‘I am working in a mental health facility during coronavirus – we expect a rise in anxiety following lockdown’

The Independent’s ‘Dispatches from the Covid-19 frontline’ is an interview series detailing the reality behind the headlines as told by the nation’s vital key workers. Nathan Rhodes, 28, is a service manager of a supported accommodation facility in east London. He tells Sophie Gallagher what it’s like to work in a mental health facility right now.

We are one of the places people go to when they leave hospital if they have been admitted for mental health-related reasons. We provide them with a stepping stone back into an independent life in the community. As their mental health is becoming more stable we can give them supported accommodation and assistance.

We are run by the local authority in Tower Hamlets and are a vital part of the mental health pathway. Some of our residents are classed as high support, others lower support. At any one time we have around 19 people living here (our maximum capacity), they each have their own separate one-bedroom flat. They normally stay with us, on average, for four years, although some need a longer time than others before they’re ready to move on.

I have been here since November, before that I was managing another mental health service in the borough. I started my career in support work five years ago and gradually built my way up. Prior to coronavirus I would normally work a 40-hour week, 9 to 5 from Monday to Friday. Occasionally I’ll be on call if we need extra help.

We first heard about Covid-19 fairly early. We watched it spread in China and then creep closer and closer to the UK. In February we started taking it very seriously at work and had to make additional plans for preparedness; we needed contingency plans in case staffing levels dropped due to sickness, in case medication supply lines were interrupted, in case the virus found its way into the facility (because everyone has their own home, self-isolation is easier, but it was still a risk and we were worried about the impact on them being alone).

It was a good job we did make the plan as our facility was impacted by Covid-19. We had multiple staff off sick with symptoms, all at one time. We had to rely on staff being moved from other locations to help carry the workload. Then two of the residents had suspected coronavirus as well. We asked them to follow government advice and self-isolate for seven days.

This was difficult because normally we see these people at least once every 24 hours – to give them medication or to catch up on how they are doing and manage their welfare. On the practical side they hadn’t necessarily foreseen getting ill and planned a week’s worth of shopping in the cupboards, so we needed to go out and get essentials for them.

We also had to explain to them about what the lockdown changes meant; what they should be doing, what they were allowed to do and what the consequences might be. We tried to be very transparent. We also wanted to explain why they were going to start seeing staff in full personal protective equipment (PPE). We normally only wear gloves but now we are in goggles, masks, gloves, visors, the whole works. It has been something to adapt to for staff as well as residents.

As well as adapting to wearing the PPE we’ve had to strategise on how to make sure we have enough. Now the supply lines are in place we can get what we need but at the beginning there were certainly some times when it was getting a bit ‘oh...really hope we can find some’. Luckily we have banded together with other services to ensure we’re all covered and our business development team has pivoted to being responsible for PPE.

In terms of the impact on people’s mental health, we’ve definitely seen an increase in residents’ anxiety, which is perfectly natural and what we expected to be honest. One of the biggest things we try to avoid for them is social isolation, but now that is what is being asked of us. So we are trying to stay connected – we ring them regularly to check in.

I think we will see a general, nationwide increase in mental health difficulties after lockdown. Social isolation isn’t just a problem for those with pre-existing mental health problems, as human beings we all need to be talking to and seeing people.

One good thing we have seen during the pandemic is a recognition that our services are essential.

As key workers, we’ve always had people be appreciative of us, but there is definitely a renewed appreciation for our level of dedication. This isn’t a career where we could remain safe at home, otherwise who would be left to support these people?