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Letters Social distancing in covid-19

Social distancing in covid-19: what are the mental health implications?

BMJ 2020; 369 doi: (Published 06 April 2020) Cite this as: BMJ 2020;369:m1379

Rapid Response:

COVID-19: changing the world’s stigma perception of mental health help-seeking

COVID-19 worldwide enforced social distancing is likely to impact our mental health and wellbeing. [1] Studies highlighting the psychological impact of previously enforced lockdowns (extreme social distancing) reported post-traumatic stress symptoms, confusion and anger. [2] Concerns over social isolation and increased feelings of anxiety and depression during the current lockdown are evident. [3] This suggests that a new cohort of people will access informal and formal mental health support. Indeed, many countries have made mental health support available to healthcare professionals to help them cope with the impact of COVID-19. [4] Coupled with the increased use of these services by the public, there is a sense of a new normality to mental health help-seeking.

Over 70% of people with diagnosable mental health conditions do not receive treatment worldwide. [5] Mental health stigma is one of the most significant barriers to treatment seeking. [6,7] Yet, this level of active stigma usually associated with the current level of mental distress experienced during COVID-19 lockdown does not seem to be present. The awareness of COVID-19’s universal threat to our wellbeing has connected people in a new way worldwide. Despite the COVID-19 pandemic’s devastating effects, going forward, this pandemic could dramatically reduce mental health stigma leading to increased mental health help-seeking globally; talking about our mental health will become a new norm.


1 Venkatesh A, Edirappuli S. Social distancing in covid-19: what are the mental health implications? BMJ 2020;369:m1379. doi:10.1136/bmj.m1379
2 Brooks SK, Webster RK, Smith LE, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020;395:912–20. doi:10.1016/S0140-6736(20)30460-8
3 Holmes EA, O’connor RC, Perry H, et al. Position Paper Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science. The Lancet Psychiatry doi:10.1016/S2215-0366(20)30168-1
4 NHS staff to be offered mental health support for Covid-19 ‘shell shock’ | Society | The Guardian. (accessed 16 Apr 2020).
5 Henderson C, Evans-Lacko S, Thornicroft G. Mental illness stigma, help seeking, and public health programs. Am. J. Public Health. 2013;103:777–80. doi:10.2105/AJPH.2012.301056
6 Clement S, Schauman O, Graham T, et al. What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol. Med. 2015;45:11–27. doi:10.1017/S0033291714000129
7 Gulliver A, Griffiths KM, Christensen H. Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC Psychiatry 2010;10:113. doi:10.1186/1471-244X-10-113

Competing interests: No competing interests

17 April 2020
Lindsay H. Dewa
Research Fellow
Catherine Kilkenny
Imperial College London
School of Public Health, Reynolds Building, London