Introduction

The devastating loss of life, the impact of lockdown and the inevitable recession will have deep and lasting consequences on the lives of so many Londoners.

It’s clear that the Covid-19 pandemic has been a mental health emergency, just as much as a physical one.

Anyone already living with a mental health problem has fared worse in the pandemic: two-thirds of adults who already had experience of mental health problems told us that their mental health had declined during the first lockdown period. We also know that many people who were previously well will now develop mental health problems, as a direct consequence of the pandemic and all that ensues.

In particular, there has been a significant mental health impact on:

• frontline staff who have been exposed to traumatic scenes
• Black, Asian and Minority Ethnic communities who have experienced much higher death and infection rates
• those of us dealing with unemployment or financial worries
• people recovering from coronavirus
• families with children and single parents
• children and young people.

 

Five priorities for the Mayor of London

Our manifesto sets out five priority areas with actions that the Mayor needs to take to address the mental health emergency facing Londoners as a result of the pandemic. The five priorities are to:

1. Protect Londoners from financial stress
2. Protect those Londoners that suffer from inequalities due to poverty and ethnicity
3. Protect the mental health of children and young people
4. Invest in appropriate community services
5. Reform the Mental Health Act

Download the Mind in London manifesto as a PDF (356 kb)

1. Protect Londoners from financial stress

We know that concerns about unemployment, income decline and unmanageable debts can have a significant impact on our mental health and is closely linked to increased rates of common mental health problems, increased substance abuse and suicide.

We are likely to see a rise in financial stress and debt due to job insecurity and unemployment following the recession due to the Covid-19 pandemic and multiple local and national lockdown restrictions. The high cost of housing in London also plays a part in increasing vulnerability to financial stress and the risk of homelessness. Children with mental health problems are twice as likely to live in households suffering financial hardship. Financial hardship in some London boroughs mean that existing tried and tested services are under threat of cuts or may even disappear in some areas.

Mind in London provides:

Employability services with tailored one to one and group support to build skills and confidence for those of us with mental health problems who are entering or re-entering the jobs market and access to education.

Information and advice around income maximisation and welfare benefits; access to housing and homelessness support; and access to community and clinical support for anyone with mental health problems through Integrated Care Systems and Primary Care Networks.

What do we want the Mayor to do?

• Work with mental health organisations to plan and deliver appropriate services within a planned approach to economic and social recovery.
• Provide tailored support to people on benefits, living in poverty or at risk of homelessness who have a mental health problem or who consider themselves at risk of developing a mental health problem, including access to direct support for claiming Universal Credit.
• Support more Londoners with mental health problems who want to work, to find employment and stay in work. Respect that work is not an option for some people and work with partners to provide community and peer support to people that can’t work so that these Londoners have the chance to be active members in their community.

‘The lockdown has made me very isolated. I am now unemployed and worried about accessing food, medicine and enough money to live on.’

Mind Survey respondent

2. Protect those Londoners that suffer from inequalities due to poverty and ethnicity

The Covid-19 pandemic has shone a light on structural inequalities at the heart of our society. Higher mortality rates across Black and Asian communities have highlighted structural inequalities and institutionalised racism in health services. For instance Black people are less likely to receive psychological therapies and are 40% more likely to access treatment through the police or a criminal justice route.

Economic and social inequality leading to poverty and deprivation add another layer. For example Black people are more likely to be on lower incomes and live in more deprived neighbourhoods. Child poverty is not just a short-term risk to mental health: it has an effect throughout life.

Mind in London advocates and supports local Minds across London to develop and evolve as anti-racist organisations. Mind in London can:

• Co-design appropriate services and influence good practice with people with lived experience of mental health problems.
• Work alongside community groups working with Black, Asian and minority ethnic communities to build capacity.

What do we want the Mayor to do?

• Hold the five London Sustainability and Transformation Partnerships (STPs) and Integrated Care Systems (ICS) to account for delivering the recommendations of NHS England’s Advancing mental health equalities strategy
• Work with the NHS and local authorities to ensure increased diversification of London’s mental health workforce
• Support both the NHS, and alternative providers, to offer more culturally appropriate services and responsive crisis support that better engages and reflects the diversity of our city
  Ensure that the voice of those of us with lived experience of mental health problems influences all decisions on health and wellbeing provision in the capital.

'I am worried about money, the uncertainty of when things will start to return to normal, if my work will still be there and how this will affect my children’s lives in the next few years.’ 

