[Withdrawn] Guidance for the public on the mental health and wellbeing aspects of coronavirus (COVID-19)

Question 1

What you need to know

Accepted Answer

The coronavirus (COVID-19) pandemic is having an impact on everyone’s lives. During this time, you may be bored, frustrated or lonely. You may also feel low, worried, anxious, or be concerned about your health or that of those close to you. You may also feel concerned about the economic impact of the pandemic and how this could affect your job or finances. These are all common reactions to the difficult situation we face. Everyone reacts differently to events and changes in the way that we think, feel and behave vary between different people and over time. It’s important that you take care of your mind as well as your body.

Most people will find strategies that work for them and for the difficult feelings associated with the pandemic. Some people, especially those with pre-existing mental health problems, may need extra support.

Question 2

Background

Accepted Answer

This guide provides advice on how to look after your mental health and wellbeing during the COVID-19 pandemic^{[footnote 1]}.

There is more information on how to stop the spread of coronavirus available.

Question 3

What can help your mental health and wellbeing

Accepted Answer

Think about your daily routine

Life has changed for us all at the moment. Think about patterns you have fallen into and whether you could adapt them and create more positive routines. Try to engage in useful activities (such as cleaning, cooking or exercise) or meaningful activities (such as reading or keeping in touch with friends). You might find it helpful to write a plan for your day or week.

Consider how to connect with others

Maintaining relationships with people you trust is important for your mental wellbeing. If you can’t meet in person, think about how you can stay in touch with friends and family via telephone, video calls or social media instead – whether it’s people you normally see often or connecting with old friends. If you live alone you can also form a support bubble with another household.

The NHS Volunteer Responders can also provide a free telephone ‘check in and chat’ if you are feeling isolated. Call 0808 196 3646 to register for this service.

Help and support others

Think about how you could help those around you – it could make a big difference to them and can make you feel better too. It is important to listen to and acknowledge other people’s concerns, worries or behaviours. Could you message a friend or family member nearby? Are there community groups that you could join to support others locally? Remember it’s important to do this in line with guidance on COVID-19 to keep yourself and everyone safe.

Talk about your worries

It is quite common to feel worried, scared or helpless about the current situation. Remember that this is a difficult time for everyone and sharing with family and friends how you are feeling and the things you are doing to cope can help them too. If you don’t feel able to do that, there are people you can speak to via NHS recommended helplines.

Look after your physical wellbeing

Your physical health has a big impact on how you are feeling emotionally and mentally. At times like these, it can be easy to fall into unhealthy patterns of behaviour which, in turn, can make you feel worse. Try to eat healthy, well-balanced meals and drink enough water. Visit One You for advice on improving your health and wellbeing, including ideas for healthy meals you can cook at home.

Be physically active. Doing exercise and other physical activity can have a positive impact on your mood, improve your sleep, and reduce stress and anxiety. There are lots of easy ways to get moving like walking or gardening. If you can’t exercise outside, you can find free, easy 10-minute workouts from Public Health England (PHE) or other exercise videos to try at home on the NHS Fitness Studio. Sport England also has tips for keeping active at home.

Seek advice and support if you smoke or use drugs or alcohol

Smoking or using drugs or alcohol to cope in times of stress and disruption can make things worse, including your mental health. NHS Better Health provides information and advice on quitting smoking and helps you find a package of support that’s right for you. You can also talk to an adviser on the National Smokefree Helpline on 0300 123 1044 (call charges may apply).

One You provides advice and resources to help with cutting back on alcohol. You can also call Drinkline on 0300 123 1110 (call charges may apply) for advice and support and Down Your Drink provides interactive web-based support to help people to drink more safely.

If you are concerned about drug use, FRANK offers information and advice, including where to get help, and provides an advice line on 0300 123 6600 (call charges may apply). Mutual support for those wanting to give up and stay off drugs is available from organisations such as SMART Recovery, Alcoholics Anonymous, Narcotics Anonymous, Cocaine Anonymous and Marijuana Anonymous.

