COVID-19: What the looming mental health crisis means for health inequalities


The pandemic in which we are currently living has seen many of us just about surviving, and certainly not thriving. The impact of COVID-19 has been far reaching and touched upon every aspect of our lives; the way we work, the way we socialize, the way we interact with our families.

Unsurprisingly, there is a growing concern over the impact the pandemic has had internationally, beyond the physical virus. October 10th marks Mental Health Awareness Day, and so this month in particular, we are focussing on what kind of ripple effect COVID-19 has had on our mental health.

In terms of the UK, the answer in short is a big effect. A recent report from the charity Centre for Mental Health has found that levels of psychological distress and mental ill health are rising internationally in the wake of COVID-19. Following consultation with NHS England and NHS Trusts, the charity believes that 8.5 million adults and 1.5 million children in England alone will need mental health support due to the pandemic. Whilst two-thirds of these people will have had an existing mental illness, many of them will require support for the first time.

Lost loved ones, lost jobs and huge changes to the way we live our lives are some of the drivers causing this wave of ill mental health. Whilst health anxiety and agoraphobia as a result of COVID-19 are widespread, it is already apparent that there are specific groups of people facing higher risks to their mental health at this time.

One such group are people from black and minority ethnic backgrounds. A survey undertaken by the charity Mind in July this year found that existing inequalities in access to healthcare, housing, employment and finances have had a greater impact on the mental health of people from black, Asian and ethnic minority groups than on white people during the coronavirus pandemic.

These issues are compounded by the fact that black and ethnic minority groups are at higher risk from the virus itself. In April, people of color represented one-third of all COVID-19 patients admitted to hospital, despite making up only 14% of the British population. We have since learnt that the risk of COVID-19-related death is more than four times as high for people of black ethnicity than for those of white ethnicity. Whilst this stark difference in mortality is partly a result of socio-economic disadvantage—including the fact that ethnic minorities are more likely to live in overcrowded households, in deprived areas, and have jobs that expose them to higher risk—a remaining part of the difference has not yet been explained by science, or otherwise. It is therefore unsurprising that British people of color are experiencing higher rates of anxiety during this pandemic.

This is not a new problem, health inequalities existed long before we knew of this coronavirus. Professor Marmot published the report ‘Health Equity in England: The Marmot Review 10 Years On” in February this year. This report assessed how far England had come in the previous decade in addressing the health inequalities outlined in Marmot’s original report. Spoiler alert: not very far. The review uncovered some hard to swallow truths, in particular that people living today can expect to spend more of their lives in poor health than those living a decade ago. Worse still, the health gap between wealthy and deprived areas has grown in the 10 years since he first assessed the issue.

Yet again these inequalities are worse for certain people. The report shows that half of minority ethnic groups – mostly black, Asian, and mixed ethnic groups – have significantly lower healthy life expectancies than white British people. Furthermore, all minority ethnic groups – Bangladeshi, Pakistani and black people in particular – are living in higher rates of poverty than white people. With these inequalities already deeply entrenched in our society, COVID-19 has added further fuel to this fire.

To even begin to right this wrong, society must face up to the discriminatory nature of this coronavirus and acknowledge that black and ethnic minority groups are being hit the hardest by not just the physical, but the mental health impact of COVID-19.

But improved awareness alone will not cut it. We must also be honest that mental health resources within the NHS—as well as within other countries around the globe—were already struggling to keep up with demand before COVID-19 struck. The Royal College of Psychiatrists recently found that one in four people with mental health concerns are waiting at least three months to start NHS treatment, with some not getting help for up to four years. Whilst this lack of resource will be exacerbated by the pandemic, global healthcare systems must prioritize the limited resources currently available and act in a way to ensure health inequalities are not also exacerbated.

It is already clear that the people who will be disproportionately impacted by the pandemic are those who are already impacted by health inequalities. Action must be taken to ensure groups receive the mental health care they require. We must ensure mental health resources are targeted where they are needed most in a timely, accessible, and culturally appropriate way to counteract the impact of multiple disadvantages which still exist in society. By working together, and with appropriate Government funding, the NHS, local authorities and the third sector can ensure that the communities who have endured the worst health outcomes from COVID-19 receive the tailored mental health support they need.

One day in October may be Mental Health Awareness Day, but the whole of the month is Black History Month. Now feels like a really important time to reiterate that black lives matter, which means black people’s mental health must be taken seriously. To do this, the NHS must now prepare for what lies ahead.

If you are interested in discussing how we can work together to tackle health inequalities, please contact us.

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