‘The world has not yet learned from the COVID crisis’ experts warn
The second paper, entitled ‘Policy and public health implications for mental health in the wake of the COVID-19 pandemic’, looked in more detail at population-level mental health and the effects of various policy responses. It found that policies that benefit mental health include wage subsidies and severance programs, eviction prevention, school- and university-based mental health services, support for survivors of domestic violence and adaptive community interventions in low-resource settings.
However, the researchers found that these policies lacked equality across the globe, and that the digital and economic divide often increased inequality.
Recommendations from the second paper include:
- Mental health should be considered as an important factor in economic and social policy making
- Embed mental health in community prevention and recovery programs
- Integrate clear, reliable communication strategies into disaster planning
- and develop financial models that protect mental health budgets in times of crisis.
The study was conducted by 43 experts from around the world, coordinated by MQ Mental Health Research and the Lancet Standing Commission on the COVID-19 Pandemic and Mental Health.
Professor Peter B. Jones, Professor of Psychiatry at the University of Cambridge and Chairman of the Commission, says
“It has been a privilege to work with members of the Commission who are deeply immersed in the rapidly accumulating and voluminous evidence. Issuing sound recommendations is beneficial but the greatest impact will come from their implementation.”
“The effects of this epidemic on mental health services and the need for care where there are problems. It is true that we were all in the same storm, but we were not in the same boat.”
“The creation of a position and the way people with mental disorders stopped seeking help, and mental health services stopped providing care in times of violence. There is real promise to guide responses to future outbreaks. Protecting health services should not be the goal if we lose people who need them.”
Collectively, the papers show that there was no “mental health crisis” worldwide, but there was a clear spike in depression at the start of the epidemic, deep inequalities, and major disruptions in mental health care. Evidence shows that many of the worst outcomes were driven less by the virus itself than by long-term structural problems in mental health systems and the broader social inequalities that the epidemic exposed and reinforced.
Professor Etheldreda Nakimuli-Mpungu, Professor of Epidemiology at the London School of Hygiene and Tropical Medicine and Chairperson of the Commission said:
“In low-resource settings, COVID-19 has shown that mental health suffers most when people lose money, food, safety, schooling, and trust — and improves when governments protect livelihoods and communities. The lesson is clear: mental health must be built into social protection, community services, and disaster planning from the ground up. If we only rely on specialist services after an injury, we will always be too late.”
The authors also highlight the need for long-term, nationwide research, especially in low- and middle-income countries, to understand the long-term mental health consequences of the epidemic and policy choices.
In summary – the commission recommends that policymakers embed mental health in social protection and recovery plans for future disasters, and invest in integrated digital and social services that reduce, rather than widen, inequalities.
You can read more about the study by listening to the Lancet’s ‘In Conversation’ podcast with interviews from fellow commission chairs Peter Jones and Ethel Nakimuli-Mpungu.
