Why virtual support just isn’t the same...

I wanted to write this piece because it’s been almost a year now since the arrival of COVID-19 into the UK and also since I had a ‘normal’, face to face appointment with either my psychologist or care coordinator. 

Back in March 2020, when we entered the first lockdown and my appointments stopped, I genuinely only expected it to be for a few weeks. However, here we are almost one year later and it has become the norm for me to chat to my care coordinator from my sofa in my slippers, with the dog dozing at my feet (ideally), or barking madly at the postman (more frequently), whilst we try to have a serious conversation.

Initially, contact with both my psychologist and care coordinator after the lockdown was announced, was by phone. I found that very stressful, mostly because it was change from routine. I don’t cope well with change and thanks to Covid, the whole world literally changed overnight. However, in addition to that, I also had to battle my phone related anxiety, which has been a problem for me since my teenage years. I hate speaking to people on the phone because you can’t see them. Obvious yes but it means I find it way more difficult to judge their mood, their thoughts and whether or not they’re even listening to me. Granted, it is more anxiety provoking for me to have to initiate the phone call but even receiving a call from someone I know (friend, family, professional, whoever) makes me feel sick beforehand. This stress was something I really didn’t need to add to the newly turned upside down world, which all made my appointments more difficult than before. And the reason I was having them in the first place was because things were too difficult to manage!

After several weeks of phone terror, the mental health trust finally caught up with technological advances and my appointments became video based. But this didn’t come without its issues either. I wasn’t particularly well versed in video calling, and neither were the professionals. And suddenly there were a whole load of other worries to deal with. Firstly, would the software work on my tablet, how much battery did I need to have, would my wi-fi be fast enough (some people don’t even have access to wi-fi), what if the connection froze, what if I couldn’t hear them? 

But also, there were more personal concerns. Where should I sit in my flat to make it as neutral as possible? I didn’t want them invading my home. Normally, my appointments all take place at a Trust building in the next town from me. It’s a real pain to have to drive there every week but it does mean that the meetings all take place on neutral territory. 

It has been hard having to invite my workers into my home, especially when that home is literally the place I am spending 24/7 during the lockdowns. It has been hard readjusting to not having an entirely separate space to retreat to- which is what my flat used to be.

Video calling has also made me worry about the security of the appointments. During a face to face appointment, I am in a room with no one but the professional that appointment is with. And, unless someone is literally standing at the door with a glass, I know that whatever I say is kept between me and them. However, on a video call, I have no idea who else may be in the room. 

I am lucky in the sense that living alone, I don’t have anyone who may be eavesdropping on my appointment in the flat (except for the dog but she is too busy interrupting with her postman alert patrol to care that much), but for others this is a real concern. I worry that the neighbours may hear, despite knowing this is unlikely, and I am in a constant state of panic that someone is going to come to the door mid appointment. All of this raises my heart rate and anxiety before we’ve even begun. 

Then there’s the issue of time. Face to face, my appointments with my care coordinator last an hour. Strangely though, on the phone or via video, I seem to be asked the question “so, shall we make another appointment for next time?” after roughly half that time. Somehow conversation is more difficult to sustain when you’re not actually in a room with someone. Knowing that I have less time, combined with the worry of them not really listening, if on the phone, or not feeling secure, if via video, means I am actually far less likely to talk about sensitive issues at all. Consequently, the quality of the appointments falls and so does their usefulness.

COVID-19 has recently had a massive impact on my EMDR therapy too. Due to the fact that I tend to dissociate a lot during sessions, doing EMDR remotely/virtually is just too dangerous and not practical for me. The psychologist has finally been allowed back to do 1:1 work if clinically necessary but she has to wear full PPE ie. visor, mask, gloves and apron to do so, as well as keeping her social distance. We trialed me sitting in a room with her, and my care coordinator, dressed like that during a joint meeting (the one time I have seen either of them in the flesh for almost 12 months) but I found it too overwhelming. That was without doing any active therapy work. As a result, I have recently been discharged from my psychologist and therapy, albeit temporarily, mid-treatment and now have no contact with my psychologist at all. I can’t begin to explain how disruptive this feels. Not only have we started work that we currently can’t finish, meaning the can of worms we opened are currently squirming around my mind with no way of getting them back inside, but also I now feel abandoned by my psychologist and that hurts so much. Logically I know that at some point we will go back to the worms and it’s not my psychologist’s fault that she’s had to discharge me but this is a pandemic - a hugely stressful life event for everyone - this is a time I need most support, NOT for it to be cut.

Of course I am grateful that my mental health support has continued in some fashion despite coronavirus but nearly a year on, I am really feeling the lack of face to face support. Phone, or even video support, is not an adequate replacement going forward and I hope the executives in charge of provision recognise this. 

I hope that by sharing my own experiences with how things have changed, others who have experienced similar things will know they are not alone.