Look after your sleep

Feeling anxious or worried can make it harder to get a good night’s sleep. Good-quality sleep makes a big difference to how you feel mentally and physically, so it’s important to get enough.

Try to maintain regular sleeping patterns and good sleep practices, such as creating a restful environment and avoiding caffeine close to bedtime. The Every Mind Matters sleep page provides practical advice on how to improve your sleep.

Try to manage difficult feelings

Many people find the news about COVID-19 concerning. However, some people may experience such intense anxiety that it becomes a problem. Try to focus on the things you can control, such as managing your media and information intake – 24-hour news and constant social media updates can make you feel more worried. If it is affecting you, try to limit the time you spend watching, reading, or listening to media coverage of the pandemic. It may help to only check the news at set times or limiting yourself to checking a couple of times a day.

The Every Mind Matters page on anxiety and NHS mental wellbeing audio guides provide further information on how to manage anxiety.

Get the facts

Gather high-quality information that will help you to accurately determine your own or other people’s risk of contracting COVID-19 so that you can take reasonable precautions. Find a credible source you can trust such as GOV.UK, or the NHS website, and fact-check information you get from newsfeeds, social media or other people.

Think about how inaccurate information could affect others too. Try not to share information without fact-checking with credible sources.

Do things you enjoy

When you are anxious, lonely or feeling low, you might reduce the time you spend doing things that you usually enjoy or stop doing them completely. Focusing on your favourite hobby, learning something new or simply taking time to relax should give you some relief from anxious thoughts and feelings and can boost your mood.

If you can’t do the things you normally enjoy, try to think about how you could adapt them or try something new. There are free tutorials and courses online as well as entertainment, such as online quizzes and music concerts.

Set goals

Setting goals and achieving them gives a sense of control and purpose. Think about things you want or need to do, particularly those that you can do at home, such as reading a book or learning something online.

Keep your mind active

This can help you feel in control and less low or worried. Read, write, play games, do crossword puzzles, sudokus, jigsaws or drawing and painting – whatever works best for you.

Take time to relax and focus on the present

This can help with difficult emotions, worries about the future and generally make you feel better. Relaxation techniques can also help some people to deal with feelings of anxiety. For useful resources, see Every Mind Matters and the NHS mindfulness page.

If you can, get outside. If you can’t, bring nature in

Spending time in green spaces can benefit both your mental and physical wellbeing. If you can’t go outside, you can try to still get these positive effects by spending time with the windows open to let in fresh air, arranging space to sit and see a nice view (if possible) and get some natural sunlight.

Question 4

Challenges you may be facing

Accepted Answer

You may have challenges in your life that are affecting your mental health. The following advice may help you to think about potential issues you may encounter and to plan for them. Making these plans could help to protect or improve your mental health during these challenging times.

Essential supplies

If you are not able to go out, think about how you can get any supplies you need, such as food, medication or other essentials. You might be able to phone or email your local shops to get a food delivery, or get food online, or get friends, family or neighbours to help. If there’s no one to help you get essential supplies, find out if you can get help from a volunteer through the NHS Volunteer Responders programme.

If you’re finding it hard to afford food, find out if you’re eligible for Universal Credit. If you have a child, find out if they can get free school meals. Apply for Healthy Start vouchers if you’re 10 or more weeks pregnant or have a child under 4. Get more information on accessing food and other essential supplies.

Financial concerns

Worry about work and money issues can have a big impact on your mental health. The Money Advice Service has created the Money Navigator Tool to help you identify the support you may need and signpost to tailored information and guidance. For further guidance on what your rights are at work, what benefits you are entitled to and what further support is also available from, see guidance for work and support or advice from Citizens Advice or the National Debtline.

Treatment and support services

It is important that you continue to receive the care and support you need to help you stay safe and well. We urge you to continue to seek support from the NHS and other health providers for your existing health conditions and any new health concerns.

You can access a range of NHS services from home, including ordering repeat prescriptions or contacting your health professional through a telephone or online consultation. Speak to your therapy team or therapist about options for starting or continuing a course of talking therapies.

Accessing medication

You might be able to order repeat prescriptions by phone, or online using an app or website, if your doctor’s surgery offers this.

