2020 was a year that brought inequalities due to race and ethnicity, sexual orientation and gender identity into a focal point. The lack of respect for human rights in many countries, including people living with mental health conditions, was evident.

The theme of World Mental Health Day 2021 is ‘Mental Health in an Unequal World’. Over the last 18 months, we’ve seen that those who were isolated became more so. Those whose freedoms were limited became more so. Those who face discrimination for their nationality, skin colour or ethnicity, suffer more so. Those who had difficulty accessing resources or finances found it more difficult still. Such inequalities have an impact on people’s mental health.

The lived experiences of this are evident in news coverage. Anti-Asian hate crimes were reported to have spiked since the start of the coronavirus outbreak, with 31% of American-Asians subjected to racial slurs or ‘jokes’ directed at their ethnicity and 26% of those surveyed were fearful of being physically attacked¹. The same study found that coronavirus, and the racial prejudice that followed, contributed to a significant mental health gap between white Americans and Asian-Americans, the latter suffering with twice as many cases of depression and anxiety.

In the UK press, femicide and gender-based violence have been a prominent and repeated headline; an outpour of fear and anger reignited following the murder of Sarah Everard. More tragedy ensued with Sabina Nessa’s murder, included as one of the 81 women allegedly killed by men over 28 weeks². The weight of more gender-based violence fatiguing the emotional reserves of individuals across the UK³.

In the mental health field, the British Association for Counselling and Psychotherapy conducted a study of 5,000 of their therapist members, who identified significant mental health impacts of the pandemic, with 64% noting an increase in referrals for social anxiety⁴. With each person subject to inequalities and having lived through the pandemic, we can see how someone might become socially anxious.

Social anxiety, defined by the NHS as a long-term and overwhelming fear of social situations, is a likely and valid after effect of the time and experiences we have endured. The perceived threat level about returning to social situations will differ due to health, economic or social inequalities.

As a psychotherapist, the therapeutic process that I facilitate is with the individual. So today, I’m writing for you. For those finding it hard to re-engage with the outside world. Those who can’t venture beyond your home with emotional safety. And those struggling to manage outside of the comfort zones we have created over the past 18 months. If you’re preparing to re-engage with the outside world (or struggling to do so), the following may help.

• Practice makes progress. Start with the easier situations and work your way up to the harder ones. Working to your comfort is the best way to reintegrate and become more secure with the outside world again. Evaluate what you can and cannot cope with socially and, little by little, build your engagement from there.
• Practice self-compassion. Manage your feelings and expectations at your own pace. Communicate your needs and boundaries with others and remove any self-imposed pressure to return to your ‘old life’ if this is causing you a lot of stress.
• Find your coping mechanisms. For some people, it’s mindfulness through journaling or breathing techniques. For others, it’s practising gratitude. It might be identifying triggers and planning how you might manage these. If you’re not sure what your coping mechanisms might be, speak to a mental health professional who will be able to guide you with learning new skills or techniques, or even explore your social anxiety and ways of combatting this, in the hope that you can enjoy good mental health.

As we stand amid the gap in health, economic and social inequalities, I hope that the 2021 World Mental Health Day campaign offers an opportunity for us to reflect. I hope that support resources and organisations will be shared. Without toppling inequalities, we’re unlikely to be able to turn the tide on global mental health. This is a chance for us to work together in highlighting how inequality can be addressed.

If any of these issues have impacted you, please consider the following support services:

• Anxiety UK
• No Panic
• The Black, African and Asian Therapy Network (BAATN)
• Victim Support 
• Better Help

¹Anti-Asian discrimination and the Asian-white mental health gap during COVID-19, Wu, Qian & Wilkes, 2020

²The Guardian, 2021

³Mental Health Today, 2021

⁴BACP Mindometer report, 2021