The psychological effects of Quarantine and how to reduce it ( Brooks, Webster et al Lancet 2020, 912-20)
predicted that there would be an increase in mental health problems following quarantine. Comparing this time with previous experiences of quarantine led the authors to suggest that there would be an increase in depression, alcohol problems and post- traumatic stress disorder.
Many people have been dealing on a day to day basis with Death and agonising decisions. Front line workers and many others have been coping with serious anxiety. Anxiety can lead to feelings of shortness of breath, and there will be many who are concerned that they are affected, and those who are affected may be very concerned about passing on infection to others.
Generally the advice we have been given has been helpful. Social distancing, protecting those at risk and supporting and helping frontline workers has been practiced generally quite well although there have been many exceptions. What about those who have been struggling with anxiety? I did a recent interview regarding this and you may like to listen in full to this ( see below)
You might also like to listen to a talk on Anxiety and Stress management, in two parts, on the resources section of my website.
In many places we seem to be past the worst of the Covid crisis. In Northern Ireland, where I live, there have been several days with no further deaths from Covid which is very encouraging.
However, in many parts of the world Covid continues to rage. It is also so difficult to hear of children dying of malnutrition as a result of the Covid crisis. As a church here we have been able to pass food parcels to many people, particularly refugeesand charities continue to be most grateful for financial support to areas of the world hit hardest. As someone said
Staying safe and learning to stay safe is so important.
Molly Russell took her life aged only 14 after accessing graphic images of self-harm. Her father stated that Instagram had helped kill his daughter. As psychiatrists we are taught the importance of thorough assessments of those who self-harm or are at potential risk of suicide, but the reality is that only one quarter of suicides had been seeing a mental health professional before the fatal event.
Recently I had the privilege of listening to a well-known expert, Dr Alys Cole-King talk on the topic of suicide prevention.
STAYING SAFE-THREE KEY MESSAGES
In three particular areas Dr Cole-King has helped to shape my thinking and practice. As a Consultant Psychiatrist working with the elderly, I frequently assess people who feel that life is not worth living or are having suicidal thoughts. In each case thorough assessment is vital, but what other messages does Dr Cole King bring?
Firstly, she emphasises the importance of Compassion. I am glad to see this being included in psychiatric practice. Compassion is defined as sensitivity to the distress in others and a commitment to do something about it. If compassion is so important, to what extent can it be taught? Do we have good role models for compassion? It is recorded several times that Jesus Christ was moved with compassion and then met the particular needs of the people listening to Him. For example, He saw people as harassed and helpless, like sheep without a shepherd (Gospel of Matthew 9v36) and in response, on this occasion, He taught the people, as He saw and recognised their individual needs.
Secondly, Dr Cole-King emphasises the importance of helping people look beyond the crisis. Questions like,’ When you previously faced major difficulty in your life, how did you get through?’ help point people beyond the immediate crisis. We know from helping those at the very point of suicide, that very often people do not actually want to die; it is rather that they cannot find a way through their difficulties. The story of Kevin Hynes in ‘Hey, Kid are you OK? illustrates this. He jumped from the Golden Gate bridge but after he jumped he cried out, ‘God, please save me. I don’t want to die!’ A sea lion nosed him to the surface until the rescue boat arrived and his life was saved.
.Thirdly, she emphasises the importance of having a good safety plan. This is something the person at risk can work on together with the person helping them. The website http://www.stayingsafe.net/ gives a good example of a safety plan.
My book Mindful of the Light has two chapters on The person who is suicidal and Spiritual Help for the Suicidal Person
Although professional help is always advisable in the assessment of those who are suicidal, ASIST workshops help train people in suicide prevention.
PTSD is common. A recent survey in the Lancet of 2,000 eighteen year olds in England and Wales showed that one in every 13 had evidence of PTSD.
Only a third or so of those who experience major trauma developed PTSD. Of those who developed PTSD in this survey about a half had also had depression, a quarter had evidence of alcohol dependence and a fifth had harmed themselves.
‘THE TROUBLES’ NORTHERN IRELAND
The level of PTSD is high in Northern Ireland where I live. Many who have lived through ‘The Troubles’ here have had horrific experiences and in clinic I have encountered fire fighters, policemen and prison officers who have been through harrowing times. In PTSD people will often have flashbacks and nightmares of the experiences they went through. They will often be ‘on edge’ and want to avoid any reminder of the experience. They will usually try to bury the experience deep inside themselves and may find certain aspects of the experience difficult to remember. They may actively avoid ever going near where the incident happened.
Last Friday evening, I was continuing some of the talks I have recently been giving at Clonard Monastery. (Previous talks on Anxiety, Suicide, Addictions and Depression were broadcast live and can be accessed on the CLONARD MONASTERY FACEBOOK PAGE. Further talks on Psychosis and Bereavement will be on Fridays 22nd and 29th March at 7-30pm )
This last Friday I was talking on PTSD. In small groups people were able to talk about their experiences. We pointed out where more specific help was available. Trauma based cognitive behaviour therapy and EMDR (Eye Movement Desensitisation Reprogramming) are both valid and well attested forms of therapy and some of my colleagues have excellent results in this area.
We also encouraged the audience to believe that the Lord Jesus Christ can bring healing to the traumas they had suffered. We had a good time of prayer for individuals who had been through traumatic experiences. We have been delighted to be involved with Clonard Monastery with these talks, particularly since Clonard were instrumental in helping to bring reconciliation during ‘The Troubles’.
When healing occurs, through various means, people are able to look back on their painful experiences without the distress and fear that they had become accustomed to with PTSD.