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Mental Health

Psychosis: why the rise in cases during the pandemic is so concerning

With new figures suggesting that the number of people experiencing psychosis has surged during the pandemic, Stylist speaks to one woman about her experience. 

Trigger warning: this article contains detailed description of a psychotic episode, as well as a mention of sexual assault. If either of these subjects are triggering for you, please click off this article. 

We may have come leaps and bounds as a society when it comes to the way we talk about common mental health conditions such as anxiety and depression, but there’s still a lot of work that needs to be done – especially when it comes to the UK’s mental health services.

While demand for support and treatment was on the rise before the pandemic, the events of the last 18 months have triggered a surge in the number of people struggling with their mental health – including those dealing with suspected first episodes of psychosis.

The condition – which can be both a symptom of mental illness such as schizophrenia, bipolar disorder or severe depression or a one-off occurrence – can involve seeing or hearing things that other people don’t (hallucinations) or developing beliefs that aren’t based on reality (delusions).  

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Compared to other mental health conditions, psychosis remains quite rare – statistics from Mental Health England suggest that around 6% of the population have experienced at least one symptom of psychosis – but according to a new report from the charity Rethink Mental Illness, the number of people dealing with psychosis for the first time has surged significantly over the course of the pandemic.

The report, which was based on an analysis of NHS data, found that there was a 29% increase in the number of people referred to mental health services for a suspected first episode of psychosis in April 2021 compared to April 2019.

And while the most recent data for July 2021 suggests the number of people presenting to mental health services with symptoms of psychosis has returned closer to pre-pandemic levels, the charity is concerned that any further surges could lead to delays in treatment.  

A woman sat on her bed at home
The report found that, in April 2021, the number of cases had increased 29% compared to April 2019.

Luyando, 31, from Kent, who lives with bipolar disorder, knows just how important accessing timely and adequate support for psychosis can be. She first experienced psychosis at the age of 24 after experiencing sexual assault, when the stress from reporting her experience to the police – who she felt mishandled her situation – became overwhelming.

“One day, completely unrelated, the police showed up at my house and said they’d reprimanded my brother,” she tells Stylist. “Them showing up triggered everything for me. The paranoia started from that moment – it was like a light switch. I thought that everything they were saying was fake, and that instead of reprimanding my brother they’d come to spy on me.”

From that point, Luyando explains, the psychosis began to worsen. Over the course of three days, she found herself consumed by a long list of delusions, ranging from the beliefs that she was “God’s chosen child” and she’d made “millions” online to the beliefs that her abuser had been arrested and that her life was being filmed “like on The Truman Show”. 

“It was like my brain was picking up messages – like someone was putting thoughts in my head that I couldn’t control,” she says. “I had a lot of racing thoughts and my speech was very rapid as well, and I went on social media and was writing a lot, too. I kept posting things on Facebook – people were ringing my house phone like, ‘What’s going on?’.”

After dealing with these symptoms for three days – during which time she says her family called the hospital and were told to give her some sleeping pills – the situation came to a head when the emergency services came to visit her at home and she took out a knife.

“Because I believed I was being filmed I thought the police would show up if I walked outside with a knife in my hand, so I was like, ‘watch this’ to the cameras I thought were all around me,” she recalls. “Of course, all everyone else saw was just me walking out with a knife, so they ran away and called the police, and then I was taken to hospital.” 

Woman in bed on her phone
Luyando says she posted repeatedly on Facebook in the midst of her psychosis, prompting concerns from her friends and family.

At first, Luyando says, she was sedated – and can’t remember much of the first two weeks in hospital. But after those two weeks – and once she’d been prescribed anti-psychotic medication – her symptoms began to lessen; after a month, she was able to return home.

“My psychosis kind of tapered off after the medication began to work, but my symptoms were still there when I was discharged,” she says. “However, the medication has helped massively – I haven’t had another episode since then.”

With more people like Luyando experiencing first episodes of psychosis in response to the pressures of the pandemic, rapid access to treatment has never been so important. Indeed, while many like Luyando are able to access assessment within the two-week timeframe recommended by NICE, Rethink Mental Illness fears that things could worsen if the current uptick in diagnoses continues. 

“Psychosis can have a devastating impact on people’s lives,” said Brian Dow, deputy chief executive of Rethink Mental Illness. “Swift access to treatment is vital to prevent further deterioration in people’s mental health which could take them years to recover from.”

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Dow continued: “The increased number of suspected first episodes of psychosis are cause for alarm. We are now well beyond the first profound shocks of this crisis, and it’s deeply concerning that the number of referrals remains so high. As first presentations of psychosis typically occur in young adults, this steep rise raises additional concerns about the pressures the younger generation have faced during the pandemic.

“The pandemic has had a game-changing effect on our mental health, and it requires a revolutionary response. Dedicated additional funding for mental health and social care must go to frontline services to help meet the new demand, otherwise thousands of people could bear a catastrophic cost.”

With last week’s budget failing to set aside funding for mental health services post-pandemic, it waits to be seen whether the government will respond to calls from charities to address growing demand. But if one thing’s for sure, it’s that adequate support and treatment can make a tremendous difference for a wide range of mental health conditions – and we need to ensure the right services are there for those who need them. 

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