Mental health challenges to populations

Recently, much discussion has been had locally about the mental health of citizens. While the topic was categorised as ‘taboo’ in many cultures, it came to the fore as the COVID-19 pandemic took centre stage. It is well known that the pandemic has taken a severe toll on the mental wellbeing of persons all over the world.
For example, the initial challenge of dealing with the lockdown measures, the fear of being infected with the virus, or having to deal with the death of a loved one has caused tremendous stress and anxiety on many. All of this is added to the economic pressures that are brought on due to persons not being able to go out and work to support themselves and families.
Due to the lack of resources, many countries are unable to mount the kind of response that is needed to address the mental health challenges of their populations, or many are forced to scale back the level of response needed due to other areas competing for scarce resources.
According to a recent World Health Organisation (WHO) survey, the COVID-19 pandemic has disrupted or halted critical mental health services in 93 per cent of countries worldwide, while the demand for mental health services is increasing.
A survey of 130 countries provides the first global data showing the devastating impact of COVID-19 on access to mental health services, and underscores the urgent need for increased funding. The survey was published ahead of WHO’s Big Event for Mental Health? a global online advocacy event on October 10 that will bring together world leaders, celebrities, and advocates to call for increased mental health investments in the wake of COVID-19.
According to WHO, the survey was conducted from June to August 2020 among 130 countries across WHO’s six regions. It evaluates how the provision of mental, neurological and substance use services has changed due to COVID-19, the types of services that have been disrupted, and how countries are adapting to overcome these challenges.
It was reported that over 60 per cent of countries reported disruptions to mental health services for vulnerable people, including children and adolescents (72 per cent); older adults (70 per cent), and women requiring antenatal or postnatal services (61 per cent).
More than a third (35 per cent) reported disruptions to emergency interventions, including those for people experiencing prolonged seizures; severe substance use withdrawal syndromes; and delirium, often a sign of a serious underlying medical condition.
Additionally, 30 per cent reported disruptions to access for medications for mental, neurological, and substance use disorders. Around three-quarters reported at least partial disruptions to school and workplace mental health services (78 per cent and 75 per cent respectively).
WHO had previously highlighted the chronic underfunding of mental health. The Organization had pointed out that, prior to the pandemic, countries were spending less than two per cent of their national health budgets on mental health, and were struggling to meet their populations’ needs.
The pandemic is increasing demand for mental health services; for example, bereavement, isolation, loss of income, and fear are triggering mental health conditions, or exacerbating existing ones.
Meanwhile, COVID-19 itself can lead to neurological and mental complications such as delirium, agitation, and stroke. People with pre-existing mental, neurological or substance use disorders are also more vulnerable to SARS-CoV-2 infection. They may stand a higher risk of severe outcomes, and even death.
WHO has issued guidance to countries on how to maintain essential services, including mental health services, during COVID-19, and recommends that countries allocate resources to mental health as an integral component of their response and recovery plans. The Organization has also urged countries to monitor changes and disruptions in services, so that they can address them as required.
It should be pointed out that although 89 per cent of countries reported in the survey that mental health and psychosocial support are part of their national COVID-19 response plans, only 17 per cent of those countries have full additional funding for covering these activities. This all highlights the need for more money for mental health. Spending two per cent of national health budgets on mental health is not enough, according to WHO.
As stated by WHO, those who do invest in mental health would reap rewards. Pre-COVID-19 estimates reveal that nearly US$1 trillion in economic productivity is lost annually from depression and anxiety alone. However, studies show that every US$1 spent on evidence-based care for depression and anxiety returns US$5.