Accessing mental health services during COVID-19: adapted services, complex needs and increase in demand

For Mental Health Awareness Week, Derbyshire Mental Health explains the ways they are meeting the needs of their service users by providing adapted services during COVID-19 and the subsequent lockdown.

The Derbyshire Federation for Mental Health is a small charity of 21 part time staff members. We provide a range of mental health support services throughout Derbyshire for adults and young people living with or recovering from mental ill health

The weeks leading up to the Covid-19 lockdown in the UK saw our current clients become increasingly anxious about the threat of Coronavirus. We started to introduce the use of hand sanitiser and observe social distancing methods when running our social groups. Hence when lockdown inevitably arrived, we had already started to adapt our services so we could continue to support our clients to the best of our ability and meet their needs within the Government restrictions. 

One of the first things we did was install a rota-base system amongst our staff so people contacting the organisation are greeted by a person and not an answerphone during these difficult times.  Since the end of April, we have noticed an increase in calls to our organisation and many are from individuals who have not previously had a mental health condition and can, therefore, support directly or signpost appropriately.

Those who attended our adult and young people groups and drop-ins prior to the lockdown are now receiving weekly calls to see how they are doing from Support Workers instead. We have also set up online groups and activities for them to attend via YouTube and Zoom. These have been well received and attended.

Those who attended our adult and young people groups and drop-ins prior to the lockdown are now receiving weekly calls to see how they are doing from Support Workers instead. We have also set up online groups and activities for them to attend via YouTube and Zoom. These have been well received and attended.

We’ve added new support plans which include staff assisting with shopping and pharmacy collections both supporting individuals to do this themselves and do it on their behalf.

Adapting services for those with more complex needs

The more difficult aspect of our support to fulfil is those in the community with significant support needs.  We assist these individuals to manage their mental health conditions and provide support that enables them to maintain their independence and live in the community. These individuals tend to have the more severe and enduring mental health conditions and rely on the support packages they are assessed to need. Most of these clients received weekly 3 to 12 hours of face-to-face support from our organisation before lockdown.

When the lockdown was announced we reassessed all the clients receiving this type of tailor-made support service and put revised support packages in place to ensure the safety of both our workers and the clients during the pandemic. Many were happy to receive daily calls by their designated workers instead of usual provisions.  Others required the continuation of the support they previously received, which required us to risk assess all these clients and the scenarios our workers would be faced with.

On occasion, we have been able to retain this level of support by moving these services to more community settings, but often this is unsuitable, and we have had to continue at-home support. When this was unavoidable, we tried to source and purchase adequate PPE – a mammoth task due to UK-wide shortages and increased prices – and implement stricter health and safety working practises.

Six weeks in and we are now finding the clients within these services experiencing a deterioration in their mental health. We are now having to increase the level of services we provide, e.g. more phone calls and/or speaking to them face-to-face on their doorstep. We also find ourselves needing to provide more support in individual’s homes to help them manage their health and daily living.  

Continuation of services and beyond COVID-19

None of us yet know what the UK will look like in the future.  The Business plan our Trustees and Managers agreed in March is now back on the agenda to be redrafted, but we remain positive about our future.  The pandemic has tested our resolve as an organisation.  As the CEO, I have been proud of the services that have remained possible due to the flexibility and professionalism of our staff and our positive and willing approach has been recognised and thanks has been in abundance. Communication from the Commissioners of the contracts we deliver has been very positive with several direct payment clients having their hours increased. 

Our relationship with other health and social care professionals is generally good. During the pandemic, we have been asked to assist with many client issues (some outside our usual remit) and a couple of new clients have been referred to us.  But we have worked with our statutory partners to ensure clients get the best possible care and that as professionals we are looking out for each other too! 

It has made us consider and embrace new ways of working and some we will continue to use long after the Coronavirus has been defeated and to meet the new challenges that we will no doubt face from the fall out of the pandemic in the UK. The increased use of digital technology has given significant learning and this will be feeding into the business plan and service delivery, especially covering a rural area.