The UK is facing a post-COVID-19 mental health crisis, but lessons learnt during the coronavirus epidemic provide a model for protecting mental health care provision for those requiring intensive care, including frontline professionals, for identifying the most vulnerable and for building greater resilience in the wider population. To understand mental health, we need to understand better how the brain works, and how its emergency survival measures can have secondary shockwaves across the whole brain system, as lockdown has had on the country.
When challenged by a threat to survival, the brain’s primitive ‘reptilian core’ responds automatically with the binary fight or flight algorithms (1), putting the other brain domains into lockdown. If these innate short-term measures are prolonged, the algorithms can cause long-term harm. Self-isolation and social distancing also negatively impact on mental health, because the brain interprets forced separation from the protection of the group, whether preventative or as punishment, as another threat to survival.
The development of the coronavirus vaccine was based on scientific knowledge amassed over a long period on how the body and immune systems work. In a similar way, this mental health crisis can utilise a body of scientific knowledge on how the brain and its systems work to develop a programme of recovery and build future mental health resilience. Feedback from lockdown on mental health benefits and challenges would support the programme, while small-scale, often volunteer, pilot studies that have been proved to be effective could be rolled out with minimum delay and expenditure.
As it is the brain that devises new ideas, their implementation and enables behavioural changes, a better understanding of how the brain works could help develop long-term strategies in all sectors of public policy, heal social divisions and improve decision-making at all levels.