Abstract
BackgroundThe COVID pandemic has been devastating for not only its direct impact on lives, physical health, socio-economic status of individuals, but also for its impact on mental health. Some individuals are affected psychologically more severely and will need additional care. However, the current health system is so fragmented and focused on caring for those infected that management of mental illness has been neglected. An integrated approach is needed to strengthen the health system, service providers and research to not only manage the current mental health problems related to COVID but develop robust strategies to overcome more long-term impact of the pandemic. A series of recommendations are outlined in this paper to help policy makers, service providers and other stakeholders, and research and research funders to strengthen existing mental health systems, develop new ones, and at the same time advance research to mitigate the mental health impact of COVID19. The recommendations refer to low, middle and high resource settings as capabilities vary greatly between countries and within countries.DiscussionThe recommendations for policy makers are focused on strengthening leadership and governance, finance mechanisms, and developing programme and policies that especially include the most vulnerable populations. Service provision should focus on accessible and equitable evidence-based community care models commensurate with the existing mental health capacity to deliver care, train existing primary care staff to cater to increased mental health needs, implement prevention and promotion programmes tailored to local needs, and support civil societies and employers to address the increased burden of mental illness. Researchers and research funders should focus on research to develop robust information systems that can be enhanced further by linking with other data sources to run predictive models using artificial intelligence, understand neurobiological mechanisms and community-based interventions to address the pandemic driven mental health problems in an integrated manner and use innovative digital solutions.ConclusionUrgent action is needed to strengthen mental health system in all settings. The recommendations outlined can be used as a guide to develop these further or identify new ones in relation to local needs.
Highlights
The COVID pandemic has been devastating for its direct impact on lives, physical health, socio-economic status of individuals, and for its impact on mental health
The aim of this paper is to outline a roadmap to guide countries to strengthen mental health systems to tackle the increasing burden of mental disorders. Using both World Health Organization’s Mental Health Action Plan 2013–2020 [12] and the WHO health systems strengthening framework [13], we propose a set of recommendations from the perspectives of policy makers, service providers and research funders, organised into low, middle- and high-resource scenarios
Will COVID 19 lead to a surge in mental health needs in the community [5, 7], but the way it has crippled the health systems globally to address the need of any other health problem, it is likely to have a devastating effect on the longer term needs of people who need care for mental illnesses [5]
Summary
The COVID pandemic has been devastating for its direct impact on lives, physical health, socio-economic status of individuals, and for its impact on mental health. An integrated approach is needed to strengthen the health system, service providers and research to manage the current mental health problems related to COVID but develop robust strategies to overcome more long-term impact of the pandemic. The direct impact of COVID 19 on mental illness of those infected or health workers involved in care of those infected is significant, and is often precipitated due to increased stigma, social isolation and quarantine [5]. All this is even more complicated due to the socioeconomic impact of the pandemic on the lives of the poor and most disadvantaged communities such as homeless and migrant workers. Researchers have highlighted the need for focussed research that should be funded related to the impact of COVID-19 [9]
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