Abstract
Objectives: This paper reviews the mental health policies that have been implemented in Chile in response to the COVID-19 pandemic and the international context of countries' responses. Even before the start of the pandemic, there were significant barriers to access mental health services in Chile, coupled with a scenario of nationwide social unrest and protests that questioned the legitimacy of public institutions; now the rapidly worsening outbreaks of COVID-19 are exacerbating the pre-existing mental health crisis.Methods: We conducted a bibliometric and content analysis of the Chilean mental health public policies implemented during the COVID-19 pandemic and then compared these policies with international experiences and emerging scientific evidence on the mental health impact of pandemics.Results: Our analysis of the policies identifies five crucial points of action developed in Chile: (i) an established framework to address mental health in emergency and disaster situations; (ii) a timely COVID-19 Mental Health Action Plan; (iii) inclusion of mental health in the public health agenda; (iv) development of a presidential strategy during the pandemic for comprehensive mental health and well-being; and (v) emerging research assessing the mental health implications of COVID-19.Conclusions: In Chile, the public policy responses to address the mental health consequences of the COVID-19 pandemic has been characterized by the coordinated implementation of mental health plans, ranging from a health sectoral initiative to inter-agency and intersectoral efforts. However, it is imperative that increased funding is allocated to mental health, and efforts should be made to promote the participation of people with lived experiences and communities in the design and implementation of the proposed actions. This aspect could be of key importance to social peace and community recovery after the pandemic.
Highlights
The coronavirus pandemic, an unprecedented global sociosanitary crisis, has impacted the mental health of the general population worldwide, and that of individuals with prior mental illness, those infected with SARS-CoV-2, and health workers [1]
The exact extent of this impact has varied by country, as it is strongly shaped by local mental health policies that were implemented as part of the initial response to the pandemic [2, 3]
Essential elements of the Model include reducing vulnerability through strengthening community resilience and capacities and focusing on preventive, rather than reactive, interventions. It proposes the implementation of mental health and psychosocial support (MHPSS) actions throughout the risk management cycle and effective disaster risk reduction, adopting the integration of interventions at different levels, according to the InterAgency Standing Committee’s (IASC) recommendations [2]
Summary
The coronavirus pandemic, an unprecedented global sociosanitary crisis, has impacted the mental health of the general population worldwide, and that of individuals with prior mental illness, those infected with SARS-CoV-2, and health workers [1]. The pre-pandemic development of each country’s mental health system, and its unique social and economic context, largely define its ability to implement the proposed policies, especially in light of the economic recession that could deepen inequalities in access to and quality of mental health care [4]. Under these circumstances, mental disorders co-occur with other chronic diseases that are rooted in social and economic inequities [5, 6]. There is a wide variation between countries: before the pandemic, it was estimated that this imbalance ranged from 1.8 to 72.1 times the burden of mental illness in relation to spending, with a median of 6.1 in the region [11]
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