Mental Health and COVID-19 take leading agenda role
Member States highlight mental health and COVID-19 response at the WHO Executive Board
By Anna Watkins
Twenty two member states came out yesterday to express their support for a report by the WHO Director General on mental health preparedness and response for the COVID-19 pandemic. Member States took the opportunity of having mental health firmly on the agenda to highlight that this has long been a neglected issue, with Israel stating ‘We need to ensure mental health is at the forefront of the discussion’.
Thailand, who proposed the agenda item (14.3) and has received resounding praise for doing so, highlighted that mental health ‘service provision should not be only hospital based services’, pushing the importance of community based services in order to ensure comprehensive continuity of care, which has been a running theme throughout the session. The US supported this, specifically endorsing ‘recommendations to apply a whole of society approach’ and India gave concrete examples of how they have made mental health services available at a community level, including setting up a 24/7 helpline specified for different target groups, and online capacity building of health workers to provide mental health support and training for their i-call platform. Improving mental health literacy to reduce stigma and promote early interventions has been a key way that multiple member states have committed to increase resilience and support at community levels.
In Australia, community mental health has also been at the forefront of pandemic preparedness, with the country prioritising a whole of society approach. Their focus has been on supporting economic needs, plus increased tele-health services and targeted MHPSS support; prioritising accessible and affordable community based services, especially in the context of high prevalence and comorbidities of substance use and mental health. Kenya also gave examples of their integrated, community level approach, rolling out psychological first aid training in order to prioritise MHPSS at community level. As with many others, Kenya highlighted the devastating impact COVID-19 has had on the mental health of their population: ‘mental health duress and anguish has severely affected lives and livelihoods and had catastrophic impact on our communities.’
This mental distress was unfortunately, a not unexpected, but saddening theme. Even in Tonga, which represented the Pacific islands, and where COVID-19 cases have been particularly low, ‘anxiety and depression has been felt in many throughout the prolonged pandemic’. Tonga took this opportunity to proudly announce their first ever national mental health policy and their newly established division for mental health preparedness in the ministry - a huge achievement for mental health in the Kingdom.
An integrated response, specifically in universal health coverage (UHC) plans has come through as a strong reaction to the report, with the EU (represented by Austria), African region (represented by Gabon), Sudan and Israel all explicitly calling for mental health to be a major part of any UHC package. The EU said states must ‘ensure mental health is considered as a cross-cutting component, especially in our emergency response’ and have primed their member states to ‘build back better’ - a key theme of the UN Secretary General’s previous 2020 statement.
It was also welcomed that the report drew attention to the horrific Human Rights abuses that often come hand-in-hand with poor mental health services. Gabon and Japan were amongst those highlighting this important subject, with Portugal praising the Quality Rights initiative in the context of human rights and mental health. Kenya succinctly summarised this, welcoming the WHO Director General’s proposal to reduce suffering and promote Human Rights.
Overall, the main call to action was for greater support to countries in improving rights-based, person-centred mental health services that are accessible to all. Many called for WHO to further support countries to implement the newly updated Comprehensive Mental Health 2030 Action Plan to be adopted at the May World Health Assembly. On behalf of AFRO region, Gabon approved the Comprehensive Mental Health 2030 Action Plan, and requested further support in light of the challenges faced in order to improve the delivery of MHPSS to people affected by COVID-19, and scaling up mental health services particularly at primary and community levels. Colombia called for ‘strategic guidelines to become operationalised immediately through the mental health action plan’, and for the WHO to facilitate practical adoption of recommendations following the pandemic. As Thailand rightly pointed out:
‘The mental health effects from crises last longer than the event itself. We need to pay attention to long term demand.’
Many member states took time to specifically thank the WHO teams for their resilience and support, with Singapore stating WHO staffer’s ‘efforts have been recognised, you are not alone’. Portugal summed up the overall message perfectly - ‘Over the past few months we have all been worryingly watching as the pandemic has caused a mental health emergency. This is an absolute priority for action.’