Doctors are seeing a rise in people reporting severe mental health problems during the coronavirus pandemic, leaders from NHS England said this week.

The recent rise comes after a 30% drop in people reporting mental health issues during the peak of the coronavirus pandemic. Researchers suggested the drop came after people didn’t want to visit their doctors and stay away from health services, BBC News reports.

Now, people have returned to their doctors. And the current demand for help might exceed pre-pandemic levels by 20%, according to BBC News, suggesting there’s been additional mental health issues created by the pandemic.

Reported problems from the pandemic have included isolation, substance use, domestic violence issues and economic concerns, according to the NHS, which is a public body of the department of health and social care in England.

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There were also “particular concerns that the stark inequalities in accessing services and recovery rates that Black and minority ethnic communities face will be exacerbated,” the report said, according to BBC News.

Concerns about the mental health impact of the coronavirus pandemic have been noted by epidemiologists and virologists over the last few months. Researchers said it’s not surprising that forcing people to stay home and shutting down cities — leading to business closures and unemployment — might lead to mental health struggles.

Frederick Buttell and Regardt J. Ferreira at Tulane University wrote in the journal Psychological Trauma that staying safe from the pandemic could impact our mental health.

“In an ironic twist, many of the strategies that are critical to ensuring our collective public health during this pandemic may put people at greater risk for ... mental health issues,” they wrote.

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A number of studies from China, Spain and the United States found that people are suffering amid the pandemic. People tend to feel anxious, depressed and traumatized. Some remain lonely from staying inside and being forced to stay socially distanced away from people. Domestic violence has increased, too, as more people are forced to stay home. Disadvantaged groups have seen several more concerns because they’re losing their jobs and have the extra burden of financial insecurity.

But this doesn’t mean people can’t do their part to care for others. Feeling empathy for others is an important step people can take to help others feel better, researchers said.

“What we’re going through right now is a trauma, or at least a major stressor on a global scale,” according to Kira M. Newman of Greater Good Magazine. “This is one of those times when life really is harder by a little bit or a lot, depending on your situation. Feeling bad is part of being human — and right now, that’s something many of us need to face, even as we work to feel better, stay connected, and help others.”