No Health Without Mental Health

The COVID 19 ban on visiting loved ones in hospitals and care homes is harmful to health, especially mental health. We all depend on connections with family and friends to sustain our physical, mental and spiritual well-being, especially when this is threatened by illness.

This ban breaks that connection at a time when it is most needed for those who are in hospital or care homes for a prolonged period and can cause or exacerbate mental ill health. Partial connection can be sustained for some people by phone and video link; but that is not the same as physical presence.

My wife has been in hospital for over a month. She is suffering from severe depression and a range of physical health problems including a broken hip.

Suddenly I am not allowed to visit, let alone hold her hand to comfort her. At the same time, I am still quite free to go to the pub and drink any amount of alcohol but if I meet friends in my garden I can now be fined. Such mixed messages are not just ineffective but also destructive to the social fabric of our lives. 

Of course, there are practical problems and unrestricted visiting is not feasible.

However, for people who are in hospital (or care homes) for a prolonged period, especially when they have mental health problems, ways need to be devised to maintain sustaining and comforting relationships. Human beings are social animals who need social interaction.

We know that if babies are not cuddled or shown warmth and love they will die, but even as adults need emotional support from and contact with those close to us, especially in times of illness.

There has to be a balanced compromise whereby sensible precautions and protective measures are taken in hospitals (and care homes) to reduce the risk of infection but appropriate social interaction is still not only allowed but encouraged as part of the road to recovery and sustaining well being.

We need to stop the spread of COVID 19; but this does not have to be at the cost of our mental health and wellbeing. Sadly we already have evidence that COVID is associated with increased rates of depression and suicide.

This is no doubt, to some extent, inevitable in view of the need for people to become more physically distanced and therefore less able to touch, hug and soothe each other.

However, particularly by using the phrase “socially distanced” we have confused the need for physical risk reduction with the need to cut off social contact as if they were one and the same thing. With sensible rather than panic-driven measures it is possible, even in a hospital and care homes, to protect the body from infection whilst allowing social relationships to continue.  

The NHS and care homes could have used the summer interlude to devise ways of sustaining contact with families and friends, especially when necessary to improve or sustain mental health. The government could have promised leadership and the resources to enable this.

Even if we deliberately tried to design a programme to destroy human mental health it would be hard to come up with anything more powerful than isolation. By unnecessarily disconnecting people from the emotional nutrition and social networks of their lives, we are unpicking the very social fabric of public health.

Love, physical closeness and emotional connection are the very roots of good mental health and any rules and policies must be calculated in terms of minimising risks in these areas. As mental health deteriorates, people will in any case behave in more physically risky ways.

There must be a balance. The line is being drawn in the wrong place and this was shown graphically when I am prevented from even seeing my wife in hospital, let alone touching her despite being fully prepared to comply with all requirements in terms protective equipment and procedures.

The consequences of enforced isolation from significant others may be unintended; but hopefully by writing this I am supporting many people who have argued the case for enabling carefully managed human contact with significant others for people in hospital or care homes. 

When unforeseen or unintended difficulties arise, such as damage to people’s mental health, there is an urgent need for a change of policy. There is a lack of logic, clarity and coherence in current policy which is causing confusion and is counter productive. 

The current ban on visiting is threatening to sweep away the very fabric of human connection and the daily coping mechanisms that play a vital role in keeping us all healthy. The irony is that in attempting to control the virus to protect people we are damaging what it is to be human and causing incalculable psychological distress.

An urgent rethink is needed.

Mike  Bush

Visiting Lecturer in Mental Health Leeds University

Retired Senior Mental Health Social Worker