Caring for other people

You may be worried about how to ensure care for those who rely on you– either your dependants at home or others that you regularly visit. Let your local authority know if you provide care for, or support, someone you don’t live with and this is being interrupted by COVID-19. Further advice on creating a contingency plan and sources of support are available from Carers UK.

Question 5

Where to get help for your mental health

Accepted Answer

If you are experiencing stress, feelings of anxiety or low mood, you can visit the NHS mental health and wellbeing page for self-assessment, audio guides and practical tools. Every Mind Matters also provides simple tips and advice to start taking better care of your mental health.

If it is affecting your daily life, contact NHS 111 or speak to your GP. NHS mental health services remain open. You can find further information on how to access mental health services and search what is available in your area. Support is also available through the mental health charities.

If you need help for a mental health crisis, emergency or breakdown, you should get immediate expert advice and assessment. Visit NHS.UK to find out where to get urgent help for mental health. In a medical emergency, call 999. This is when someone is seriously ill or injured and their life is at risk. A mental health emergency should be taken as seriously as a physical health emergency.

Question 6

Advice for groups with additional mental health needs or facing specific issues

Accepted Answer

Existing mental health problems

If you already have a mental health problem, then you may be finding the COVID-19 pandemic particularly challenging. The advice above should help, but here are a few extra things that you could consider. This is based on guidance provided by Mind. Rethink Mental Illness has also created an online hub to provide advice and support for people living with mental illness and those supporting others.

If you are already receiving mental health care, contact your mental health team to discuss how your care will continue or could change in response to your changing needs, and to update your safety and, or care plans.

If you have an existing mental health problem but are not currently receiving care from a mental health team and feel that you can no longer adequately manage your condition yourself, you can discuss options for accessing further support with your GP. You can also self-refer to access talking therapies for anxiety and depression via NHS psychological therapies services (IAPT services).

Managing difficult feelings or behaviours to do with hygiene, washing or fears of infection

Some mental health problems can cause difficult feelings or behaviours to do with washing or hygiene. If you experience this, you might find it hard to hear advice about washing your hands.

It is important to follow government advice on helping to avoid the spread of COVID-19, but if you find you are going beyond the recommendations, if this is making you feel stressed or anxious, or if you are having intrusive thoughts here are some things you could try:

let other people know you’re struggling, for example, you could ask them not to discuss the news with you
breathing exercises can help you cope and feel more in control. You can find a simple breathing exercise on the NHS website and Mind’s pages on relaxation have some tips and exercises you can try
set limits, like washing your hands for the recommended 20 seconds
plan something to do after washing your hands, which could help distract you and change your focus
it could also help to read Mind’s tips in their information on obsessive compulsive disorder (OCD) or advice from OCD UK

Managing panic and anxiety

If you have panic attacks or flashbacks, it might help to plan a ‘safe space’ in your home that you can go to.

You can also find ways to comfort yourself if you’re feeling anxious. For example, Mind has games and puzzles you can use to distract yourself, and breathing exercises that may help.

Managing feelings of being trapped or claustrophobia

If you are spending more time than usual at home this may increase feelings of claustrophobia or being trapped, so try to get outside if you can. You could also open the windows to let in fresh air, find a place to sit with a view outside, or sit on your doorstep or in your garden if you have one. It can also help to regularly change the rooms you spend time in, if possible, as this can help to give you a sense of space.

Managing eating disorders

If you think you may have an eating disorder contact your GP as soon as you can. If you have an eating disorder or struggle with your relationship with food, you may be finding aspects of the current situation particularly challenging, for example, the reduced availability of specific foods, social isolation and significant changes to your routine.

The eating disorder charity BEAT provides online advice and a free helpline for adults on 0808 801 0677.

Your GP or your local NHS community eating disorder team can also provide support and advice, where possible.

People with a learning disability

If you have a learning disability, you may be finding the COVID-19 pandemic stressful. You may be worried about changes that might happen because of it, such as staying at home more. You may also be worried about your family or those close to you.

An easy read guide to looking after your feelings and your body is available. Mencap provides information on COVID-19 and how to manage difficult feelings you may be having.

