During the pandemic, people have often felt less in control of their lives, which has been difficult for many.    

People, from all age groups and communities, talk about the impact that the pandemic has had on their mental health. A Gateshead Council survey of residents found that in June 2020, 75% of respondents said they were very worried, or somewhat worried, about the impact Covid-19 was having on their lives at that time. Many people experiencing mental health problems, at whatever point on that journey, have found recent months very tough. 

We're seeing lots more patients who are struggling with their mental health as a result of lifestyle changes during the pandemic. It's a priority for us to get people to pick-up their prescriptions in person, where possible, so that they have that interaction with people and get out of the house.
 

There has been an increase of cases with anxiety in patients. This accumulating from various factors such as fear, stress, financial constraints, not being able to see loved ones etc. To deal with this and other mental health related problems we have had to adapt to a more personal touch like community pharmacy used to be before the nature of the modern world. It is something we have always done as an independent pharmacy but in this climate, it has become the forefront of our processes. 
Community Pharmacist 

I had spent from June 2015 to March 2020 trying to get to grips with my poor mental health, having been released from my section. Over the next four years, I had various improvements and setbacks. The improvements were due to my time at the gym, some socialising, my mental health service run out of the GP surgery, my independent living officer and my involvement with the Poverty Truth Commission in Gateshead. The bad was my treatment at the hands of the Universal Credit system causing me to have relapses in 2017 and 2019.
 

In March of 2020, the Poverty Truth commission had its launch event and I told my story to a packed audience. I was at the peak of my mental health recovery and was looking forward to the year ahead, then the first lockdown started as did my problems.
 

First all of my support services vanished overnight, gym and coffee morning venues shut. I coped because we were all in the same boat. It became harder to manage when the first lockdown ended, for me nothing changed. I only left the flat once a week to get food, so my feeling of isolation and anxiety started to spiral. In July, I went to my sisters for three weeks, and regrouped, but on my return to Gateshead, with another lockdown announced, I had to give in and move in with family until Christmas and then with a third lockdown, I moved in permanently and gave up my residence in Gateshead.
 

It took until July this year, 2021, to restart with mental health services and start the long road again. Lessons need to be learnt around how to engage with those people who are diagnosed, or need to be diagnosed with mental health issues, without meeting face to face.
PJ, Poverty Truth Commissioner, Gateshead 

In terms of how people have reported the impact of the pandemic, what we've heard has been a great desire for reconnection and shared activity, a wish to build on the mutual aid initiatives that sprang up, a renewed keenness for the outdoors for many people. However, while ourselves and many others in the Voluntary and Community Sector have tried our utmost, there is still a dearth of secondary care services which appear increasingly difficult to access and are often not face-to-face. What we are seeing is a greater degree of difficulty in many people's lives, from low income and Universal Credit changes to a loss or reduction in statutory support services, which naturally exacerbates people's mental health problems.
 

We wouldn't like to talk in terms of complex needs, because when people relate their stories, they aren't complex, but very, very, understandable, with intersecting factors. The complexity arises with the system's response to people, and its inability to acknowledge that co-/multimorbidity is the norm. 
Alisdair Cameron, Co-Director, ReCoCo 

Not only are some groups and communities at greater risk of Covid-19 transmission, severity of illness and mortality, but they have also been disproportionately impacted by the lockdown, and other measures put in place to tackle the health crisis. This has included increased barriers to accessing health and social care services, support services stopping or going online, the loss of routine, loneliness and increased isolation, financial difficulties or having to spend more time in unsuitable or dangerous accommodation.  

