The ‘Luxury’ Of Mental Health In The Face Of A Pandemic
Implosion- In steering the path of our lives, we would have to fight more than one battle. But when the battles we encounter is as a result of an inward turmoil being reflected by an exterior occurrence, then there is the tendency for a tug-of-war to ensue on the inside. This undoubtedly disrupts the outward existence of man and his environment.
Since January 2020 that the World Health Organization (WHO) declared the outbreak of the COVID-19 pandemic to be a Public Health Emergency of International Concern, the WHO has been working round the clock to diffuse the ticking viral bomb. Also, since its characterization as a pandemic by the WHO, Public Health Authorities around the globe have been working tirelessly to contain the COVID-19 outbreak.
As fate would have it, with each stitch came a much bigger tear and more like putting a new wine into an old wine skin, the virus burst forth at its seams spreading ‘pollen’ of fear, dismay and destruction in every nook and cranny of the world. This time round, the crisis is generating stress throughout the world’s population as economies are currently in limbo.
According to a survey conducted by the World Health Organization, the COVID-19 pandemic has disrupted and halted critical mental health services in 93% of countries worldwide while the demand for mental health is increasing. The 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.
MENTAL HEALTH, A LUXURY GOOD
Shockingly, ultimate peace of mind has become a luxury as the pandemic drives a tent peg of despondency in the temple of most people. Peace of mind should never be an unaffordable commodity to be traded to the highest bidder, which in this case is COVID-19. Interestingly, Mental health is one of the most neglected areas of health globally. This was true before COVID-19; however, the pandemic has further aggravated the status of mental health.
According to WHO, there are several reasons why mental health has been ignored. The first one is an associated stigma. The second is a perception of mental health disorders as a “luxury good”, as opposed to actual illnesses. The additional top reasons include a fragmented and outdated service model. Some of these include the provision of mental health services mainly in psychiatric hospitals, severe lack of preventative mental health service; lagging policy changes and also a shortage of human resources. The pandemic has further heightened an already precarious situation as most mental health services are mere ‘house of cards’ which are bound to fall apart at the persistent huff and puff of the pandemic, thereby increasing demand for mental health services. Without a shred of doubt, consistent bereavement as a result of deaths occasioned by the pandemic, isolation due to lockdown, loss of income and fear are triggering mental health conditions or exacerbating existing ones. The consequential effects of such harrowing plights encountered on a global scale are that people may be facing increased levels of alcohol and drug use, insomnia, and anxiety. Meanwhile, COVID-19 itself can lead to neurological and mental complications, such as delirium, agitation, and stroke. Sadly, 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.
SUTURING THE WOUNDS OF THE PANDEMIC
Without a shred of doubt, COVID-19 has the seeds of a major mental health crisis. Early reporting from Ireland shows a tenfold increase in the number of people seeking online counselling. This has snowballed into some people showing high degrees of psychological distress, such as healthcare workers, older adults, people with pre-existing conditions, children, those in precarious domestic situations, and fragile humanitarian and conflict settings. Together, these groups make up maybe most of humanity; these are our friends, family, neighbours, they’re us. Most of the discussion about addressing COVID-19-related mental health problems is focused on what we can do as individuals. The World Health Organization has published a helpful document. 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 also urges countries to monitor changes and disruptions in services so that they can address them as required.
Although 89% of countries reported in the survey that mental health and psychosocial support is part of their national COVID-19 response plans, only 17% of these countries have full additional funding for covering these activities. This all highlights the need for more money for mental health. As the pandemic continues, even greater demand will be placed on national and international mental health programmes that have suffered from years of chronic underfunding. Spending 2% of national health budgets on mental health is not enough. International funders also need to do more: mental health still receives less than 1% of international aid earmarked for health.
Those who do invest in mental health will 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.
A new World Health Organization survey shows that critical funding gaps are halting and disrupting crucial mental health services in Africa, as demand for these services rise amid the COVID-19 pandemic. That notwithstanding, the WHO is doing everything possible to move discussions on mental health to the forefront of what matters most in the ongoing pandemic disruptions.
BEATING THE CLOCK OF COVID-19
The Director-General of the World Health Organization, Dr Tedros Adhanom Ghebreyesus, once opined that “Good mental health is absolutely fundamental to overall health and well-being. COVID-19 has interrupted essential mental health services around the world just when they’re needed most. World leaders must move fast and decisively to invest more in life-saving mental health programmes – during the pandemic and beyond.”
Per reports gathered from the WHO from their survey of 28 African countries which was undertaken as part of the first global examination of the devastating impact of COVID-19 on access to mental health services, it underscores the urgent need for increased funding. Of the countries responding in the African region, 37% reported that their COVID-19 mental health response plans are partially funded and a further 37% reported having no funds at all. This comes as the COVID-19 pandemic increases demand for mental health services.
The Regional Director for Africa from the WHO, Dr Matshidiso Moeti, revealed that “Isolation, loss of income, the deaths of loved ones and a barrage of information on the dangers of this new virus can stir up stress levels and trigger mental health conditions or exacerbate existing ones. The COVID-19 pandemic has shown, more than ever, how mental health is vital to health and well-being and must be an essential part of health services during outbreaks and emergencies.”
The survey further revealed that African countries account for 15 out of the top 30 countries globally for suicide per 100 000 people. While there is scant data on how COVID-19 is increasing mental health conditions on the African continent, one study in South Africa found that 10–20% of the 220 people surveyed reported potent experiences of anxiety and fear as a result of the pandemic. Another survey of 12,000 women in low-income communities in Uganda and Zambia found an increase in persistent stress, anxiety and depression.
The WHO assessment of mental health services took place in July and August 2020 and 27 of the 28 African nations which responded have included mental health in their COVID-19 response plans, underscoring the growing recognition of the importance of this once neglected area of health.
Dr. Moeti revealed that with increasing pressure on health systems and rising demand, stretched and chronically underfunded mental health services are under increasing strain.
“While at the global level, up to 70% of countries have responded to the challenges posed by COVID-19 with telemedicine, in Africa, governments have set up counselling helplines and increased training for key health responders in basic psychosocial skills. Even before the pandemic, the region had one of the lowest mental health public expenditure rates, at less than US$ 10 cents per capita”.
COVID-19 is adding to a long-simmering mental health care crisis in Africa. Leaders must urgently invest in life-saving mental health care services. “We also need more action to provide better mental health information and education, to boost and expand services, and to enhance social and financial protection for people with mental disorders, including laws to ensure human rights for everyone.”