There are ways you can take care of yourself:

you should keep in touch with people you trust (like friends, family and employer) over the phone or internet. Follow the advice in the social distancing guidance and the guidance for households with possible COVID-19 infection. An easy read version of this guidance is also available
there may also be self-advocacy groups in your area offering more support online or by phone. You can ask your families or carers for help to search for these groups

While it is important to be aware of COVID-19, it is important not to forget about any other health conditions you might have. Make sure you take any medication you have been prescribed, keep any hospital appointments you have (unless you have been told otherwise by the hospital) and tell people if you can’t attend appointments.

Supporting someone with a learning disability. The help they need will depend on the nature of their disability. People with a mild or moderate learning disability may need additional accessible information and more time to understand what they might need to do to keep themselves safe and well at this time. People with severe or profound and multiple learning disabilities will need more help to ensure they are able to follow the advice on COVID-19 (for example, handwashing) and to make sure the right communication aids are available. This will be specific to each person. It will also be important to keep a degree of normality where possible, doing things that are enjoyable and enabling people to talk about how they are feeling. For useful tips for talking about feelings, see Skills for Care advice.

People with autism

If you have autism you may be finding the COVID-19 pandemic stressful and may be worried about getting the virus or changes that might happen because of it, such as changes in routines. This can affect your mental health, but there are ways you can take care of yourself.

Think about how you can adjust your routines to keep doing the things you would usually do to keep well. This might include finding ways to keep doing your hobbies and interests online or getting exercise. You know what strategies have helped you in difficult situations in the past, so use them again now.

If you have support from others, plan with them how you can remain well and relaxed. There are also other things you can do to help to manage your emotions if you feel you are losing control, such as:

keeping a diary
learning relaxation techniques
creating a plan with your carer for when you are feeling anxious

You may find it helpful to create a ‘My Health Passport’. It can be filled in easily and presented in any situation to social, health or employment professionals. If you do become unwell and need medical treatment, share your My Health Passport or autism diagnosis so staff know the best way to support you.

If you are still feeling worried and want more help you can contact National Autistic Society.

Supporting a person with autism. Bear in mind they may struggle to identify symptoms of COVID-19, as well as having difficulty talking about the emotions it creates. Try to be aware of changes in behaviour that may help you to identify their emotional state, as well as physical symptoms.

It is important to be clear when you are communicating about the situation, how to stay safe and the symptoms of the virus. Try to avoid language that can be taken literally or definitive statements, as this is a rapidly developing situation and a person with autism may be more distressed if things change when they were told they would not.

Older people

COVID-19 can make anyone seriously ill, but for some people the risk is higher. People 70 years of age and older are at increased risk of severe illness from COVID-19. If you are in this age group, and particularly if you also have a medical condition that increases the risk of severe illness, it is natural for you to feel concerned or affected by changes you have to make to your daily life.

Draw on support from your friends, family and other networks. Try to stay in touch with those around you, this might be over the phone, by post, or online. If you have been advised to stay at home, let people know how you would like to stay in touch and build that into your routine.

If you need help but you’re not sure who to contact, Age UK provides information, telephone friendship and an advice line on 0800 678 1602 that can put you in touch with local services.

People with dementia

For people with dementia, and their carers and families, the COVID-19 pandemic is making daily life particularly challenging and may cause additional distress. Staying connected, maintaining a routine and making sure to keep active and entertained as much as possible are all essential to supporting the mental health and wellbeing of people with dementia and their carers.

If you are supporting someone with dementia, they may have difficulty understanding instructions about self-isolation, social distancing or handwashing. It is important to take time to make this information as simple and accessible for them and repeat it as appropriate. People with dementia may also lack awareness of, and be less able to, report symptoms because of communication difficulties – you should be alert to the presence of symptoms of COVID-19.

The Alzheimer’s Society has published information on COVID-19 for people affected by dementia and provides a telephone support line on 0333 150 3456 (call charges may apply). If you’d like to connect and talk with other people affected by dementia, visit the Alzheimer’s Society online community Talking Point.