Impact of the pandemic on ethnically diverse and/or minoritised communities People from ethnic minority communities are at higher risk of mortality due to Covid-19. People from ethnic minority communities also provided more hours of unpaid care, experienced higher levels of income loss, and were twice as likely to have experienced food insecurity throughout the pandemic. (Suleman M, Sonthalia S, Webb C, Tinson A, Kane M, Bunbury S, Finch D, Bibby J. (2021) Unequal pandemic, fairer recovery: The COVID-19 impact inquiry report. The Health Foundation (opens new window)) 

Gateshead Visible Ethnic Minorities Support Group (GVEMSG)-GemArts works with the most isolated, disadvantaged and vulnerable Black Asian and Minority Ethnic communities to develop their personal, social and creative skills. Covid-19 has had a huge impact on our communities and has further amplified existing health and racial inequalities as people from Black, Asian and Minority Ethnic communities are more likely to suffer long-term impacts and poor outcomes from Covid-19.
 

We know that many people from our communities during this crisis are feeling even more isolated, lonely, worried and vulnerable, which is having a negative impact on their health and wellbeing - with women, older people, children and young people at greatest risk. Due to social, economic and cultural barriers, language barriers,mainstream services not being culturally appropriate and digital exclusion, exacerbated by the pandemic, it has been an extremely challenging time for our communities. 

Much of the support and advice during the pandemic has been online and this has created more barriers as many people from our communities are not able to access or afford digital devices, cannot afford data if they do have devices, live in overcrowded housing so have little privacy, or have very limited digital skills, and if they can access online advice and support, they are not confident to do so as English is not their first language. In addition, community groups are not meeting, community spaces have been closed and support staff have been furloughed so engaging and supporting communities face to face has been a huge challenge.
 

From the beginning of the pandemic GVEMSG-GemArts quickly responded to community needs and worked with our amazing staff and volunteers to:

• create multi language Covid-19 advice videos 
• offer a telephone befriending and translation/interpretation service for vulnerable minority ethnic communities to access support and advice 
• expand our arts, health and wellbeing programme by cooking 100 hot Indian vegetarian meals per week and delivering them with creative arts packs to vulnerable families and those who are shielding across Gateshead 
• produce and deliver culturally appropriate training and advice to support Gateshead Covid Champions programme.

We have also been able to create a safe environment where people from minority ethnic communities and those with lived experience can discuss their communities' legitimate concerns about the vaccine without stifling debate, and challenge misinformation and receive 
reliable messaging about the programme. 
Vikas Kumar MBE, Director, GEM Arts

Peace of Mind is a refugee led community charity. When the pandemic struck, so many people lost their jobs. We took on the role of a food bank.

We went from helping 50 people a week to 107 families, representing above 200 children, accessing our culturally appropriate food parcel support every week during the first lockdown.
 

Covid had the biggest impact on those with no recourse to public funds. Most homeless/refused asylum seekers were offered accommodation but often found difficult to access hot food. One homeless asylum seeker told us in the first lockdown, "This pandemic will not kill me, but the poverty and hunger will kill me." Along with food poverty, the biggest issue of the pandemic and lockdown has been the impact on the mental health of refugees/asylum seekers.
 

Black, Asian and minority ethnic communities were more vulnerable to the virus. Chinese communities got abuse and people from other communities, who could not wear a face mask, were accused of spreading the virus. 
Sara Muzaffar, Chairperson, Peace of Mind
 

There was often a reluctance for people to stay at home when they were ill. People are grateful to have a job, they feel that they have to go to 
work and shouldn't be off sick. If they work in the gig economy or agency work, they needed to go into work to earn money. They either 
didn't know about any financial support available or didn't want to ask for it.
 

For refugees, immigration status can lead to lots of conspiracy and myths. If they are waiting for a decision from the Home Office, they might think that having Covid symptoms will affect their immigration status (even though the Home Office was saying that this wasn't the case). Vaccinations also gave rise to conspiracy theories, particularly where there is lack of trust or confidence in authorities.
 

Refugees and asylum seekers are in a different situation to more established Black, Asian and minority ethnic communities. The Government lumped everyone together. Gateshead Public Health Team worked with different groups to develop information for refugees and asylum seekers for different asylum seeker and refugee communities. The Public Health Team trained members of each community. Information was translated into different local languages. 

