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Health / More referrals to mental health services could be coming

No increase yet in drugs or psychological referrals

THERE has been no increase in numbers on the opiate substitute programme during coronavirus lockdown, according to the isles’ mental health services who are promoting the message “be kind” at a time when people may be experiencing extra stress.

Head of NHS Shetland mental health services Karen Smith said that substance abusers, particularly drug users, belonged to stigmatised and vulnerable groups of people who needed help regardless of their addiction.

The service, based at the Lerwick Health Centre, has been open throughout the coronavirus pandemic for self-referred patients and those coming on doctors’ orders.

Consultations, she said, were ongoing, with several patient visits per week. These people meet staff wearing “appropriate PPE”. Consultations can also be undertaken by video link.

NHS Shetland's Choose Life coordinator Karen Smith will be taking part in the roadshow.
Karen Smith.

People seeking help with mental health issues must be referred by a doctor before receiving help at the Lerwick based service.

Smith said: “One of the things we have not done across the whole service is drop any referrals from coming in. Our referral rates have not changed. The number of people accessing treatment has not changed.

“We are trying to keep things positive. Anyone worried about their drug or alcohol use, or that of a family member, can contact the service for self-referral. We have to be mindful that these are vulnerable groups of people.”

Smith said that while numbers on the opiate programme remained even, it was difficult to gauge exactly how many were taking heroin, as people have to come forward and engage with the programme to be counted.

People recovering from addiction can either attend chemists for their prescriptions, or where they are shielding or self-isolating, can have these delivered on a daily basis, or less frequently when they are further down the route to recovery.

While there is no pharmaceutical treatment for drugs like cocaine, the service can provide therapeutic treatments for people wishing to give up these drugs, as well as for those on opiates.

The service works in conjunction with other agencies like the police, Shetland Community Bike Project, employability pathway, Link Up and Mind Your Head.

The Scottish Drugs Forum recently provided funding for iPads so that patients can video-conference with forum staff in a continuing effort to free them from dependency.

Shetland Link Up normally provides a drop-in centre for adults experiencing or recovering from mental distress and at risk of social isolation. It has suspended its drop-in sessions for the meantime, but continues to support people over the phone.

Mental health charity Mind Your Head service manager Anouska Civico said that there had been surprisingly no increase in referrals during the lockdown period, but the experience of other countries indicated that the numbers seeking help might increase at the end of this month.

While the service has been closed for face-to-face consultations, it is still helping people over the phone and its casebook is currently full up.

Civico said: “I think for some people it’s a bit of a hard period. It’s been quite nice to have a bit more time off, but now some people are starting to struggle.

“Looking a the trend in other countries, the signs are that the end of May will see an increase in people trying to access psychological services.”

She added that increases in stress and anxiety could be especially bad for people with children, who have been off school in Shetland since mid-March.

“It’s going to be really interesting to see who refers themselves. I envisage we will see an increase in parents struggling to juggle working from home and child care.”

Frontline staff such as care workers may also suffer when they have time to take stock of what they have been through and consider the constant risk of exposure to Covid-19 they and their families have been facing.

“These staff have gone on regardless because they have to perform in that role. When they have time to sit back and reflect, that’s when the reality of the situation will kick in,” she added.

Anouska Civico of Mind Your Head.
Anouska Civico.

Civico said that some potential clients were waiting for distancing rules to relax so that they could have face-to-face meetings rather than use the phone. For others, it was quite suitable to be able to talk about their problems over the phone.

Privacy could also be an issue for people who would find it difficult to engage with the service from a home setting.

She added that for some people who were prone to social isolation anyway, it might be especially hard for them to readjust to social contact once the lockdown is relaxed.

More general health advice is available at Shetland Health Improvement’s Healthy Shetland Facebook page.

Northern Isles MP Alistair Carmichael meanwhile today (Tuesday) called on the UK and devolved governments to work together on a shared action plan to support the mental health of frontline workers during the coronavirus crisis.

Speaking remotely in parliament Carmichael stressed the “renewed importance” of governments setting an example during Mental Health Awareness Week and the value of a four-nations plan to boost cooperation.

He said: “This being Mental Health Awareness Week can we spend some time considering the mental health impact that the coronavirus pandemic is going to have on those frontline health and social care workers that are charged with tackling it.

“In particular would it not be a great example for the good working of our four governments if an action plan on mental health could be constructed that would have the support of all four governments?”

Responding, health secretary Matt Hancock said he was mindful of the “mental health impact, particularly on staff, but across the board of coronavirus.”

He added: “We work very closely with the four CMOs (chief medical officers) of the UK and between ministers to make sure that clinical advice is coordinated. After all it is based on the science and I am very happy to take these proposals forward and discuss it with the CMOs.”