Information on dementia is available from Alzheimer’s Research UK. You can also speak to a dementia specialist Admiral Nurse on Dementia UK’s Helpline or 0800 888 6687.

Experiencing grief or bereavement

Over our lifetime we’re all likely to experience the loss of a loved one. Whenever it happens, it can be an extremely difficult and challenging time. This will also be true if you are experiencing bereavement and grief during the COVID-19 pandemic.

You might be struggling with the shock not just of the bereavement, but that you may not have been able say goodbye in the way that you would have wanted. If you are isolating alone this could be particularly hard and it may be harder to connect with your usual support networks.

When you are bereaved, you are likely to feel waves of intense emotions as you come to terms with loss. These can include sadness, guilt, shock and anger. All are common and there is no right or wrong way to feel. Grief affects us all in different ways, but the important thing is to grieve and to have the right support to do this.

You can learn more about grief and support available through the NHS. Cruse Bereavement Care offers advice and support on dealing with bereavement and grief during the COVID-19 pandemic, or At a Loss.org provides signposting to services across the UK.

If you have a problem with drugs or alcohol

Drug and alcohol use can contribute to poor mental health. Equally, poor mental health can lead to increased use of drugs and alcohol, and the stress of staying at home can make these habits harder to control. Cutting down or quitting drugs and alcohol use can help you take back control of your moods and emotions.

You should seek medical advice before cutting down as it can be dangerous, and even fatal, to stop too quickly without proper support. Information on stopping drinking for people dependent on alcohol is available.

It can also be dangerous or very unpleasant to stop using some drugs too quickly or without proper support. Get medical advice before you cut down or stop using drugs, especially if you have withdrawal symptoms.

All local areas have services to help people with drug and alcohol problems, and you can find more information on what is available in your local area using the NHS drug and alcohol service finder.

If you are currently in drug and alcohol treatment, you can speak to your drug and alcohol service about any concerns you have about attending appointments or getting any medication they may be prescribing to you. If you are unable to access your usual support networks, mutual support is available from organisations such as SMART Recovery, Alcoholics Anonymous, Narcotics Anonymous, Cocaine Anonymous and Marijuana Anonymous.

Specific mental health support is available for NHS and social care workers and can be found on NHS People for NHS staff, and through the CARE workforce app for adult social care staff. The support includes wellbeing information and confidential listening from trained professionals in a number of areas, from coaching and bereavement care to mental health and welfare support. For confidential wellbeing support operated by the Samaritans call 0800 06 96 222. You can contact Hospice UK for bereavement and trauma support on 0300 303 4434 (call charges may apply).

Health and social care staff can also access wellbeing apps Silvercloud, Sleepio and Daylight, for advice on how to cope with stress, improve sleeping patterns and suggestions for mindfulness.

Support for students

If you are a student at university or college this year it probably feels very different to what you were expecting. The COVID-19 pandemic may have affected your life and studies and might leave you feeling lonely and unsupported, frustrated, anxious, or stressed. You might also be struggling financially if part-time work has been affected by the pandemic, or worried about job prospects after you graduate.

It’s at times like these that you need to be able to talk to someone and let them know how you are feeling. Encourage yourself to regularly communicate with friends and family whether that is via messages, calls or video chats. If you are feeling the strain on your mental health and wellbeing, your place of study should have information about mental health and wellbeing support available, such as a wellbeing or counselling service, student advice services, support networks and other resources.

For NHS mental health support, contact your GP or you can self-refer to talking therapies for anxiety and depression via NHS psychological therapies services (IAPT). These services are free, and therapies can be delivered effectively remotely online and on the telephone.

Students can access IAPT anywhere in England based on the GP they are registered with, including their home GP if you haven’t moved to a GP near your new address. If you need help with anxiety or depression you can also contact your local GP service.

The Student Space website contains advice and information to support students during the COVID-19 pandemic.

Some of the links to guidance, resources and services are specific for England. For the devolved administrations, specific guidance can be found on the following pages for Scotland, Wales, and Northern Ireland. ↩

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This guidance was withdrawn on 19 July 2021