Towards a step change in our political structures and contribution to the public good

Richard Pemberton and Tony Wainwright on using the lessons of Covid-19 to move on.

“We have severed nearly all the natural physical constraints on the growth of our species: we can live anywhere from the Arctic to the tropics and, while they last, our water supplies are piped to us; our only significant predator now is the occasional micro-organism that briefly mounts a pandemic.” (Lovelock & Tickell, 2007, p.182)

“Given the very social, political, and economic nature of these threats, the social sciences have much to offer in terms of preparation and response. To date, however, social scientists have often been poorly integrated into public health efforts to address infectious threats, including disease outbreaks and the emergence and spread of antimicrobial resistance. Development and coordination of social science expertise is needed to maximise its public health effect.” (Giles-Vernick et al., 2019, p.462)

Covid-19 has turned our personal and professional lives upside down. For far too many it has brought tragedy and trauma in its infectious wake. The long-term individual economic and social costs are only just starting to take shape, but a significant recession seems unavoidable. 

Despite its terrible human and economic costs, it has ushered in many much-needed changes to services and professional practice. The differing parts of our profession and the social sciences have come together like never before and have delivered ground-breaking collaborative work. 

Is the scale of the joined up working and practice a flash in the pan or is it going to be the new normal? 

Can we use what has been learned over Covid to come to life as a profession, with the same energy to help tackle the other emergency in our midst, climate change? 

Can we use it, particularly in area of health and wellbeing, to reshape our overly divided professional house? The long-argued need for a conceptual and applied integration across specialisms is compelling.

What needs to happen to maximise our chances of realising these ambitions?

Covid as a catalyst for change 

The pandemic has moved psychology centre stage in a variety of important and dramatic ways. Steven Taylor prophetically argued in 2019 that psychology has a key role in successfully managing and defeating the uncontrolled spread of disease, but also in the prevention of pandemics altogether. This contention is given added weight by the much-raised profile of the British Psychological Society. Under the Society’s new leadership, academia, the behavioural sciences and applied psychology have come together to deliver, for example, tiered psychosocial support and models and guidance for exhausted and all too often inadequately equipped staff. Confronted simultaneously by threats to their own lives and exposure to tragic levels of fatalities of people in their care, we have played an important role in framing the demands and risks and using best evidence to help minimise the number of them that become traumatised.  

Our professions’ relatively high-profile input to the government’s pandemic scientific advisory structures, particularly in SAGE and SPI-B, has both been impressive and highly contentious. Where scientific advice ends and politics begins is being tested under the glare of tabloid scrutiny and – given the scale of the preventable death toll – an inevitable blame game. Nonetheless, if you want to actually get people to wash their hands more and touch their faces less and reduce the likelihood of civil disturbance, psychology and the social sciences have the evidence and theory to help policy makers make the right moves and reduce the spread of diseases. It is too soon to call it, but the relative success of science-led approaches to getting us out of our current predicament will determine whether public faith in science and expert opinion increases or not. 

The scale of innovation and cross-divisional working within psychology has been truly impressive. Will it persist after the pandemic, or will we allow ourselves to retreat back into our all too often fiercely guarded and factional boxes? Will we be able to use the learning from the massive social changes we have experienced to fundamentally reset the way we apply our knowledge and expertise to the other major threat the world is facing?

Connections between the pandemic crisis and the climate crisis

There are strong parallels between the origins of the pandemic and the climate and environmental crisis. Both are indications of the way we have been living since the industrial revolution. The literature on this is extensive and there is no better place to explore it than the Centre for the Study of Existential Risk at Cambridge. Alongside other existential risks (for example super-intelligent AI, meteorite collisions) there are these two major threats: pandemics and the associated biological hazards like antibiotic resistance, and the climate and environmental impact of human behaviour. They are connected by the way their impact on our public health systems (which are fragile) can be catastrophic, leading to loss of life and widespread suffering. This is particularly true in the developing world but the effects as we have seen are global. On the economic front we would point to a key theorist and thinker, Kate Raworth, who has developed the concept of Doughnut Economics (Raworth, 2018). With a history of working with NGO’s in the field and now a professor at Oxford, Raworth provides a framework for understanding how we need to reduce consumption so that we do not wreck the planet, but not so much that we produce widespread suffering. 

