Author's reply

I am very grateful to Professor Arnone for his response to my editorial.¹ I agree that ‘COVID-19 offers an opportunity to revisit the current state of mental health services and develop ways to maximise healthcare delivery’. There are many lessons to learn, not least of which is the need for community mental health teams ‘to shift to online consultations for the foreseeable near future’, as Professor Arnone points out.

Although I agree that we need to upskill in the area of online work and to increase access to technology, the pandemic has also highlighted the limitations of online working and consultations conducted while wearing face coverings. If these are the only methods available for assessing patients, they will suffice, but much is lost: certain aspects of facial expression, nuances of conversation and significant dimensions of rapport. We need to work on other aspects of these interactions to make up for these deficits.

Professor Arnone's point about funding is also very well made. Mental health services will play a key role in managing our responses to future resurgences of COVID-19 as well as the long-term consequences of the virus.

Much of the distress linked with COVID-19 will be clearly associated with psychosocial problems (isolation, unemployment, bereavement), but some will be firmly biological, following from COVID-19 infection itself. Managing these kinds of complex, biopsychosocial problems is precisely what psychiatry has done for decades. Psychiatry has never been as purely biological as the biologists would like, or as purely psychosocial as others would wish. It is a unique mix, and COVID-19 is our greatest challenge yet.