New research published in The Lancet Psychiatry warns that lessons have not been learned from the COVID-19 pandemic when it comes to mental health. The researchers recommend that mental health should be treated as a core consideration when it comes to pandemic preparedness, rather than a downstream consequence.
The research was performed by an international group of experts, including from low- and middle-income countries, and people with lived experience of mental illness or long COVID. They examined the different responses from governments around the world and reviewed existing evidence, to assess what policies were most effective for protecting mental health.
This work was produced by a five-year international commission, meaning that the study could review the higher-quality, often long-term studies, which have emerged since the pandemic, and the initial deluge of small, and less informative studies from the early days of the pandemic.
The findings have been published in two papers. The first paper, titled ‘The implications of the COVID-19 pandemic for clinical mental health care’, examined how mental health services changed during the pandemic. The researchers found that symptoms of anxiety and depression generally increased in the first months of the pandemic, then stabilised or returned close to pre-pandemic levels in many high-income countries – but that vulnerable groups, including socioeconomically disadvantaged communities, minoritised ethnic groups, children and young people, and people with pre-existing mental illness, experienced greater and more persistent harms.
Despite these changes in symptoms, levels of clinical mental illnesses showed less change overall, though eating disorders increased, particularly in young women. Mental health services in many countries were disrupted, meaning existing mental health patients lost access to face-to-face care. Healthcare providers and community services were often forced to improvise with little evidence to guide them. In some communities, digital platforms allowed for some continuity of care. However, communities with little access to digital technology missed out.
The second paper took a wider view of population-level mental health and the effects of different policy responses. It found that the policies that benefitted mental health included wage subsidies and furlough schemes, eviction bans, school- and university-based mental health services, support for survivors of domestic violence, and adapted community interventions in low-resource settings.
However, the researchers found that these policies were unevenly implemented around the world and that digital and economic divides often widened inequalities.
The study was carried out by 43 experts from around the world, brought together by MQ Mental Health Research and the Lancet Psychiatry Standing Commission.
The research concludes with the recommendation that policymakers embed mental health in social protection and recovery plans for future disasters, and invest in blended digital and community-based services that reduce, rather than widen, inequalities.
The implications for organizational resilience
While the research papers are aimed at governments and policymakers, there are clear lessons for organizations too. It is widely recognised that people are at the heart of organizational resilience, however many pandemic plans are focused on the impacts of people becoming unavailable for operating and enabling organizational processes. This research shows that pandemic planning – and other forms of resilience planning – should include measures to help workforces to maintain mental health levels during times of crisis.
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