Mind, Survey Respondent

3. Protect the mental health of children and young people

Children and young people have been among those most impacted by the pandemic. Mind’s survey on the impact of the first lockdown found that two thirds of young people’s mental health had declined and over a third of young people with existing mental health problems were self-harming to cope. Many young people and families in London are experiencing unsuitable home learning environments; lack of safe spaces in schools; food poverty; digital exclusion and other inequalities.

School disruption and closure, uncertainty around exams and soaring unemployment will all impact adversely on young adults’ potential to gain qualifications and find work. The pandemic and subsequent recession will have long-term effects on the mental health of young people.

Even before coronavirus, young people with a mental health problem were already being left behind by our education system, with nearly 1 in 5 young people experiencing a mental health problem dropping out of education due to stigma.

Mind in London deliver a variety of interventions targeted at children and young people and has piloted the Whole Schools Approach for mental health.

What do we want the Mayor to do?

• Invest and influence commissioning of preventative services for CYP together with relevant acute services
• Support early prevention, identification and intervention through local authorities and partnerships with the community and voluntary sector across London
• Make London’s schools the gold standard in treating mental health and wellbeing as equal to academic success and ensure that young people with mental health problems in London schools are not faced with stigma, discrimination and exclusion.
• Train and support London’s teachers and staff in mental health and wellbeing.
• Equip young Londoners with clear and honest information and make them leaders and role models at the heart of co-designing services for young people
• Provide tailored support to young people that are transitioning from child to adult services in London – too often these young people fall through the gap or are suddenly thrust into age-inappropriate settings because they have turned 18.

‘The isolation from not only family and friends but from my pastoral manager at school has taken a toll. I was on the list for counselling and now I have no one to talk to.’

Mind Survey respondent

4. Invest in appropriate community services

The multiple waves of Covid-19, together with regional and national tier responses, have caused a surge in need for mental health services. It’s estimated that an additional two million Londoners will require access to mental health services as a result of the pandemic.

Mental health services were overstretched before the pandemic; without a significant injection of additional cash, they will now be overwhelmed. We need to ensure that statutory services invest in and commission appropriate services that respond to the needs of their diverse communities and to additional needs following the pandemic.

Mind in London works with local commissioners to provide the focused solutions for their communities including crisis alternatives; bereavement support; suicide prevention and postvention; and perinatal support.

What do we want the Mayor to do?

• Hold the five London Sustainability and Transformation Partnerships (STPs) and Integrated Care Systems (ICSs) to account for delivering the recommendations and funding commitments in the Five Year Forward View for Mental Health; and NHS England Long Term Plan in full.
• Ensure that all NHS staff in London have training in mental health.
• Promote, and resource, a holistic, non-medical approach so that people presenting to services with mental health problems receive support for their wellbeing and social needs alongside any clinical interventions.
• Support both the NHS, and alternative providers, to offer more culturally appropriate services and responsive crisis support that better reflect and engage the diversity of our city.
• Ensure that the voice of people with lived experience is represented and able to influence all decisions on health and wellbeing provision in the capital.

‘Not being able to access the relevant physical and mental health services… has left me distraught and depressed as there is no way for me to treat my symptoms that are plaguing me daily.’

Mind Survey respondent

5. Reform the Mental Health Act

The Act is outdated and discriminatory with Black people four times more likely to be sectioned and three times more likely to be restrained or held in isolation.

The pandemic has further highlighted the urgent need for reform. Many mental health hospitals were ill-equipped to control the spread of coronavirus and this, combined with staff sickness and absence, left those detained under the Mental Health Act far more exposed to Covid-19 than the wider population. Right now, thousands of people are still subjected to poor, sometimes appalling, treatment, and many will live with the consequences far into the future.

Mind in London supported Mind’s call for the UK government to implement the recommendations of the Independent Review. Mind in London will work to ensure as many people as possible with experience of mental health problems take part in the public consultation process, to make sure their voices and experiences are at the heart of reforms.

What do we want the Mayor to do?

• Protect the rights of anyone who chooses voluntary admission for hospital treatment in London to prevent involuntary sections and improve their experience of care
• Provide high-quality safe spaces that are culturally appropriate and reflect the cultural diversity of London
• Develop cultural sensitivity and awareness in London police and NHS services to tackle the inequalities and racial discrimination associated with the Act.
• Ensure access to high-quality, culturally sensitive advocacy and information for all Londoners subjected to the Act.

‘They don’t see me as an individual, with a specific history. They see a catalogue of Black men who come off as this stereotype of being big and dangerous and angry.’

Colin, Mind film participant