COVID-19 took the world by storm in January 2020. Initially identified in Wuhan, China, the disease quickly spread across the globe, causing over 2.8 million deaths. It has brought economic turmoil, collapsed international cooperation, and incited xenophobia and racism. Amidst these critical areas lies another field in which COVID-19’s impact has been largely overlooked: mental health.
During an unprecedented pandemic, it is clear that disease prevention measures and vaccination research have occupied much of experts’ energy and resources. However, in the effort to combat the spread of disease, we cannot neglect another critical area of health care. We must remain diligent about monitoring mental wellness, especially anxiety and mood disorders.
The COVID-19 pandemic highlights many countries’ weaknesses in providing accessible mental-health services for their populations. It demonstrates poor infrastructure in existing health-care systems, formed through incomplete policies that do not provide significant attention to mental health. Furthermore, it illustrates the weaknesses and gaps within the field of global health, and the need for nongovernmental organizations (NGOs) to take a more comprehensive approach in the areas of health care and overall wellness.
Why is Mental Health a Global Concern?
Global health is a field within public and population health focusing on improving quality of care and achieving health equity worldwide. Since the establishment of the World Health Organization (WHO) in 1948, the field has been recognized for a number of feats, including the eradication of smallpox and the near-eradication of polio. Other significant achievements include increasing accessibility to vaccines, promoting reproductive and sexual health education, and addressing nutrition and food security. The WHO has accomplished these goals through decades of work and strategic plans of action.
However, its work is less outstanding on noncommunicable diseases, which includes mental health. In 2013, the WHO adopted the Mental Health Action Plan with the desire to place greater focus on the issue. The WHO’s Mental Health Atlas 2017 found that although significant progress has been made in promoting global mental health, there is still limited investment and shortages of trained professionals in many states.
It is estimated that 10 percent of people worldwide suffer from a mental health disorder. However, many states deem that it is not a priority when compared with other health areas. This view affects the way the issue is prioritized within national budgets and health policy; the global expenditure on mental health is less than two dollars annually per capita. There are a number of factors that devalue mental health in policy—cultural stigmas affecting the conversation, high treatment costs, and the fact that it is often not as visible or easy to understand as physical illnesses.
For these reasons, countries may lack adequate mental-health resources. One example is the Philippines, which did not enact mental-health legislation until 2018. The law established a bill of mental-health rights based on international law, and expanded services. But today, the funds allocated to these services are “grossly insufficient to respond to the mental-health needs of the Filipinos,” as two Phillippine lawmakers argue. This results in millions of people with limited resources struggling without the care they need. And unfortunately, this is only exemplified further during the COVID-19 pandemic, as health scares, economic turmoil, and overall feelings of uncertainty place additional stress on people and negatively affect mental well-being worldwide.
Mental Health in Times of Disaster
Research regarding global mental health can be complicated. Many countries have different interpretations of wellness, and there are cultural differences regarding what constitutes mental-health care and sufficient treatment. Despite this, there is significant research on the impact disasters have on mental health and the need for proper treatment to support people as early as possible.
Many existing reports on post-conflict societies look primarily at the threat of disease spread and nutritional deficiencies, rather than the impact of conflict on community mental health. Even when mental-health services are emphasized, recommended forms of support may be tied too closely to a Eurocentric understanding of trauma. This means that external efforts can fail when health-care resources are provided without consideration for societal and cultural barriers. For instance, in cultures where community and family play greater roles than the individual, effective mental-health support must have a communal focus.
Cultural competency is an essential part of supporting communities after disaster, and organizations on the ground must approach situations with a deeper understanding of local cultures and issues. Without understanding the intricacies of different communities, efforts to support mental wellness will fall short.
Another area where more research is necessary is the relationship between mental health and pandemics. This is especially important given the scope of COVID-19 as a global disease. In 2009, the WHO released a report focusing on “Protecting Mental Health During Epidemics,” though despite the title, only a portion of it looked directly at mental health and plans of action. The report does not fully discuss the exacerbation of mental illness during crisis, and overlooks the impact on individuals with existing mental illnesses.
It is essential for experts to act diligently as the pandemic continues to unfold, and to urge governments to enact necessary protective measures. Experts must expand upon existing research to understand the relationship between mental health and pandemics, and the effects it has on people with existing mental conditions.
International Cooperation Can Improve
As COVID-19 continues to impact communities worldwide, more people will be affected and resources will be strained even further. If existing structures are not altered, governments may continue to overlook people with mental-health concerns, worsening social and public health issues.
Fortunately, there is hope that NGOs can work with governments to improve mental-health services. In May 2020, the UN released a policy brief focusing on “COVID-19 and the Need for Action on Mental Health,” which provided comprehensive recommendations for ensuring widespread mental and psychosocial support. These recommendations include universal health coverage, community-based services, uninterrupted care for critical services, and investment in interventions. Policy mechanisms such as these are best accomplished by governments, though when they fail to act effectively, NGO support is necessary to bridge the gap.
A comprehensive response is necessary on both the domestic and international front to support mental-health care. Existing mechanisms are minimal at best, and do not provide sufficient support in normal times, let alone during a global pandemic. Now would be the opportune moment to make much-needed revisions to the strategy. Without it, there is a likelihood that stress and psychological suffering will continue to harm many people even after the pandemic fades.
