Addressing the impact of COVID-19 pandemic on global mental health

In a special session addressing global mental health before, during and after the COVID-19 pandemic held at the ESCMID Conference on Coronavirus Disease (ECCVID) Professor Vikram Patel H(arvard Medical School, USA) will present a new review of the impact of the COVID-19 pandemic on global mental health.

He will explain: "Mental health problems were already a leading cause of suffering and the most neglected health issue globally before the pandemic. The pandemic will, through worsening the social determinants of mental health, fuel a worsening of this crisis,"

The pressures on mental health, that already existed in abundance before this global pandemic, are increasing at an alarming rate. Prof Patel will touch on some of these in his talk.

There are so many issues which affect large sections of the population, including worries about jobs and income security, social exclusion, school closures and working from home creating huge pressure on families. There are also disruptions to medical services and care, potential domestic violence situations, and the varying levels of fear people have of being infected by this new virus."

Vikram Patel, Professor, Harvard Medical School

The pandemic threatens to reverse years of global development, including in the countries that can least afford to start going backwards. In August 2020, World Bank President David Malpass predicted as many as 100 million people will be pushed back into extreme poverty.

As a result of the global economic recession, the mental health tsunami is going to sweep through all countries, rich and poor. "The 2008 recession, which largely affected only the US, was followed by a wave of 'deaths of despair' in the USA, driven by suicide and substance use," explains Prof Patel.

"Without huge levels of government support for both the mental health sector and a whole host of other sectors, we are tragically facing a repeat of this, but perhaps on a much greater scale."

He points out at that before COVID-19 arrived, there was already a global mental health crisis. "The relative burden of mental and substance use disorders increased by nearly 50% in the past 25 years. These disorders now account for one in every ten years of lost health globally and suicide rates in young people are rising in many countries."

However, he concludes: "I believe the pandemic presents a historic opportunity to reimagine mental health care, by realising the science which demonstrates that we must reframe mental health beyond a narrow focus on 'diagnoses, doctors and drugs'.

This implies that we need to greatly increase the emphasis on prevention through actions on social determinants in the first two decades of life, adopt a human rights approach to eliminate coercion and place the lived experience at the heart of all mental health care, and scale up the evidence demonstrating that non-specialist, community based providers can effectively deliver psychosocial interventions.

Above all, the science emphasizes the need to embrace the diversity of experiences and interventions to address this crisis - that for most of us, will be the worst health crisis we are likely to see in our lifetimes."