MEMBER BLOG: COVID-19 AND MENTAL HEALTH - WHAT' WE’VE LEARNED

By Sarah Kline, Deputy CEO, United for Global Mental Health

Six weeks ago, as the COVID-19 pandemic continued to unfold around the world, a new webinar series* put the spotlight on tackling the impact coronavirus was having - and will continue to have - on mental health. As some countries tentatively now begin to lift lockdown restrictions, whilst the pandemic unravels in those continents who had lagged behind epidemiologically, what has six weeks of insights and reflection by mental health experts and frontline workers revealed, and how can they inform how we build back better? 

The phrase “we are in this together” has been used by many and it remains true that enforced isolation and social restrictions are putting increasing pressure on entire populations’ mental health. Fear of infection and dying, the emotional strain of physical distancing, stress due to personal economic uncertainty, increase in substance abuse and greater domestic violence are affecting increasing numbers of people. The universality of the situation is unprecedented. Panellists Devora Kestel and Florence Baingana (WHO) and Simon Wessely and Neil Greenberg (Kings College London) agreed in the first session in April that we need to learn now from what is happening, especially in high income countries, and be aware that similar mental health challenges - along with the impact of poverty and financial insecurity - will face LMICs in the very near future.

It has become ever more apparent that the COVID-19 response is a marathon not a sprint - and this includes the impact on, and need for, support for mental health as the Webinar series has highlighted. Given recent warnings that COVID-19 will be with us for a long time, we will be experiencing the impact on mental and physical health for years not months. “Initially, we planned for a COVID-19 mental health strategy for 1-2 months in Pakistan. Now we are planning for two and half years,” explained guest panellist Taha Sabri, Speak Your Mind campaigner and Co-Founder of Taskeen, a mental health NGO based in Pakistan. 

While large segments of the general population around the world are feeling increased levels of anxiety and fear, some groups are particularly vulnerable to the mental distress as a result of COVID-19, and require urgent support. These include:

• those with existing mental health conditions, who may be experiencing a disruption to services or their medication supply

•  frontline health workers who may be justifiably anxious about getting infected, and passing on infection to their families; many of whom are having to work overtime in highly demanding situations; and without whom an effective COVID response is impossible

• and refugees, who may be housed in unsanitary or cramped conditions, and for whom being in confinement may bring back traumatic memories.

In discussions around what a maximally efficient global response to COVID-19 means, there is a growing consensus that mental health needs to be integrated into overall response and recovery plans. Greater investment into mental health and psychosocial support (MHPSS) at community level may help prevent mental ill health. A more empathic approach to public health messaging may improve adherence to public health information and protocol; and, finally, some of those most vulnerable to contributing to the spread of COVID-19 are also those with poor mental health, including people in psychiatric institutions, the homeless, and those with long-term addictions. Linked to this, funding for the mental health response to COVID-19 has been slow and wholly inadequate. While some countries have announced additional funding (such as New Zealand, Australia and the UK), most countries are not yet prioritising support and more advocacy is required to build the case and secure sufficient investment. 

The webinar series has also touched on the fact that there is still much we don’t know about COVID-19, that further research must shed light on. From the neurological implications of the virus, to its impact on health systems. One thing is clear, people with lived experience should be at the centre of the research agenda.

“Empowerment and support are very important so that people with lived experience can meaningfully participate and share experiences during this time,” said Charlene Sunkel, Global Peer Support Network, South Africa.  

Finally, we have been reminded during the series that it is not all ‘doom and gloom’. It is possible the experience of COVID-19 could bring us together and make us kinder to one another. It is already raising the awareness of mental health and reducing stigma, as Florence Baingana, WHO Africa Region, said:

“The pandemic has helped raise the profile of how important mental health psychosocial support (MHPSS) is and how cross-cutting it is”. 

Join us for the next webinar to discuss the mental health impact on people in vulnerable situations.

*The webinar series is organised by a partnership between UnitedGMH, Lancet Psychiatry, Mental Health Innovation Network and MHPSS.net