Myths and conspiracy theories about vaccines were tackled by talking and listening and discussion with communities. 
Sirak Hagos, Director, Integration Station

Six out of 10 people who died with Covid-19 between January and November 2020 were disabled. Those with a learning disability were at even greater risk of dying than those with a physical disability. (Suleman M, Sonthalia S, Webb C, Tinson A, Kane M, Bunbury S, Finch D, Bibby J. (2021) Unequal pandemic, fairer recovery: The COVID-19 impact inquiry report. The Health Foundation (opens new window)) 

Disabled people, whether or not they have 'underlying health conditions' that place them at higher risk of Covid-19, are more likely to report that restrictions have had greater impact on their lives than non disabled people from their relationships being affected through to reduced access to health care.26 Service restrictions have had a significant impact on people with the learning-disabled community. The last year saw a traumatic loss of routine, activities and contact with family and carers, that was hard to understand and to cope with. (Local Government Association (2021) Health inequalities: Learning disabilities and COVID-19 (opens new window))

My lockdown was challenging at first until I got used to it. I was angry at first, but I kept going on Zoom. After a few lockdowns I went back to Lawnmowers Arts Centre. This is my experience of Covid until it goes fingers crossed - I hope so. In the 1st lockdown I was at my mum's for the whole year of 2020 and then lockdown 2021 I went back to my supported living home. I was happy! Still get to see my mum and dad as well.
 

In lockdown, I did Lawnmowers gigs, met family and saw mates, all over Zoom. I fed the horses, made banana bread and saw my girlfriend.
Matthew Dennis, Member, Lawnmowers Theatre Company

My lockdown was one of the worst experiences ever, not knowing what's going on, not being able to go out to see people, too many rules. And people dying, no food in the shops. 
Debbie Bell, Artist and Shadow Board Member, Lawnmowers Theatre Company

My lockdown was frustrating on Zoom. 
Andy Stafford, Founding Member, Lawnmowers Theatre Company 

When lockdown restrictions were first introduced in 2020, we quickly realised the extent of digital exclusion within our communities and the risk this posed to people with learning disabilities who rely on regular interaction with their support networks.
 

Thanks to the Coronavirus Community Support Fund and Northumbria Police and Crime Commissioner funding, we mobilised our team to provide practical and emotional help and advice tailored to the needs of the people we support to help them connect online with confidence. This ranged from supplying devices and data to providing ongoing training and support to develop skills and confidence to get the most out of their internet access.
 

Through this project, we learned that digital exclusion takes many forms but that with the right tools and support people with learning disabilities can thrive online. 
Lindsay Henderson, Head of Communities, Your Voice Counts 

The lockdowns were really hard, I have two sons with special needs, they didn't understand what was happening when they couldn't go to their day centres anymore. One of them started to self-harm because of all the changes and loss of routine. Being in the house trying to entertain them all day was difficult; my husband has a heart condition so most of their care needs fell to me. We had to fight to get one of my sons back into his day centre when the lockdowns eased, and to try to get the same taxi driver who he knew and felt comfortable with. My boys are now back at their allotment project, but they're confused because some of the staff and their friends still aren't back. It's good to get some respite again though and be able to get out of the house. 
Service user, Tyneside Women's Health Project 

We went into isolation on the 17 March. We were scared, the news around Covid was terrifying, it seemed you were either a bit poorly or dead, we had no backup plan for if we got sick, as the sole carers for a child with cerebral palsy and one with autism it's not as easy as asking a neighbour to watch the kids for you, you need support from trained professionals.
 

We had no social worker at the time, ours had left in February. No one had a plan for carers or the people they cared for in emergencies. Respite was closed and we had no carers coming in, so it was just the four of us for seven weeks and we rarely left the house. At the time we lived in Gateshead in an ill-adapted terrace house.
 

