Public Guidance on the Maintenance of Mental Health During the Coronavirus Outbreak
Mental health guidance from Public Health England.
What you need to know
The coronavirus (COVID19) outbreak is going to have an impact on everyone’s daily lives, as the government and the NHS take necessary steps to manage the outbreak, reduce transmission and treat those who need medical attention.
During this time, you may be bored, frustrated or lonely. You may also feel low, worried, anxious, or be concerned about your health or that of those close to you. Everyone reacts differently to events and changes in the way that we think, feel and behave vary between different people and over time. It’s important that you take care of your mind as well as your body and to get further support if you need it.
This guide provides advice on how to look after your mental health and wellbeing during the coronavirus (COVID-19) outbreak.
For wider guidance on how to protect yourself and others, and actions to take if you think you may have contracted the virus please see the guidance on this page.
This guidance will be updated in line with the changing situation.
What can help your mental health and wellbeing
Consider how to connect with others: Maintaining relationships with people you trust is important for your mental wellbeing. Think about how you can stay in touch with friends and family via telephone, video calls or social media instead of meeting in person – whether it’s people you normally see often or connecting with old friends.
Help and support others: Think about how you could help those around you – it could make a big difference to them and can make you feel better too. Could you message a friend or family member nearby? Are there community groups that you could join to support others locally? Remember it’s important to do this in line with guidance on coronavirus (COVID-19) to keep yourself and everyone safe. And try to be accepting of other people’s concerns, worries or behaviours.
Talk about your worries: It is quite common to feel worried, scared or helpless about the current situation. Remember that this is a difficult time for everyone and sharing how you are feeling and the things you are doing to cope with family and friends can help them too. If you don’t feel able to do that, there are people you can speak to via NHS recommended helplines or you could find support groups online to connect with.
Look after your physical wellbeing: Your physical health has a big impact on how you are feeling emotionally and mentally. At times like these, it can be easy to fall into unhealthy patterns of behaviour which in turn can make you feel worse. Try to eat healthy, well-balanced meals, drink enough water, exercise inside where possible and outside once a day, and try to avoid smoking, alcohol and drugs.
If you are able to go outside, consider walking or gardening (keeping the recommended 2 metres from others as outlined in the social distancing guidance). If you are staying at home, you can find free easy 10 minute work outs from Public Health England or other exercise videos to try at home on the NHS Fitness Studio. Sport England also has good tips for keeping active at home.
Look after your sleep: Feeling anxious or worried can make it harder to get a good night’s sleep. Good-quality sleep makes a big difference to how you feel mentally and physically, so it’s important to get enough.
Try to maintain regular sleeping patterns and keep good sleep hygiene practices – like avoiding screens before bed, cutting back on caffeine and creating a restful environment. The Every Mind Matters sleep page provides practical advice on how to improve your sleep.
Try to manage difficult feelings: Many people find the news about coronavirus (COVID-19) concerning. However, some people may experience such intense anxiety that it becomes a problem. Try to focus on the things you can control, including where you get information from and actions to make yourself feel better prepared.
It is okay to acknowledge some things that are outside of your control right now but constant repetitive thoughts about the situation which lead you to feel anxious or overwhelmed are not helpful. The Every Mind Matters page on anxiety and NHS mental wellbeing audio guides provide further information on how to manage anxiety.
Manage your media and information intake: 24-hour news and constant social media updates can make you more worried. If it is affecting you, try to limit the time you spend watching, reading, or listening to media coverage of the outbreak. It may help to only check the news at set times or limiting to a couple of checks a day.
Get the facts: Gather high-quality information that will help you to accurately determine your own or other people’s risk of contracting coronavirus (COVID-19) so that you can take reasonable precautions. Find a credible source you can trust such as GOV.UK, or the NHS website, and fact check information that you get from newsfeeds, social media or from other people.
Think about how possibly inaccurate information could affect others too. Try not to share information without fact-checking against credible sources.
Think about your new daily routine: Life is changing for us all for a while. Whether you are staying at home or social distancing, you are likely to see some disruption to your normal routine.
