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20 Mar 2021

How Covid-19 has impacted mental health inequality - and how to get help

Mental health inequalities have worsened during the pandemic. Find out how the system can be discriminatory and how to get help that works for you

The UK was already facing a mental health crisis before coronavirus came along, but the psychological impact of the pandemic has made things worse - and further entrenched existing inequalities.

According to the Office for National Statistics (ONS), almost one in five adults are likely to be experiencing some form of depression - doubled from one in 10 before the pandemic.

Our own research reveals that many people are seeking mental health support for the first time.

We surveyed 800 people about their experiences accessing therapy or counselling during the pandemic. Encouragingly, 75% of those who had started therapy said it was helping and 70% would seek therapy or counselling again in the future if needed.

But it's harder for some people to access therapy than others, and experiences of therapy itself can differ drastically - if it's offered at all.

Inequalities in mental health

Accessing the right kind of care is easier for some than others, and people aren't on equal footing in the first place.

For Black people, recent global events highlighting structural racism and police brutality, combined with the disproportionate impact of the pandemic on Black African and Black Caribbean people in the UK, has been a double blow to mental health.

Often, other factors that influence mental health inequalities overlap, compounding the problem.

The Centre for Mental Health says that people with disabilities, people living in social housing, women, non-binary people and people with previous experience of mental health issues are more likely to struggle mentally as a result of the pandemic.

How the system fails minority groups

'Systemic racism can foster distrust in the healthcare system and make people reluctant to seek help,' explains Natalie Creary, director of Black Thrive, an organisation working to address Black mental health inequalities.

Recent research by the Scientific Advisory Group for Emergencies (SAGE) highlighted that such fears have led to reluctance to take up Covid-19 vaccines among Black, Asian and minority ethnic (BAME) groups.

It's a similar story with mental health. No wonder, when Black people receive lower levels of referrals to talking therapies, but a recent government review revealed that they're more than four times more likely to be detained under the Mental Health Act than white people.

Health inequality among BAME groups

  • 49% told us their mental health was negatively affected by recent global events highlighting structural racism
  • 35% felt the mental health system had been discriminatory to them over the past year
  • 25% said they would have preferred culturally specific therapy, but could not access it.
Based on a Which? survey in December 2020 of 293 people from BAME backgrounds who sought mental health support in the past year.

Wider societal inequality issues are also reflected in mental health: our survey found that people from BAME backgrounds were more likely to report struggles due to employment or financial issues (33%) than white respondents (23%).

People from BAME groups were also more likely to be seeking help for the first time (68% compared with 52% of white respondents).

Long Covid - what it is and accessing support

What help is available?

Creary says it's important for people to know their rights when accessing services and to feel empowered in knowing what information they need.

One way this can happen is through peer support and advocacy services, which can be accessed through charities and community groups.

It can also be useful to have a friend or family member help you with researching your options and contacting support groups, if this is an option for you.

Accessing culturally specific therapy

Going private is one option for people who are underserved by the NHS and mainstream routes to support, says Myira Khan, the founder of the Muslim Counsellor & Psychotherapist Network.

She says that right now, there's just not enough cultural sensitivity embedded within mainstream therapy services. For many of her clients, working with a Muslim therapist is important, as culture plays a big role in their identity.

Natalie Creary agrees, saying there is also a lack of Black therapists in the NHS and that a lot of Black therapists work in the private sphere, which can be a cost barrier for many.

While not everyone from a BAME background will need or want a therapist from their same cultural or ethnic background, the overwhelming whiteness of NHS therapy is an issue.

It can be a deterrent to seeking help all together and result in poorer outcomes from treatment.

Creary points out that Black people can feel exhausted by having to spend their first few sessions of therapy explaining the mental health impact of racism.

NHS options are scarce

The NHS has started referring people to culturally specific therapy run by charity organisations, but this isn't standard and is for now mostly concentrated in larger cities.

Creary says the NHS is sceptical of African-centred therapies, meaning it's difficult to access them via the service.

The NHS mental health and wellbeing website, for example, has no links to specific services for BAME groups, but it does give tailored advice for LGBT+ and older people.

Last summer, NHS chief executive Simon Stevens told NHS staff that 'more systematic action is needed to tackle the underlying causes of health inequality' within the organisation.

How mental health charities fill the gaps

Of our survey respondents, 11% said that they were receiving mental health support from a charity or local community organisation.

These organisations often step in to fill gaps in NHS or other mainstream routes to therapy and aim to help redress the financial restrictions that can come with accessing private therapy.

The challenge for grassroots organisations is that demand often outstrips supply.

Black Minds Matter, which launched last year to provide free therapy for Black people by Black therapists, has provided therapy to 500 people. But there are 2,500 people still on the waiting list, which has had to temporarily close while more funds are raised.

As Andy Bell, deputy chief executive of the Centre for Mental Health, says, 'the work of organisations like this is fantastic, but it shouldn't let mainstream institutions off the hook'.

Where to find help

If you - or someone you know - needs mental health support, it's important to speak to someone.

A lot of people start with their GP, but there are also charities you can speak to, or you might have a local community group offering support.

See our guide to seeking counselling or therapy for advice on where to start and how to have a productive discussion about your mental health with your GP.

Mental health charities Mind and Rethink Mental Illness both have resources for coping during the pandemic.

If you want to search for a private therapist, you can try a therapist directory, such as:

  • BACP British Association for Counsellors and Psychologists
  • Counselling Directory for all kinds of counsellors and therapists
  • Pink Therapy for therapists specialising in LGBTQI+ issues
  • BAATN Black, African and Asian Therapy Network
  • MCAPN Muslim Counsellor & Psychologist Network.

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