COVID-19 and the Need for Action on Mental Health
Although the COVID-19 crisis is, in the first instance, a physical health crisis, it has the seeds of a major mental health crisis as well, if action is not taken. Good mental health is critical to the functioning of society at the best of times. It must be front and centre of every country’s response to and recovery from the COVID-19 pandemic. The mental health and wellbeing of whole societies have been severely impacted by this crisis and are a priority to be addressed urgently.
Psychological distress in populations is widespread. Many people are distressed due to the immediate health impacts of the virus and the consequences of physical isolation. Many are afraid of infection, dying, and losing family members. Individuals have been physically distanced from loved ones and peers. Millions of people are facing economic turmoil having lost or being at risk of losing their income and livelihoods. Frequent misinformation and rumours about the virus and deep uncertainty about the future are common sources of distress. A long-term upsurge in the number and severity of mental health problems is likely.
Moreover, specific populations groups are showing high degrees of COVID-19-related psychological distress. Frontline healthcare workers and first responders have been exposed to numerous stressors and ensuring the mental health of healthcare workers is a critical factor in sustaining COVID-19 preparedness, response and recovery. In every community, there are numerous older adults and people with pre-existing health conditions who are terrified and lonely. Emotional difficulties among children and adolescents are exacerbated by family stress, social isolation, with some facing increased abuse, disrupted education and uncertainty about their futures, occurring at critical points in their emotional development. Women are bearing a large brunt of the stress in the home as well as disproportionate impacts more generally. And people caught in fragile humanitarian and conflict settings risk having their mental health needs overlooked entirely.
During the past few months, there have been efforts initiated to support people in distress and to ensure care for people with mental health conditions. Innovative ways of providing mental health services have been implemented, and initiatives to strengthen psychosocial support have sprung up.
Yet, because of the size of the problem, the vast majority of mental health needs remain unaddressed. The response is hampered by the lack of investment in mental health promotion, prevention and care before the pandemic.
This historic underinvestment in mental health needs to be redressed without delay to reduce immense suffering among hundreds of millions of people and mitigate long-term social and economic costs to society.
To minimize the mental health consequences of the pandemic, it is important to consider urgently the following three recommended actions:
1. APPLY A WHOLE-OF-SOCIETY APPROACH TO PROMOTE, PROTECT AND CARE FOR MENTAL HEALTH
Mental health actions need to be considered essential components of the national response to COVID-19. A whole-of-society approach for mental health in COVID-19 means:
including mental health and psychosocial considerations in national response plans across relevant sectors, for example supporting learning and nurturing environments for children and young people who are confined at home;
responding proactively to reducing pandemic-related adversities that are known to harm mental health, for example domestic violence and acute impoverishment; and
crafting all communications to be sensitive of their potential impact on people’s mental health, for example by communicating empathy for people’s distress and including advice for their emotional well-being.
2. ENSURE WIDESPREAD AVAILABILITY OF EMERGENCY MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT
Mental health and psychosocial support must be available in any emergency. Achieving this objective during the COVID-19 pandemic means:
supporting community actions that strengthen social cohesion and reduce loneliness, for example supporting activities that help isolated older adults stay connected;
investing in mental health interventions that can be delivered remotely, for example quality-assured tele-counselling for frontline health-care workers and people at home with depression and anxiety;
ensuring uninterrupted in-person care for severe mental health conditions by formally defining such care as essential services to be continued throughout the pandemic; and
protecting and promoting the human rights of people with severe mental health conditions and psychosocial disabilities, for example, by monitoring whether they have equal access to care for COVID-19.
3. SUPPORT RECOVERY FROM COVID-19 BY BUILDING MENTAL HEALTH SERVICES FOR THE FUTURE
All affected communities will need quality mental health services to support society’s recovery from COVID-19, and this requires investment in the following:
using the current momentum of interest in mental health to catalyze mental health reforms, for example by developing and funding the implementation of national services re-organization strategies that shift care away from institutions to community services;
making sure that mental health is part of universal health coverage, for example by including care for mental, neurological and substance use disorders in health care benefit packages and insurance schemes;
building human resource capacity to deliver mental health and social care, for example among community workers so that they can provide support; and -• organizing community-based services that protect and promote people’s human rights, for example by involving people with lived experience in the design, implementation and monitoring of services.
Rapid implementation of these recommended actions will be essential to ensure people and societies are better protected from the mental health impact of COVID-19.