Think about how you can adapt and create positive new routines – try to engage in useful activities (such as cleaning, cooking or exercise) or meaningful activities (such as reading or calling a friend). You might find it helpful to write a plan for your day or your week.
Do things you enjoy: When you are anxious, lonely or low you may do things that you usually enjoy less often, or not at all. Focussing on your favourite hobby, learning something new or simply taking time to relax indoors should give you some relief from anxious thoughts and feelings and can boost your mood.
If you can’t do the things you normally enjoy because you are staying at home, try to think about how you could adapt them, or try something new. There are lots of free tutorials and courses online and people are coming up with innovative online solutions like online pub quizzes and streamed live music concerts.
Set goals: Setting goals and achieving them gives a sense of control and purpose – think about things you want or need to do that you can still do at home. It could be watching a film, reading a book or learning something online.
Keep your mind active: Read, write, play games, do crossword puzzles, sudokus, jigsaws or drawing and painting. Find something that works for you.
Take time to relax and focus on the present: This can help with difficult emotions, worries about the future, and can improve wellbeing. Relaxation techniques can also help some people to deal with feelings of anxiety. For useful resources see Every Mind Matters and NHS’ mindfulness page.
If you can, once a day get outside, or bring nature in: Spending time in green spaces can benefit both your mental and physical wellbeing. If you can’t get outside much you can try to still get these positive effects by spending time with the windows open to let in fresh air, arranging space to sit and see a nice view (if possible) and get some natural sunlight, or get out into the garden if you can.
Remember that social distancing guidelines enable you to go outside to exercise once a day as long as you keep 2 metres apart from others who are not members of your household group.
Staying at home
Recent guidance is clear about the need for people to stay at home. If you are feeling anxious it might help to think about potential challenges and make a plan for them.
Supplies: Think about how you can get any supplies you need – either from a neighbour, family friends or a delivery service so you don’t worry about running out. Try to pick healthy food, especially as you might not get as much exercise as normal.
Financial concerns: You may be worried about work and money if you have to stay home – these issues can have a big impact on your mental health. For guidance on what your rights are at work, what benefits you are entitled and what further support is available please see our guidance for employees or advice from citizens advice or the National Debt line.
If you care for other people: You may be worried about how to ensure care for those who rely on you – either your dependants at home or others that you regularly visit. Let your local authority know if you provide care, or support someone you don’t live with. Further advice on creating a contingency plan is available from Carers UK.
If you are being treated or taking medication for existing conditions
Continue accessing treatment and support where possible: Let relevant services know that you are staying at home, and work out how to continue receiving support during this time:
- ask about having appointments by phone, text or online. For example, this could be with your counsellor, therapist or support worker, nurse, care worker or befriender
- if you use care services that will be affected by staying at home, you should let your local authority and care provider know so alternative arrangements can be put in place
- make it clear if any support is still needed. Tell them that alternative arrangements are required if any of the usual support can’t continue. This may include things like carers visiting, day centre sessions, or friends and family coming over to help
Keep taking your medication: You might be able to order repeat prescriptions by phone, or online using an app or website if your doctor’s surgery offers this.
- ask your pharmacy about getting your medication delivered or think about who you could ask to collect it for you. The NHS website has more information about getting prescriptions for someone else and checking if you have to pay for prescriptions
- continue to order your repeat prescriptions in your usual timeframe. There is no need to order for a longer duration or larger quantities
- your GP practice (or clinical team) may move your prescriptions to repeat dispensing arrangements so you only have to contact your pharmacy to get a repeat of your medicine rather than your practice
- be careful about buying medication online. You should only buy from registered pharmacies. You can check if a pharmacy is registered on the General Pharmaceutical Council website
- you can contact NHS 111 in England if you’re worried about accessing medication
Where to get further support
Managing physical symptoms that are triggered by stress and anxiety
It is quite common to experience short-lived physical symptoms when your mood is low or anxious, for example:
- faster, irregular or more noticeable heartbeat
- feeling lightheaded and dizzy
- chest pains or loss of appetite
It can be difficult to know what is causing these symptoms, but often people who experience them due to stress, anxiety or low mood find that they get worse when they focus on them. See advice from the NHS on managing the physical symptoms.
