No one would have ever thought that, at the turn of the year 2020, a virus would wreak havoc around the world, upturning daily routines either in isolation or at a safe distance. The cost of this drastic shift, however, were not only social and economic.
The first few months of a world in lockdowns and remote set-ups had shown the psychological toll on the well-being of populations across the globe. With the COVID-19 pandemic still looming, the state of the people’s mental health had taken a harrowingly steep decline.
Although mental health concerns are nothing new, its prominence in global public health discussions and programs only took international stage in the 20th century. The World Health Organization (WHO) launched its Mental Health Gap Action Programme in 2008 and endorsed the Mental Health Action Plan 2013-2020 in the 2013 World Health Assembly.
Now, in the context of a pandemic, the significance of mental health in policy programs could not be overstated. As Lily Evangelia Peppou et al. in a 2020 paper emphasized, “Past experiences on viral epidemics have underscored the importance of considering mental health an integral part of any health response to biological disasters, including the COVID-19 outbreak.”
This is compounded by the fact that the WHO identifies depression as one of the leading causes of disability and a major contributor to the overall global burden of disease. Anxiety disorders, on the other hand, are recognized by the World Economic Forum as the number one prevailing mental health concern people face.
But while mental health conditions in the middle of the COVID-19 pandemic appear to be bleak, crisis always generates opportunities, and with it, change.
Crisis: Mental Health in Isolation, Distance, and Disarray
Human nature is social. Our basic face-to-face interactions help us form and develop relationships, which are often crucial for the support of our emotional well-being. But through isolation and distance, the outbreak took this away from us, leaving those in need of support in vulnerable situations.
In a 2021 study, researchers from the Columbia University Mailman School of Public Health saw a high global prevalence of mental health issues during the global health crisis. By drawing from 60 various studies, João Castaldelli-Maia et al. observed that both depression and anxiety levels across the globe, which they accounted at 24 percent and 21.3 percent, respectively, are impacted by COVID-19 mitigation measures, including public transportation and school closures, and stay-at-home orders.
Sub-region analyses of the study further showed that the prevalence level of depression—measured by averaging the depression rates before and during the pandemic—in Asia was lower at 17.6 percent compared to Europe and other regions of the world with 26.0 percent and 39.1 percent, respectively. Prevalence level of anxiety in Asia was at 17.9%, while Europe and non-Asian regions of the world were at 21.9% and 28.6%, respectively.
The structural means for mental health care and support were not spared. A WHO survey, conducted from June to August 2020, revealed that 130 countries reported “major disruptions to critical mental health services,” with data showing that 93 percent of one or more mental, neurological, and substance use (MNS)-related services worldwide being affected.
The international public health organization identifies a decrease in outpatient volume due to patients not presenting; travel restrictions hindering access to health facilities for patients; and a decrease in inpatient volume due to cancellation of elective care as main causes of such disruption.
Change: Mental Health Initiatives and Strategies
The sudden haul to what is now called the new normal also spurred with it a change in the landscape of mental health care. Where hopes for face-to-face sessions still remain at a distance, those seeking help had found hope in telehealth for therapy.
FAIR Health President Robin Gelburd writes that, in the United States, the most common telehealth procedure became psychotherapy as of January 2021, claiming its position as part of the growing use of telehealth to provide mental health interventions during COVID-19. Gelburd notes that remote psychotherapy, specifically a 60-minute session, snowballed in rankings by August 2020 and retained its spot until December in the same year.
Amid these tumultuous times, studies on remote mental health services have rendered a positive note by baring favorable outcomes. A joint paper by academics from Tulane University School of Medicine and the Tulane School of Social Work claim that telemental health as an effective approach in delivering care, attributing its success largely by eliminating transportation as a barrier in healthcare.
WHO noted that countries have employed different strategies to surmount the disruptions in MNS-related intervention or services, with telehealth coming at the top. Other approaches identified are: helplines established for mental health and psychosocial support; specific measures for infection prevention and control in mental health services; and self-help or digital psychological interventions.
While extensive literature remains scarce in quantifying the effectiveness and outcomes of telehealth in mental health interventions, the necessity of utilizing and developing remote psychosocial programs could not be any less clear. The future of healthcare would see fit to integrate the digital technology in dispensing medical service.
Concomitant to this, however, is upping the ante for countries to destigmatize and integrate mental health issues in public healthcare and state policies. This is because any hope to combat the upward trend of mental health concerns demand a holistic approach that also tackle the social aspect of mental health, particularly, through education.
According to a 2020 study published in the Psychiatric Quarterly, education through lectures and case scenarios, contact-based interventions, and role-plays as strategies yielded good results in addressing stigma in mental health. The review highlighted that “majority of the studies showed that the anti-stigma interventions were successful in improving mental health literacy, attitude and beliefs towards mental health illnesses.”
Although the pandemic may have cast a dark period around the globe, it has also shed light on the need to prioritize and address the global state of mental health. In working towards a better life and a better future, there is indeed no other time but to collaborate for social health impacts today.