By Martyn Pickersgill

AS Scotland starts to move slowly but surely out of lockdown, more than a year after restrictions were first imposed, it’s vital that we keep mental health firmly on the agenda.

At a Covid briefing earlier this year, Nicola Sturgeon said that “many people will be struggling quite a lot right now so there is help out there if you need it”. But as Scotland's Mental Health Partnership (SMHP) has argued, there have been significant negative impacts of the pandemic and the governmental responses to it.

It’s always good to hear our politicians talking about the importance of mental health. But more could be done.

We know that people living in poverty have experienced many challenges over the last year. Groups subjected to racism, transphobia, homophobia, and other kinds of prejudice and discrimination also bear the brunt of many of the worst aspects of the pandemic.

With the changes in healthcare provision since last March, many people who have long had trouble accessing psychological support in Scotland will be finding things harder than ever.

Prior to the pandemic, research I conducted at the University of Edinburgh into access to therapy in England and Scotland made clear some of the challenges of providing care when need outstrips supply. While the Scottish Government has placed mental health high on its policy agenda, many psychologists struggle to cope with the demand for their services.

There are people asking for help who are simply not getting it. Far more investment is needed.

First, greater resources have to be provided for people impacted by the pandemic. Multidisciplinary long-Covid clinics are needed, and these should include health psychologists. Such professionals can help patients to manage the physical, psychological, and social aspects of their condition.

New services and new NHS jobs are vital to provide the care that’s needed.

Second, significant funding is required to expand the services that existed before the pandemic. Overwhelmed clinicians too often have to deny, or delay, access to therapy. The disillusionment of patients who have to wait months, even years, for care is huge. And some aren’t able to access it at all.

With Covid-19, these pressures will become more acute.

Third, politicians need to take better account of the social and economic determinants of mental ill-health. There’s no shortage of research on this. Social exclusion, poverty, and racism – including institutional racism – need to be tackled, with focus and determination.

Researchers and campaigners are increasingly demanding that policies are audited for their effects on mental health. Governments must be brave enough to rework their plans where these pose risks to mental health and wellbeing.

All three paths must be taken with urgency. They need to be mapped and travelled with people who have experienced mental ill-health and psychological distress.

In directing attention to the pandemic, our Government cannot afford to let slip its focus on mental health. Things have to get better. With the right political will, they can.

Professor Martyn Pickersgill is Director of the Social Dimensions of Biomedicine Programme, Edinburgh Medical School