In Volume 20, Issue 11 of the Lancet, which is a journal of infectious disease research, the World Health Organization (WHO) published a study on how the COVID-19 crisis is affecting the mental health of people around the world. This issue will be available in hard copy on November 1, 2020, and the digital issue was released on October 22, 2020. The survey results can be used to plan and implement better mental healthcare services.

WHO Survey on Mental Health

The WHO published its survey on October 6. Their survey included questions on mental health, neurological problems and substance abuse services in 130 member states of the WHO. This was done just ahead of World Mental Health Day on October 10. The survey showed that most of the countries that participated are having some type of disruption in essential services. In particular, mental healthcare services had the greatest disruption.

Reasons for Disruption of Mental Health Services

About 89% of member countries reported a disruption to the delivery of mental health services. Member countries reported several reasons for the disruptions of mental healthcare services. These included a lack of healthcare workers, use of mental healthcare facilities for COVID-19 quarantine or treatment and an insufficient supply of personal protective equipment.

How Past Pandemics Affected Mental Health

There are some historical examples to show the negative impact of a pandemic on mental health. Communities impacted by Ebola virus disease showed that panic was widespread. Anxiety and depression rates also increased. People felt shocked when they lost friends, family members and colleagues. They were stigmatized if a member of their household became infected. Survivors were socially excluded. Insomnia, memory impairment, anxiety and depression were present in 33% to 42% of patients admitted to hospitals with Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS), which are caused by viruses closely related to the virus that causes COVID-19.

Public Health Measures Worsen Mental Health

Public health measures that are intended to halt the spread of COVID-19 have caused more isolation, leading to worsening mental health. These non-pharmaceutical interventions are essential to slowing the spread of COVID-19. Each community has enacted different measures, including closing schools, shuttering restaurants and bars and closing retail shops, adult daycare centers, childcare centers and places of amusement. The isolation has led to an increase of substance abuse. People are also experiencing more neurological consequences. Limited access to support services, counseling or hospitalization has worsened the condition of people with existing mental health problems.

Frontline Workers Are Overwhelmed

People who are frontline workers have been affected physically and mentally by COVID-19. Many have hardly had a day off work, especially if they are healthcare workers. People who work in other essential services, including pharmacies, grocery stores, food banks and similar service centers are also overworked. Those who are in low-wage jobs have suffered from more job losses. Those who haven't lost their jobs are at a high risk of infection. These workers are at a high risk of mental health complications, including stress, burnout, depression, and post-traumatic stress disorder).

Poor Mental Health Could Affect Vaccination Rates

People may have to leave their essential jobs if their mental health suffers. This could lead to unfilled positions that impact the physical and mental health of others. For example, if healthcare workers leave their jobs, there might not be enough people to deliver vaccines once one is available for COVID-19. People who are suffering from a mental health disorder might not feel they are worthy of vaccination or might not believe that it will be of any help to them.

COVID-19 Exacerbated an Existing Problem

Well before the COVID-19 pandemic began, mental health disorders were common. Nearly 13% of the global disease burden is made up of mental health disorders. Most countries around the globe haven't invested in mental health. This is true in rich countries, such as the United States, as well as poor countries, such as Gabon. The severe economic fallout of the COVID-19 pandemic will only worsen this lack of investment. Countries don't have wiggle room in their budgets to cover mental healthcare services. However, some countries could shift funding to it if they wanted to and if their citizens demanded it. For example, the United States has a large military budget, but Congress could choose to reallocate those funds to the CARES Act or a similar new budget measure that includes mental health services.