sense of stress and sadness of the situation and the discussions and decisions that had been made that day. When you feel so conflicted making decisions about other staff who are sacrificing themselves by still going to work, yet you are sat all safe from COVID risk in your house all the time, and that you should just get on with it. The whole country is having to get on with it so why can’t you? Why are you any different to anyone else? You aren’t special. But knowing that you were sinking down and down each day of managing work and home being merged, with literally no escape! When you go on social media and realise what a horrible society we live in really. When because of your job you knew all of the inequalities that exist and would play out in COVID times and no one took it seriously enough before to act. But now everyone wants to be part of your work it feels conflicting: it is great there is so much interest but on the flip side resentment of all the attention coming just because of COVID; suddenly everyone wants you to wave a magic wand and solve the world’s problems (and histories problems) overnight. And you blame yourself for not working harder to ensure people acted on these inequalities before now. I felt that I had let my profession down.

And video calling became the new normal for everything and as much as it opened up cross team working and gave a more personal experience to interactions it took over everything. One day I had been back-to-back on calls from 8am, only stopping at 1.45pm for a break before getting back on calls at 3pm. I remember just standing almost shell shocked, dazed and in a trance, not knowing what to do with myself in my living room. My brain and body was officially fried in every way. I couldn’t even think about what was I going to eat. I just sat staring into space!

During lockdown I did all the things possible to try and manage these challenges as well as possible with what I had available. I took part in online exercise classes and started teaching mine online, we set up a weekly family quiz to connect online, and I took some leave from work one day a week to reduce my working days for a while. I made an effort to eat lots of fruit and veg (when I could get them) to try and boost myself with natural vitamins.

However, after spending some days 8 hours pretty much none stop on work calls on screen, I just felt like I couldn’t possibly have a screen open in the evening, even for anything joyful.

As lockdown restrictions have eased, and slowly things are getting to a ‘new normal’ I have found myself actually struggling even more. It’s been so long of not experiencing my usual strategies and now everything is so different in what you can and can’t do. I don’t know what my strategies are anymore and how to go about trying to find some strategies to support me.

I have had to take 4 weeks sick leave from work more recently as I was just burnt out physically and mentally. To the point where for 3 of those 4 weeks I barely moved from the sofa as my body and brain were just shot! I have never experienced such a feeling, where I wanted to see no one, and just be. But every message of thinking of you and support meant the absolute world to me to know I did mean something and was worthy. And have to say that time has really shown me who is real in my life.

Reflecting on the whole experience and as we move into a different phase of COVID-19 I am left with a sense of, will there ever be parity of esteem and equal treatment and consideration of mental health and physical health. COVID-19 is very much a physical threat. And a threat it is, and I am in no way saying that lockdown wasn’t necessary or vital and we all had a huge part to play in ensuring the virus didn’t kill huge numbers.  The situation I now find myself in and the experience I have had? At no point was mental health taken into account when making decisions, is how it feels to me. And I don’t blame anyone or anything for that, but think it is a reflection of safety meaning only physical safety, we were all physically safe in our houses during lockdown, but were we mentally safe? And what risks outweigh what?

Those who were shielding and had even less choice, what consideration was given to the mental health impacts for them? Whilst there was no choice in them having to stay at home, what mitigating factors did we put into place to support them and the risks associated with their mental health? I remember many conversations with people when I raised it where it was felt that because these people are safe in their houses, and not going anywhere, we don’t need to worry about them. Actually that’s the exact reason we do need to worry and engage and interact with them. And also any other physical conditions. How many people have waited to access assessments and treatment for other life threatening conditions that may have had their chances reduced by the impact of COVID?  

And of course I say all of this from the lens of hindsight which is always a wonderful thing, but a perspective we didn’t have at the time. We are now expecting an increase in mental health services being required for a variety of consequences of the pandemic. And this is just my lens. For some people the working from home has really enhanced their life and supported them positively with their mental health, and I think that is wonderful.

But I think this whole thing proves there is no such thing as a one-size-fits-all approach to anything. You are always going to have exceptions to rules and you can’t policy make, and account, for every eventuality. Sometimes judgement calls have to be made and you have to do your best to make the right call in that moment. And that’s all we can ask for.