Mental health: it’s time to invest in quality

10/08/2020 Health, World



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The theme for this year’s World Mental Health Day, October 10, is Greater Investment in Mental Health. Why invest and why now? The answer is simple. At best, it takes good mental health for a society to prosper. During a pandemic, good mental health is more important than ever. Without a focus on mental health, any response to COVID-19 will be poor, reducing individual and social resilience and impeding social, economic and cultural recovery.

2020 has been a difficult year for mental health. The threat of infection, repeated closures, social isolation, and economic uncertainty have created widespread fear and anxiety. A quick review posted on The lancet showed the negative psychological effects of forced quarantines. Many people who previously thought they were unaffected by mental health problems have found that they too are vulnerable. Those with pre-existing mental health conditions have often found their difficulties increased. Meanwhile, the precise neurological and psychiatric consequences of the infection are unknown, but require careful monitoring. What investment is needed from governments and non-governmental organizations to mitigate the mental health impact of COVID-19 and, more importantly, to improve mental health globally?
In 2018, the Lancet Commission on Global Mental Health and Sustainable Development identified mental health as an essential component of universal health coverage and provided recommendations to improve mental health, for example, to engage a broader range of stakeholders in planning and delivery of mental health services, the majority Importantly, those who have experienced mental health disorders. Their voices should not only be heard, but also welcomed in the development of new service delivery systems.

Unfortunately, despite the commitment of world leaders to include mental health care in universal health coverage as part of the Sustainable Development Goals in 2015, this commitment did not translate into reality. Universal health coverage would provide a lifeline for those caught in the vicious cycle of economic hardship and poor mental health, where poverty is both a contributing factor to mental health problems and a barrier to accessing services that could help. The investment must increase in quantity and quality. For example, great strides have been made in providing telepsychiatry over the past 10 months; the people receiving these services must be critical to their future use and development. This participation will ensure that telepsychiatry is used in a smart and targeted way that provides appropriate support, rather than being a one-size-fits-all cost-saving measure that risks exacerbating health inequalities or inadvertently reinforcing isolation. Social.

According to a WHO survey, people with pre-existing serious and long-lasting mental conditions have been the hardest hit by COVID-19-related disruptions to mental health care systems. Other vulnerable groups include children and adolescents, many of whom have been affected by school closings, expanded health systems, restricted access to nutritious food, the breakdown of family relationships, neglect and abuse. Older adults are also vulnerable. Many with pre-existing health problems are terrified and alone, fearful of infection, death, and loss of family while physically estranged from loved ones and companions. Finally, there are the health workers themselves, who also face an increased risk of infection, stigmatization and stressful workloads, with consequent psychological repercussions. Investing in mental health is also about investing in healthcare workers.

The economic case for investment in mental health services is clear and has been put forward many times, but there is also an ethical imperative for investment, both to repair historic mistakes made in vulnerable communities and to correct current inequalities. On a global scale, this strategy involves the empowerment of individuals and communities, the recognition that high-income countries have much to learn from the innovations of low- and middle-income settings, and the recognition of the central role of health. mental health security now and in the future. The investment must be more than money if mental health services are to adapt to the challenges of the COVID-19 and post-COVID-19 era and become resilient in the face of future public health crises. There must be an investment of thought, time, and commitment to change.

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Posted: October 10, 2020

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DOI: https://doi.org/10.1016/S0140-6736(20)32110-3

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© 2020 Elsevier Ltd. All rights reserved.

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