British Psychological Society response to the Senedd Health Committee
The impact of the Covid-19 outbreak on health and social care in Wales
The British Psychological Society, incorporated by Royal Charter, is the learned and professional body for psychologists in the United Kingdom. We are a registered charity with a total membership of just over 60,000, with over 1,500 members in Wales.
Under its Royal Charter, the objective of the British Psychological Society is "to promote the advancement and diffusion of the knowledge of psychology pure and applied and especially to promote the efficiency and usefulness of members by setting up a high standard of professional education and knowledge". We are committed to providing and disseminating evidence-based expertise and advice, engaging with policy and decision makers, and promoting the highest standards in learning and teaching, professional practice and research.
The British Psychological Society is an examining body granting certificates and diplomas in specialist areas of professional applied psychology.
Publication and Queries
We are content for our response, as well as our name and address, to be made public. We are also content for the Committee to contact us in the future in relation to this inquiry.
Please direct all queries to:-
Policy Administrator (Consultations)
The British Psychological Society, 48 Princess Road East, Leicester, LE1 7DR
About this Response
The response was led on behalf of the Society by Elin Llyr, Deryn Consulting. With contributions from Division of Counselling Psychology Wales, Dr Jimmy Jones - Professional Lead Older Adult Psychology Aneurin Bevan UHB / Consultant Clinical Psychologist & Neuropsychologist, and Dr Joshua Payne – Chair of BPS’ Welsh Branch and Lecturer in Cognitive Psychology at Glyndwr University.
British Psychological Society response to the Health and Social Care Committee
The impact of the Covid-19 outbreak on health and social care in Wales
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The British Psychological Society believes that the outbreak of Covid-19 will have a significant impact on our health and social care services for years to come.
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Older Adult Population Older adults are likely to be disproportionately impacted by loss, ill-health and the effects of the lock-down. This is also a group within society who have the least access to psychological therapies. It is undoubtedly the case that COVID-19 will affect all of society and life may not quite be the same ever again. The psychological response is likely to focus on children and working age adults (coinciding with the high number of therapists working in these age groups and the number of referrals). Older adults will be mentioned in the context of dementia; yet it is likely that there will be little mention of the psychological needs of people aged over 65 years of age. Older adults are a forgotten group because referral rates do not match prevalence rates of mental health challenges. Fundamentally, there is an issue with how mental health issues are seen in older adults – as medical problems or part of ageing rather than as treatable psychological issues. The DCP’s Faculty for the Psychology of Older People has produced a document laying out considerations for meeting the needs of older people during the coronavirus outbreak.
· The Society calls on the Welsh Government to consider the impact of COVID-19 across the lifespan and the existing disparities in access to psychological therapies.
Care Homes Covid-19 is sadly causing hundreds of deaths in care homes across Wales. Staff are doing all that they can to protect and comfort residents at an extremely distressing time, and it’s vital that managers give them the support that they need to provide this and to cope with their own grief and concerns. The Society has launched some new guidance to help staff and residents cope with this particularly frightening time.
While staff working in a care home may have experienced residents dying before, this does not make each death any easier to cope with, and that staff often develop close relationships with people that they care for.
People with Learning Disabilities People with learning and intellectual disabilities will experience the pandemic in many different ways. Services may be closed; carers, friends and family may have to self-isolate, become ill, or even die. As everyone is well aware, people who live in care homes are at particular risk.
Some people may also experience positive benefits with reduced demands, and more time with their household or family. We need, therefore, to take account of each person’s individual situation and remember that the psychological distress due to trauma may take some time to appear. The Society has published guidance on meeting the psychological needs of people with learning disabilities and their carers.
· We call on the Welsh Government to support the Society’s work in promoting awareness of the appropriate adjustments that are required for people with intellectual disabilities at this exceptional time.
Young People The current crisis is affecting many young people in ways that will risk long-term consequences for their mental health. Many children and young people already have a diagnosable mental health condition, and research suggests that the majority of those believe that the pressures created by the crisis are exacerbating their needs.
Many others – including those who have experienced bereavement, abuse or domestic violence – are also likely to require additional support. The fear of becoming ill or seeing a loved one become ill, the loss of routines, the difficulties of social connection, the impact of loneliness, the disruption to education and the challenges of living in difficult or dangerous situations are creating additional pressure for young people across the country. Young people who belong to groups that are already marginalised or disadvantaged may be particularly at risk.
While mental health professionals deserve enormous credit for responding to the challenges the pandemic brings, many young people who were receiving some form of mental health treatment before the crisis are now receiving reduced support or no support at all. Other young people who would not previously have met the threshold for mental health support are likely to require it. Without preventative action, their needs are likely to escalate. The BPS has launched guidance for school leaders to consider the emotional and developmental needs of children as they return to school. Whilst we welcome the steps that the Welsh Government has already taken to prioritise mental health this falls well short of meeting the scale of need. While many voluntary sector providers have been quick to adapt to the changing landscape – moving support online and using innovative approaches to safe service delivery - there remain gaps in infrastructure and funding which threaten the long-term sustainability of these efforts.