Lessons

What can we learn from the changes we have seen over the past months in how to think about and organise large scale societal change? The influential report generally referred to as the 1.5 degree report (Masson-Delmotte & al., 2018), commissioned by the Intergovernmental Panel on Climate Change which includes among its authors psychologists, provides a detailed roadmap about what will be necessary globally to address the climate and environmental crisis. The report says: “Ambitious mitigation actions are indispensable to limit warming to 1.5°C while achieving sustainable development and poverty eradication”, and by ambitious they mean major systemic changes at all levels.  

In the UK, one of our members, psychologist Richard Carmichael, produced a report that was commissioned by the UK Climate Change Committee on “Behaviour change, public engagement and Net Zero” (Carmichael, 2019; also watch his talk at the British Psychological Society Division of Clinical Psychology 2019 conference). He says (p.10): “Predicting the levels of behaviour change that will be delivered by these interventions is extremely difficult. Policy to deliver rapid societal change and technology adoption for Net Zero is uncharted territory beyond the available evidence base and inherently subject to uncertainty. Government will need to take a pragmatic approach, begin now and learn by doing.” 

The pandemic has provided, albeit at considerable cost, a test bed for exploring how rapid societal change can happen. We have seen the problems with delaying taking action when it is needed and the unmasking of inequality (for example the differential mortality among those with a BAME heritage), and many other lessons. We need to take urgent action on all these issues. 

Positioning the profession

The remarkable number of boards, divisions, sections and special groups in the BPS and beyond are a testament to the creativity and diversity of British Psychology. They are however on bad days a source of fragmentation, guild competition, and group think. Our collective Covid-19 response demonstrates the value of joined up working and a progressive and effective professional body.

The British Psychological Society could build on its Covid-related work and establish a structure or network devoted to the impact of human behaviour on the environment; the APA already has one of these, its Division 34: Society for Environmental, Population and Conservation Psychology, and we urgently need to organise such a network, bringing together the expertise that we have which is extensive. As we have seen from the impact of the pandemic, this is not just a practical requirement but an urgent ethical necessity.

The way we apply psychology in health and social care in the UK could be radically strengthened. We need to reframe our individually focused models to in order to embrace public wellbeing (in terms of both psychological wellbeing and physical health) by bringing together all domains of practice to collaborate on promoting health and well-being and preventing harm. We suggest that we need national and regionally organised operational hubs consisting of all disciplines in psychology that have any bearing on public health or disaster planning or trauma-informed care to promote a strategy for building resilient communities (see also for some suggested approaches to place-based mental health services (National Collaborating Center for Mental Health, 2019).

The direction of travel of the NHS Plan is consistent with this, but our suggestion goes much further; it could be implemented given the support and motivation of psychologists. And we have seen how this can happen with the dramatic increase in output of the Society’s guidance from working groups on COVID that have been established. Useful material being turned around in three days is really impressive, and building on these models could pay real dividends.

What we do in the coming months will have far reaching consequences for future generations. Paradoxically, this 'shock doctrine' (Klein, 2007) might be just what we need.

- Richard Pemberton is Director of the Division of Clinical Psychology Professional Standards Unit

- Tony Wainwright is Senior Lecturer, College of Life and Environmental Sciences, University of Exeter

References

Carmichael, R. (2019). Behaviour change, public engagement and Net Zero. A report for the Committee on Climate Change. Retrieved from Available at https://www.theccc.org.uk/publications/ and http://www.imperial.ac.uk/icept/publications/

Giles-Vernick, T., Kutalek, R., Napier, D., Kaawa-Mafigiri, D., Duckers, M., Paget, J., . . . Wilkinson, A. (2019). A new social sciences network for infectious threats. Lancet Infectious Diseases, 19(5), 461-463. doi:Doi 10.1016/S1473-3099(19)30159-8

Klein, N. (2007). The shock doctrine : the rise of disaster capitalism (1st ed. ed.). New York: Metropolitan Books/Henry Holt.

Lovelock, J., & Tickell, C. (2007). The Revenge of Gaia: Earth's Climate in Crisis and the Fate of Humanity: Basic Books.

Masson-Delmotte, V., & al., e. (Eds.). (2018). Global Warming of 1.5°C. An IPCC Special Report on the impacts of global warming of 1.5°C above pre-industrial levels and related global greenhouse gas emission pathways, in the context of strengthening the global response to the threat of climate change, sustainable development, and efforts to eradicate poverty. Available at https://www.ipcc.ch/sr15/.

National Collaborating Center for Mental Health. (2019). The Community Mental Health Framework for Adults and Older Adults. Retrieved from NHS England, NHS Improvement, NCMH

Raworth, K. (2018). Doughnut Economics, Cornerstone Digital

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