The NHS needs more psychologists and other secondary care specialists alongside a new standardized treatment model if it is to avoid a “tinnitus timebomb”, according to a report which lays bare the mental health challenges of living with the much-misunderstood condition.
The ‘This Is My Silence’ report from the British Tinnitus Association, which includes the findings from a new survey of more than 2,000 people with tinnitus, revealed that there has been a drop in the number of tinnitus patients offered a referral to specialist care by their GP from 64% to 50% since March 2020 - despite COVID causing a climb in cases, links with anxiety and depression, and new National Institute for Health and Care Excellence (NICE) guidance¹ emphasizing the importance of referrals.
Tinnitus affects one in eight (7.1m) adults in the UK and is defined as a perception of noise in the ear/head that has no external source. Well-known people with tinnitus include Chris Martin, Liam Gallagher, Susanna Reid and Will.i.am². The condition has been recognized by NICE as a common symptom of Covid and long-Covid³ and studies show that national lockdowns have also worsened many people’s symptoms⁴.
The need for high-quality secondary care for people with tinnitus is highlighted by the new research, which shows that one in six people (16%) with tinnitus have had suicidal thoughts as a result of their condition and nearly half (45%) experienced depression. Other major mental health and quality of life impacts of tinnitus were found to include anxiety (71%), sleep deprivation (69%), difficulty concentrating (72%) and feelings of isolation (38%).
The study showed that an appointment with an audiologist or ENT specialist was 1.7 times more likely to reduce feelings of stress around tinnitus than an appointment with a GP, but evidence⁵ ⁶ suggests there was already a perilous lack of capacity in specialist tinnitus services prior to Covid-19, making it more difficult for GPs to refer onwards. One in three GPs have since had an urgent referral to specialist care rejected during the pandemic⁷.
The research shows that there have been some improvements in the quality of GP tinnitus appointments since the NICE Tinnitus Guidelines were published in March 2020. However, with the latest figures showing that less than half of GPs are currently following the recommendations, experts are concerned that the pressure of the Covid-19 pandemic has reduced healthcare professionals’ engagement with the guidance and the availability of secondary care specialists.
The ‘This Is My Silence report’, which was compiled by the charity in consultation with healthcare professionals across a range of disciplines, calls for additional specialist care capacity to be backed by research to develop a new national standardized method for assessing tinnitus in general practice and urges for tinnitus to be given more prominence in healthcare professional training by making it an assessed subject in medical exams.
David Stockdale, Chief Executive of the British Tinnitus Association, said: “With the Covid-19 virus and the social measures taken to keep us safe found to worsen tinnitus symptoms in a high proportion of people, healthcare services will have experienced an increased demand for support from patients with tinnitus.
“This extra pressure has exposed the fact that we need far greater investment in secondary care services that support people with tinnitus and we need a renewed focus on improving GP and community practitioner support through better training and a standardized treatment method, so that everyone gets the same level of support, no matter who they see.
“The long-awaited new NICE guidance promised a great deal but the unfortunate timing of its publication - coming less than two weeks before the first national lockdown for Covid-19 - will have significantly diluted its impact. That’s why these calls, which have been developed in consultation with healthcare professionals from a range of relevant disciplines, are so important. The mental health and quality of life impacts of tinnitus are just too great to ignore.”
The full report will be available from this link from Monday 1st February 2021: https://www.tinnitus.org.uk/
² Wikipedia. List of people with tinnitus (with referenced sources). 2021
⁵ Association of Clinical Psychologists. BMA Mental Health Workforce Survey. January 2020