If you are concerned about your physical symptoms, then do contact NHS 111 online.
For advice on coronavirus (COVID-19) and any symptoms see the NHS website.
If you are experiencing stress, feelings of anxiety or low mood, you can use the NHS mental health and wellbeing advice website for self-assessment, audio guides and practical tools Every Mind Matters also provides simple tips and advice to start taking better care of your mental health. If you are still struggling after several weeks and it is affecting your daily life, please contact NHS 111 online. If you have no internet access, you should call NHS 111.
In a medical emergency call 999. This is when someone is seriously ill or injured and their life is at risk. A mental health emergency should be taken as seriously as a physical health emergency.
Additional advice for groups with specific mental health needs
Existing mental health problems
If you already have a mental health problem, then you may be finding the coronavirus (COVID-19) outbreak particularly challenging. The advice above should help, but here are a few extra things that you may want to think about. This advice is part of comprehensive guidance provided by Mind.
Managing difficult feelings or behaviours to do with hygiene, washing or fears of infection
Some mental health problems can cause difficult feelings or behaviours to do with washing or hygiene. If you experience this, you might find it hard to hear advice about washing your hands.
It is important to follow government advice on helping to avoid the spread of coronavirus (COVID-19), but if you find you are going beyond the recommendations, if this is making you feel stressed or anxious, or if you are having intrusive thoughts here are some things you could try:
- don’t keep re-reading the same advice if this is unhelpful for you
- let other people know you’re struggling, for example you could ask them not to discuss the news with you
- breathing exercises can help you cope and feel more in control. You can find a simple breathing exercise on the NHS website and Mind’s pages on relaxation have some relaxation tips and exercises you can try
- set limits, like washing your hands for the recommended 20 seconds
- plan something to do after washing your hands, which could help distract you and change your focus
- it could also help to read some of Mind’s tips in their information on obsessive compulsive disorder (OCD)
Speaking to your mental health team
If you are already receiving mental health care, contact your mental health team to discuss how care will continue, and to update safety/care plans.
Managing panic and anxiety
If you have panic attacks or flashbacks, it might help to plan a ‘safe space’ in your home that you’ll go to.
Managing feelings of being trapped or claustrophobia
You are probably spending more time than usual at home so try to get outside if you can, once a day. You could also open the windows to let in fresh air, find a place to sit with a view outside, or sit on your doorstep or in your garden if you have one. It can also help to regularly change the rooms you spend time in (if possible). This can help to give you a sense of space.
If you are reducing your drinking significantly
If you are reducing your drinking, remember it can be dangerous to stop too quickly without proper support. If you have physical withdrawal symptoms (like shaking, sweating or feeling anxious until you have your first drink of the day) you should seek medical advice. For further advice available in your area (including remote services) see NHS advice.
People with a learning disability
You may be finding the coronavirus (COVID-19) outbreak stressful. You may be worried about changes that might happen because of it, including having to stay at home. You may also be worried about your family or those close to you.
Public Health England has easy read guidance on coronavirus (COVID-19) and how it may affect you. There is also other information available about coronavirus (COVID-19) from Mencap and how to manage difficult feelings you are having.
There are ways you can take care of yourself and prevent spreading the virus:
- as you are asked to now stay at home you should keep in touch with people you trust (like friends, family and employer) over the phone or internet – follow the advice from the stay at home and social distancing guidance
- there may also be self-advocacy groups in your area offering more support online or by phone – you can ask your families or carers for help to search for these groups
- it is also important to get information about coronavirus (COVID-19) only from places you can trust, such as the NHS website
While it is important to be aware of coronavirus (COVID-19), it is important not to forget about any other health conditions you might have. Make sure you take any medication you have been prescribed, keep any hospital appointments you have (unless you have been told otherwise by the hospital) and tell people if you can’t attend appointments.
