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Stevie Creese, Doctoral Researcher at the Health Services Management Centre (HSMC), writes on returning to work as a mental health nurse and clinician in the Covid-19 vaccination programme.

At first, I thought Covid-19 was nothing more than a storm in a teacup. As 2020 progressed, it became apparent that this virus would completely alter how people live, at least in the short term. I was not overly concerned by the physical threat of infection itself as I felt this was mitigated by the sea of just restrictions we faced. I was more concerned by the psychosocial consequences of these restrictions. Income, employment and housing are well documented as social determinants of mental (and physical) health, but the pandemic brought about uncertainty for many in these key areas.

On a personal level, I was concerned about the impact the restrictions would have on my mental health. In a matter of weeks, the vision I had for my studies and what doing a PhD would look like drastically changed. Homeworking was the new norm, and research methods would have to change, not to mention the reduced ability to access research sites and participants. At the same time, calls from the government led to former NHS staff returning in their thousands. The answer seemed simple, and I decided to take a leave of absence to return to the NHS as a nurse in April of last year (2020).

I spent four months working on a psychiatric intensive care unit that supported adults with acute mental health conditions. At first, it appeared hospital referral and admission was being avoided by mental health services, professionals, and service users. The preferred option was for community mental health teams to work from home whilst supporting service users in their homes via audio and video calls. In addition, service users were less likely to see friends, family and informal carers who may have been able to pick up early signs of deteriorating mental health.

In my opinion, mental health crises were more likely to come to the attention of emergency services than mental health services during the pandemic. The secretary of state for health announcing that mental health services could resume in late April last year (2020) was unhelpful. The assumption behind that statement is that mental health workers and services had been on hiatus since the start of the pandemic, which was untrue. It also implies that mental health services are not essential, whereas physical health services are.

My research looks at the inequality of mental health compared to its physical health counterpart. The government pledged in 2011 to bring equality between the two branches of health in its ten-year mental health strategy (No health without mental health). Yet, when the incidence of mental health conditions surged, fewer mental health beds were available, meaning that more individuals were suffering from a severe mental health condition in the community with limited face to face support. Covid-19 brought about a physical health crisis, but the crisis was not confined to physical health; it simultaneously prompted a mental health crisis. In 2021, mental health is still seen as the poor relation of physical health. 

The solution to the pandemic came in the form of a simple injection. As a nurse, I knew what needed to be done. I needed to take a second leave of absence and join the thousands of individuals providing one of the world's fastest vaccination programmes. The vaccine has initially given us a vast improvement in the nation's protection against Covid-19. In time, it should also enable restrictions to dissipate and boost the population's mental wellbeing. The programme has been bumpy at times yet simplistic and well-received by most. The vaccine programme has meant that people have something straightforward and tangible they can do to stop the pandemic and the restrictions that have caused harm to our mental and physical wellbeing.

Over the last year, we learnt what is, and perhaps more importantly, what is not "essential", at least from the state's perspective. I anticipate that in the coming months, restrictions will ease significantly, and I will return to my studies as the university finds its "new normal." I hope this brings a return of individuals being able to take part in much needed face to face human interaction. Additionally, it is vital that we start re-engaging with once loved leisure activities with little concern of infection (whilst adhering to government regulations).  Given the higher-than-expected uptake of vaccination and easing restrictions, the insecurity I felt initially is passing day by day, and is being replaced with certainty about the future in a post-pandemic world.

At present Stevie is completing his PhD in Health Service Management after being awarded an Economic and Social Research Council (ESRC) scholarship. His doctoral research project is concerned with mental health policy implementation. Stevie has over ten years’ experience of working in health and social care as a practitioner and educator. Stevie trained initially as a mental health nurse and has spent many years in clinical practice.  Stevie has spent time as a lecturer of health and social care within further and higher education, where he gained a teaching qualification through the University of Warwick. Click here to find out more about Stevie.