TY - JOUR
T1 - COVID-19 mental health impact and responses in low-income and middle-income countries
T2 - reimagining global mental health
AU - Kola, Lola
AU - Kohrt, Brandon A
AU - Hanlon, Charlotte
AU - Naslund, John A
AU - Sikander, Siham
AU - Balaji, Madhumitha
AU - Benjet, Corina
AU - Cheung, Eliza Yee Lai
AU - Eaton, Julian
AU - Gonsalves, Pattie
AU - Hailemariam, Maji
AU - Luitel, Nagendra P
AU - Machado, Daiane B
AU - Misganaw, Eleni
AU - Omigbodun, Olayinka
AU - Roberts, Tessa
AU - Salisbury, Tatiana Taylor
AU - Shidhaye, Rahul
AU - Sunkel, Charlene
AU - Ugo, Victor
AU - van Rensburg, André Janse
AU - Gureje, Oye
AU - Pathare, Soumitra
AU - Saxena, Shekhar
AU - Thornicroft, Graham
AU - Patel, Vikram
N1 - Publisher Copyright:
© 2021 Elsevier Ltd
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/2/24
Y1 - 2021/2/24
N2 - Most of the global population live in low-income and middle-income countries (LMICs), which have historically received a small fraction of global resources for mental health. The COVID-19 pandemic has spread rapidly in many of these countries. This Review examines the mental health implications of the COVID-19 pandemic in LMICs in four parts. First, we review the emerging literature on the impact of the pandemic on mental health, which shows high rates of psychological distress and early warning signs of an increase in mental health disorders. Second, we assess the responses in different countries, noting the swift and diverse responses to address mental health in some countries, particularly through the development of national COVID-19 response plans for mental health services, implementation of WHO guidance, and deployment of digital platforms, signifying a welcome recognition of the salience of mental health. Third, we consider the opportunity that the pandemic presents to reimagine global mental health, especially through shifting the balance of power from high-income countries to LMICs and from narrow biomedical approaches to community-oriented psychosocial perspectives, in setting priorities for interventions and research. Finally, we present a vision for the concept of building back better the mental health systems in LMICs with a focus on key strategies; notably, fully integrating mental health in plans for universal health coverage, enhancing access to psychosocial interventions through task sharing, leveraging digital technologies for various mental health tasks, eliminating coercion in mental health care, and addressing the needs of neglected populations, such as children and people with substance use disorders. Our recommendations are relevant for the mental health of populations and functioning of health systems in not only LMICs but also high-income countries impacted by the COVID-19 pandemic, with wide disparities in quality of and access to mental health care.
AB - Most of the global population live in low-income and middle-income countries (LMICs), which have historically received a small fraction of global resources for mental health. The COVID-19 pandemic has spread rapidly in many of these countries. This Review examines the mental health implications of the COVID-19 pandemic in LMICs in four parts. First, we review the emerging literature on the impact of the pandemic on mental health, which shows high rates of psychological distress and early warning signs of an increase in mental health disorders. Second, we assess the responses in different countries, noting the swift and diverse responses to address mental health in some countries, particularly through the development of national COVID-19 response plans for mental health services, implementation of WHO guidance, and deployment of digital platforms, signifying a welcome recognition of the salience of mental health. Third, we consider the opportunity that the pandemic presents to reimagine global mental health, especially through shifting the balance of power from high-income countries to LMICs and from narrow biomedical approaches to community-oriented psychosocial perspectives, in setting priorities for interventions and research. Finally, we present a vision for the concept of building back better the mental health systems in LMICs with a focus on key strategies; notably, fully integrating mental health in plans for universal health coverage, enhancing access to psychosocial interventions through task sharing, leveraging digital technologies for various mental health tasks, eliminating coercion in mental health care, and addressing the needs of neglected populations, such as children and people with substance use disorders. Our recommendations are relevant for the mental health of populations and functioning of health systems in not only LMICs but also high-income countries impacted by the COVID-19 pandemic, with wide disparities in quality of and access to mental health care.
UR - http://www.scopus.com/inward/record.url?scp=85103286651&partnerID=8YFLogxK
U2 - 10.1016/S2215-0366(21)00025-0
DO - 10.1016/S2215-0366(21)00025-0
M3 - Review article
C2 - 33639109
SN - 2215-0366
VL - 8
SP - 535
EP - 550
JO - The lancet. Psychiatry
JF - The lancet. Psychiatry
IS - 6
ER -
