The Covid-19 pandemic disrupted critical mental health services in 93% of countries globally while the demand for these services is increasing, according to a World Health Organisation (WHO) survey released on Monday. The survey was conducted in 130 countries from June to August.
Nearly a third (35%) reported disruptions to emergency interventions, including those for people experiencing prolonged seizures, severe substance use withdrawal syndromes, and delirium, often a sign of a serious underlying medical condition. And 30% reported disruptions to access to medications for mental, neurological, and substance use disorders.
Apart from emergency treatment, countries also reported widespread disruption of many kinds of critical mental health services.
At least 60% reported disruptions to mental health services for vulnerable people, including children and adolescents (72%), older adults (70%), and women requiring antenatal or postnatal services (61%).
Counselling and psychotherapy services have also affected in about 67% cases. As many as 65% reported critical harm to reduction services and 45% to opioid agonist maintenance treatment for opioid dependence.
Even school and workplace mental health services have been adversely affected, and according to the WHO survey about three-quarters reported at least partial disruptions of services at these places during the pandemic.
“Initial few weeks of the pandemic were worse when regular Out Patient Departments (OPDs) had to be shut, and people were finding it difficult to gain access to doctors, and even not able to procure medicines as freely as earlier. The problem was worse for people not living in the metros as transportation was also restricted. The elderly and children were much more affected. Gradually we opened online consultation services but not many were aware of it. So, yes, this pandemic has been tough on patients, including those suffering from mental illnesses. But things are now getting back to normalcy,” said Rajesh Sagar, a professor of psychiatry at New Delhi’s All India Institute of Medical Sciences.
The survey provides the first global data showing the devastating impact of the pandemic on access to mental health services and underscores the urgent need for increased funding in this area.
Prior to the pandemic, the surveyed countries were spending less than 2% of their national health budgets on mental health, and struggling to meet their populations’ needs, highlighting the issue of chronic underfunding of mental health. And the pandemic has only increased the demand for mental health services.
Bereavement, isolation, loss of income, and fear have triggered mental health conditions or exacerbated the existing ones. Many people may be facing increased levels of alcohol and drug use, insomnia, and anxiety.
The survey also found that Covid-19 can lead to neurological and mental complications, such as delirium, agitation, and stroke.
“People with pre-existing mental, neurological, or substance use disorders are also more vulnerable to SARS-CoV-2 [that causes Covid-19] infection – they may stand a higher risk of severe outcomes and even death,” it says.
The survey evaluated how the provision of mental, neurological and substance use services has changed due to Covid-19, and the types of services that have been disrupted, and how countries are adapting to overcome these challenges.
While many countries (70%) have adopted telemedicine or teletherapy to overcome disruptions to in-person services, there are significant disparities in the uptake of these interventions, shows the survey. At least 80% of high-income countries reported deploying telemedicine and teletherapy to bridge gaps in mental health, compared with less than 50% of low-income countries.
WHO has issued guidelines to countries on how to maintain essential services, including mental health services, during this pandemic. It has asked countries to allocate resources for mental health as an integral component of their response and recovery plans. The Organization has also urged countries to monitor changes and disruptions in services so that they can address them as required.
Although 89% of countries reported 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 highlights the need for more money for mental health as pre-pandemic estimates suggest 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.