For many, vaccination is the start of the journey, not the end: Good Help in the fight against Covid
How do we support the most vulnerable, not only with the vaccine, but life after it?
FLYNN DEVINE • 15 JANUARY 2021
Up and down the UK, those most vulnerable to Covid-19 are the first to receive the new vaccines.
The current scramble to deliver mass vaccination is being framed mainly as a technical issue of how we can get as many needles into as many people’s arms as quickly as possible. But sadly, those who are vulnerable to Covid-19 also tend to be most vulnerable to other health inequalities. And during the pandemic, those health inequalities have been exacerbated, often very significantly; be it by limited NHS capacity or the constraints of lockdowns, isolation and social distancing.
For many people vaccinations are not the last step before they can lead healthy and fulfilling lives again; they are in a very real sense the beginning of a much longer and probably ongoing path. The work we do now is important: ensuring the issues that many have faced during lockdowns – like isolation, separation and struggling with mental health, do not continue to grow after vaccination. There are services available, but through our work in communities across the UK we are learning that many people assume they’re not operating as usual or do not want to place additional burden upon them.
It is vital therefore that as we mobilise to deliver the vaccines, we understand our role in supporting people to be prepared and motivated for this longer journey.
If we don’t ‘catch’ people at this stage, there is a real danger that when they go home, now vaccinated and theoretically safe, we lose them. Sadly many people will be returning home to communities still in lockdown, having developed habits of self-sufficiency necessary to survive the past year, but which can make it harder for services to help them live healthy and fulfilling lives.
According to the local authorities, service managers and community members we are working with, there is now a big opportunity to use this moment to put in place support so that when people go home, they know they are not alone, but have friends, neighbours and professionals there ready and willing to help.
When it comes to ensuring that the vaccine rollout prepares people for this longer journey, there are three groups of people we need to consider: those receiving the vaccine, those providing it and wider community members who will offer ongoing informal support when people get back home.
It all starts with a conversation
Firstly we need to ensure that every person who comes through the door for a vaccine has what we call an ‘enabling conversation’, which does three things:
1) Finds out how they really are, if there’s some help they need, and makes sure they are aware of what support is out there
2) Builds their confidence and hope (what we call self-efficacy) about their immediate future; and finally but most important of all
3) Puts initial pieces of support in place – this might be as simple as a follow-up phone call.
These conversations need to be informal and friendly; making the person feel at ease and cared for.
If every person who goes into a vaccine centre has this conversation, when they go back home each will know there’s someone looking out for them and there’s someone they can call.
They will then feel slightly less isolated and hopefully more optimistic about the future.
To do this we’re going to need to make sure each vaccine centre has people there tasked and able to have these conversations. Anyone who’s experienced at motivational interviewing or coaching techniques will know what to do. Our public services are full of people with precisely these skills, but not everyone. And if help starts and finishes with providing the vaccine, what could well be life saving enabling conversations won’t happen.
Finally we need to reactivate those community networks that sprang up last March, but this time in a much more specific and targeted way, ensuring the vulnerable are re-connected to their friends and neighbours; but also that their friends and neighbours are supported to offer help that is enabling, not dependency-creating.
Throughout 2020 many of us have inadvertently become experts in providing Good Help when supporting people in our communities who are isolating and scared of the virus. We’ve all experienced how the right word can be the difference between giving someone hope and solidifying fear. These skills we’ve learnt are well evidenced and easy to apply, but we community members still often need support to do it properly.
When we do, we are giving our friends and family the best possible chance of leading healthy and fulfilling lives. This is the light at the end of the tunnel, and our best chance to make it brighter.