· The Society calls on the Welsh Government to work with the voluntary sector to launch a national campaign to reach children and young people, and their families, to promote positive approaches for maintaining mental wellbeing. · The Society also calls on the Welsh Government to commit to introducing additional support for young people’s mental health as we move out of the pandemic to meet rising demand.
Autism Many families who have people with learning difficulties or Autism have been significantly impacted by the Covid-19 pandemic. Some children and young people with Autism Spectrum Disorders have been told they have to wait for access to medication, whilst those who had recently started medication continued to be monitored, leading to a disparity in services. Whilst we appreciate the Welsh Government’s efforts to consider families with children with learning disabilities and autism in relation to Covid-19 rules and restrictions, further action needs to be taken to ensure that those individuals are not left behind as the country begins to recover from the pandemic.
Remote Consultations & Assessments With many practitioner psychologists considering undertaking remote client assessments for the first time due to Covid-19 restrictions, the Society has produced guidance to support them through the process.
Current restrictions such as limits on face-to-face meetings and the need to wear personal protective equipment presents significant difficulties. Psychologists may face the choice of whether to undertake an assessment remotely, face-to-face, or not at all and will need to carefully consider the risks of each alternative.
The Insurance Companies’ insistence of sessions being face-to-face prevents the application of choice and limits access to services by carers (parents, those who care for an older adults or have other carer responsibilities) and it means that often people will need to disclose to employers to get time of work to attend appointments that could place their jobs at risk. It can compound shame and guilt leading to an increase in stigma and can decrease the availability to young people and older adults who find online provisions easier to access due to familiarity of online working and reduced car journey’s in attending appointments.
As a result of the insurance issue and the pressure to hold face to face sessions, not only are practitioners required to be in a closed, confidential space for at least an hour, but if they are expected to wear PPE, this will have an impact on the psychological process and potentially the quality of service. It would be beneficial to be able to continue to offer remote sessions as the lockdown eases without being penalised and restricted by the insurance companies.
· With many people anxious about accessing healthcare services, the Society calls on the Welsh Government to support the further adoption of remote consultation and diagnosis. · The Society calls on the Welsh Government to offer guidance on offering remote services as the country moves out of lockdown so that practitioners are not to be at the mercy of what health insurance companies are wanting.
The Deaf community Covid-19 has presented unique challenges to people living with hearing loss, many of whom rely on visual cues such as lip-reading and sign language, which leans heavily on facial cues and expressions for communication. As a result, deaf people will be facing a challenge in situations where the wearing of face mask is required as it’s a huge communication barrier.
· Whilst the Society welcomes the Welsh Government’s efforts to provide BSL for its daily press conferences and the provision of BSL resources, we call on further action to support the Deaf community during these difficult times to ensure that they’re not forgotten.
BAME Community
It has been well documented that the BAME community has been impacted at a higher rate than others by Covid-19 and as a result, many will be suffering from anxiety. People from Black, Asian and Minority Ethnic groups are more likely to be in jobs that has greater exposure to risk of infection, more likely to be in poorer health, in more precarious employment and sufferer more serious consequences including death.
There is also the likelihood that people from BAME communities are experiencing a psychological and emotional response in relation to issues being addressed by the Black Lives Matter movement. The BPS stands in solidarity with all those who are feeling pain and expressing righteous anger about racial injustice and recommit to valuing diversity and fighting inequity.
· We call on the Welsh Government to commit its support for the BAME communities in Wales as we move out of lockdown and actively work to address issues of inequality across all social characteristics.
Other High-Risk Groups
We must not forget about the real and potential impact of Covid-19 on other individuals in the ‘high-risk’ groups with pre-existing medical conditions, disabilities, or life-limiting illnesses. Many of these individuals were underserved and underacknowledged before this crisis, and this has been confounded by poor guidance during isolation, poor information around support, and restriction of routine medical procedures. Most of these individuals are still shielding and dealing with increased anxieties around the very real increased risk of transmission of Covid-19, and additional uncertainties around the management of their care. As lockdown eases, poor adherence with social distancing is likely to have a lasting impact on their behaviour and mental health in the long term, and a ‘new normal’ will not emerge for these individuals for a long time. Initiatives that target older people and/or people with learning disabilities, deafness, autism, will not reach individuals with physical disabilities. Even if they do, they will not address many of the topics that are important for individuals with pre-existing medical conditions, physical disabilities, or life-limiting illnesses.
· We call on the Welsh Government to ensure increased support and initiatives for high-risk individuals as we slowly come out of lockdown.
Post-Covid Recovery Plan We recognise the scale of the challenge that we’re all facing, but by taking bold action now, we can reduce the impact of the pandemic and give hope to thousands of people across the country.
· We urge the Welsh Government to consider how psychological evidence and expertise will be a vital part of Wales’ post-covid recovery plan.
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