You may be finding the coronavirus (COVID-19) outbreak stressful and be worried about getting the virus or changes that might happen because of it, including having to stay at home. There are ways you can take care of yourself and prevent spreading the virus:
Understand what is happening
Keep up to date with information about Coronavirus (COVID-19) from sources you can trust, such as the NHS website.
Help to stop the virus from spreading
There are 4 easy steps you can take to reduce the risk of getting coronavirus or spreading it to others:
- wash hands regularly for at least 20 seconds with soap and water
- use a tissue for coughs and sneezes and bin it
- avoid touching your face, including your mouth and eyes
- get up to date information about staying at home or what to do if you feel unwell on the NHS 111 website. If you are unsure about your symptoms speak to someone you trust about them, like a support worker.
Plan to keep mentally well
Do the things you would usually do to keep well, like eating food you enjoy and taking exercise, once a day outside if you can. If you have support from others, plan with them how you can remain well and relaxed. There are also other things you can do to help to manage your emotions if you feel you are losing control, such as:
- keeping a diary
- using apps like Brain in Hand
- learning relaxation techniques
- creating a plan with your carer for when you feeling anxiety
You know what strategies have helped in the past, so use them again now. The National Autistic Society guidance on managing anxiety might also be helpful.
Get help if you are struggling
Hearing about coronavirus (COVID-19), and the changes it causes in your daily life, might make you feel like you don’t have control, or make you worried or scared about your health. These feelings are common. Try to speak to someone you trust such as a friend, family member or supporter.
If you do become unwell and need medical treatment, share your hospital passport or autism diagnosis so staff know the best way to support you.
If you are still feeling worried and want more help. You can call the Autism Helpline on 0808 800 4104.
Government guidance is that older people are at increased risk of severe illness and need to be particularly stringent in following social distancing measures and staying at home. Given this, it is natural for older people, particularly those with pre-existing medical conditions, to feel concerned or affected by changes you have to make to your daily life. The following suggestions may help with any difficult feelings and look after your mental health:
Draw on support you might have through your friends, family and other networks. Try to stay in touch with those around you, this might be over the phone, by post, or online. If you have been advised to stay at home, let people know how you would like to stay in touch and build that into your routine.
Get practical help
If you need help, for example with shopping or running errands, ask for it and let those around you know what they can do. If you need help but you’re not sure who to contact, Age UK runs an advice line (0800 678 1602 – lines are open every day 8am-7pm) that can put you in touch with local services.
People living with dementia
You may feel concerned about coronavirus how it could affect you. Alzheimer’s Society have published information on coronavirus for people affected by dementia.
If you’d like to connect and talk with other people affected by dementia, you can visit the Alzheimer’s Society online community Talking Point.
A range of information on information on dementia is also available from Alzheimer’s Research UK
If you are still feeling worried and want more help you can call the Alzheimer’s Society Helpline on 0300 222 11 22
You can also speak to a dementia specialist Admiral Nurse on Dementia UK’s Helpline, on 0800 888 6687.
Dealing with a mental health crisis or emergency
You may find that the added stress of the current situation could have a big impact on your mental health. In some cases, you may feel that you are having a mental health crisis as you no longer feel able to cope or be in control of your situation.
You may: feel great emotional distress or anxiety, feel that you cannot cope with day-to-day life or work, think about self-harm or even suicide, or experience or hear voices (hallucinations).
If this sort of situation happens, you should get immediate expert assessment and advice to identify the best course of action:
- If you have already been given a Crisis Line number from a health professional, please call it.
- If you’re under the care of a mental health team and have a specific care plan that states who to contact when you need urgent care, follow this plan.
- Mind also provides information about how to plan for a crisis.
- Samaritans has a free to call service 24 hours a day, 365 days a year, if you want to talk to someone in confidence. Call them on 116 123.
- Find local crisis support services near you that can support you.
- You can contact NHS 111 if you need urgent care but it’s not life threatening.
- In in a medical emergency call 999 if you are seriously ill or injured and your life is at risk. A mental health emergency should be taken as seriously as a physical health emergency.
See further advice from the NHS on dealing with a mental health crisis.