In January, Paul, a 27-year-old multimedia producer in London, confided to a friend that he was feeling suicidal. His friend rang the police, who detained Paul under the Mental Health Act for his own safety. It was then that a psychiatrist gave him a diagnosis that, for the first time, seemed to make sense of the emotional difficulties Paul had grappled with since he was a teenager: borderline personality disorder.



The psychiatrist referred Paul (not his real name) for dialectical behaviour therapy, a form of talk-based treatment designed for people with BPD. He was hoping to get started last month when he was informed by his NHS mental health provider that the treatment has been put on hold indefinitely because of the coronavirus outbreak. It felt like a huge setback at a critical time.

“It makes you lose hope a bit that things are going to change,” Paul said in an interview.

Paul is one of dozens of people with experience of mental illness who contacted BuzzFeed News after we published an article about one reporter’s struggles with isolation during the COVID-19 outbreak. In the last two weeks, we spoke to 10 of them at length, by telephone, email, and WhatsApp, about their concerns about the disorienting new reality imposed by the pandemic.

All said they’re worried about whether they, and others like them, will be able to continue accessing during the lockdown the treatments, supports, and structures they depend on to manage their lives — and to where they’ll turn if their mental health starts to deteriorate. Their names have been changed in this article so that they could speak freely about difficult psychiatric histories.

The coronavirus outbreak will be psychologically taxing for everyone who endures it: Lives are being upended, livelihoods threatened, loved ones endangered, and there is profound uncertainty about when the disruption will end and the damage that will be left in its wake when it’s over. But it’s especially alarming for the millions of British adults who were already grappling with a diagnosable mental disorder.

In the past few weeks, as Britain enforced strict social distancing measures and the NHS urgently reprioritised resources to fight the spread of COVID-19, mental health services across the country have been severely disrupted, forcing many vulnerable people into a deeply unsettling situation. Face-to-face contact for the vast majority of people has been suddenly halted and many of the services they used are now suspended.

Many NHS mental health providers were already severely stretched before the pandemic and could be overwhelmed in the coming months. Not only will they have to continue supporting existing users under extraordinarily difficult circumstances, but there is expected to be an influx of new patients as a direct result of the pandemic.

“COVID-19, and the national measures being announced to delay the spread of the epidemic, will inevitably have a significant impact on both demand for and capacity to deliver support for people with mental health needs, learning disability, or autism,” NHS England warned the chief executives of mental health providers in an official communication last month. “The impact on people’s mental health will endure beyond the epidemic.”

“We are facing a hugely challenging time for our mental wellbeing, particularly people with preexisting mental health problems,” Geoff Heyes, head of health policy and influencing at Mind, a leading mental health charity, told BuzzFeed News.

Mental health providers are rushing to put in place temporary measures, but the sector had a slow start. It was only in mid-March, when the virus had already taken hold in the country, that NHS England issued official guidance to the trusts responsible for mental health services instructing them to urgently start contingency planning.



NHS trusts were urged to immediately identify their most vulnerable patients; to secure consistent supplies of medications; to add capacity so that 24/7 phone lines would be available for people in crisis; to provide digital tools to communicate with patients remotely; and to “prepare for 20% fewer staff”.

The guidance documents were blunt about the appalling circumstances now facing the sector: “People will be at risk of mortality through suicide, injury through self-harm and of self-neglect, and therefore any changes to services need to have patient safety as the paramount concern,” NHS England said. It acknowledged that the outbreak will have a “significant impact” on the system’s capacity to support people in need, and that staff will have make “difficult decisions” in the face of diminished capacity.

NHS England did not respond to a request for comment for this article.

Since that guidance was issued, NHS trusts across the country have reduced to a core service, according to a review of dozens of public statements by those trusts.

While the trusts insist they’re doing as much as they can to ensure that acute assistance is still available around the clock for people in crisis and that the most vulnerable people in the community are still seen in person, vast numbers of people will experience a jarring change in therapeutic relationships that are essential to controlling their conditions.

Talk therapies, group workshops, and other outpatient services that are deemed non-essential have been scaled back or put on hold to enforce social distancing and so that staff can be redeployed to critical areas. In hospitals, psychiatric inpatients have been barred from having visitors.

“Maximise delivery through digital technologies,” NHS England instructed trusts last month. Instead of face-to-face appointments, they’re now offering phone calls, video conference apps and other online solutions for assessments, follow-up sessions, and other communications with patients. It’s far from ideal therapeutically.