Our eldest son slept in the living room due to him having cerebral palsy and being too big to carry upstairs. We spent seven weeks in complete isolation and spent most of the time in one tiny room. We felt forgotten about. 
Claire, Carer 

We don't get Universal Credit, but one of the things we found horrendous was the transition to adult services, we've still not met our transition social worker due to Covid restrictions.
 

Managing and finding carers to assist with moving and handling post surgery during Covid, dealing with own health problems while trying to care for disabled child and the restrictions around obtaining and viewing alternative respite for 18+ during the Covid pandemic. 
Carer, Gateshead

Young carers  

As lockdowns began, families struggled to get food due to store delivery slots being very difficult to obtain. We needed to support some families to obtain food parcels, particularly if they were shielding or had health issues that prevented them from leaving the house. One young carer, when questioned why he was accompanying his mother to the shop, showed the Young Carer ID card that we provided, and both were allowed to go in together.

Young carers worried about the person that they cared for catching Covid due to their vulnerability, especially when they returned to school and feared bringing the infection home. Many young carers seemed socially isolated and appreciated telephone calls and Zoom sessions with the Service. A high number of the young carers we supported during the pandemic struggled with increased mental health issues. We noticed a significant rise in issues relating to sleep disturbance, anxiety and depression, and reports of self-harming and eating disorders among our older young carers increased. Due to the reduced availability of suitable mental health services, our team needed to deliver increased one-to-one support to a high number of young carers during the pandemic.  

Becky and Louise's story 

Sisters Becky* and Louise* live with their mam, dad and younger brother, Danny*. He is on the autism spectrum and his behaviour is very challenging. He can be aggressive and violent, particularly towards Becky, who normally spends a lot of time in her bedroom which she must lock to keep her brother out. Caring for Danny is always difficult. The pandemic added a different set of challenges, including home schooling.

Dad was working so couldn't help through the day. Mam didn't understand the work that was being set so she couldn't help either. The family didn't have a PC and a printer, so they were unable to access schoolwork online and relied on work being sent in the post. When work was delayed, Becky would have to work for longer to try to catch up. The family were eventually able to get Becky a laptop but completing work was still difficult as she would have to lock herself in her bedroom where she had a poor Wi-Fi signal. As Danny spent less time at school, his parents had to spend more time supervising him. The whole situation was distressing for the family, especially Becky, who was often tearful. The lack of social contact was difficult for the sisters.

The Young Carer Service was able to offer some support. Both children applied to the Wellbeing Fund, with Louise getting a tablet so that she could play online with friends, and Becky getting AirPods so that she could listen to music and ignore her brother's shouting. They also attended online activities with the Service, which helped them to feel more connected.

*Names changed to protect anonymity

Anthony Lea, Business Development Manager, Carers Trust Tyne and Wear  

For some people, having to stay at home increased the risk of experiencing domestic abuse.28 Lockdown, and social distancing restrictions, enabled abusive partners to exert more control, which led those experiencing domestic abuse to feel more isolated and vulnerable, and seeking support more difficult.

The picture around domestic abuse is complex. Between April 2020 and March 2021, the number of police incidents in Gateshead, classed as domestic, increased by almost a quarter on the previous year.29 Gateshead Council's Domestic Abuse Team saw 13% more domestic abuse referrals between March 2020 to July 2020. However, over the longer period, March 2020 to February 2021, referrals were 8.4% lower compared to the previous year. 

Over the last 18 months we have seen a lower level of referrals coming into the service in comparison to last year. Lack of 'space for action' (reduced opportunities to see family and friends, access services and find options to leave abusive relationships) has led to fewer referrals, leading to concerns for those individuals who may have been living at home with their abuser during the pandemic.
 

High risk victims have been the upward trend during this time. Evidenced-based data shows a significant increase in allocation rates (where cases are picked up by the service) and longer-term intervention rates. 
Beverley Coombs, Team Manager Specialist Support Team, Gateshead Council

Next - Chapter 7: Create fair employment and good work for all