Governments and charities are committing billions of dollars to safekeep the world from future pandemics. Yet, little to nothing has been set aside for mental health care. The reason for this costly oversight ranges from stigma to lack of awareness. How can the situation be remedied?
Before the covid-19 pandemic, mental illness was already a major cause of suffering and economic hardship worldwide. We know this from countless World Health Organization reports, of which the most recent—only the second global status report on the topic— spelled out the implications of depression, anxiety, schizophrenia and more to every country at all levels of development.
During the pandemic, many policies were implemented to slow or stop the spread of the virus. These included lockdowns, masking and school closures, among other methods, which may well have had some impact on the ultimate lethality of the virus but, at the same time, contributed to isolation, loneliness and despair in many families and communities. These effects are moderated by local and national cultural norms of community support.
A GlobeScan poll commissioned by the BBC in the third quarter of 2022 explored how people across 30 countries coped with their mental and emotional health.
It found that in one group of countries, which included much of Europe and the US, people were more likely to report worsening mental health status. In contrast, people in many Asian countries, led by Vietnam, reported the opposite. In all countries young people reported higher levels of mental illness and greater difficulty accessing care and support.
What do these findings mean and how should we respond to them?
Considerable efforts are underway to strengthen future pandemic preparedness. They focus on more viral research and surveillance, faster ways to developing vaccines and medications, and strengthening public health infrastructure. Billions of dollars have been committed by governments, leading global philanthropies like the Wellcome Trust, Gates and Rockefeller Foundations.
We know that beating a pandemic entails the absence of not just covid-19 but also non-communicable diseases, including mental illness. But policies do not reflect this yet. Why?
Stigma and discrimination against people with mental illness is one importance factor. This was addressed in depth in a recently published Lancet Commission report. The report details the impact of stigma and discrimination on patient care, on priority setting in health, on individuals, on employers and far more. Its recommendations are sound and clear and start with avoiding the use of stigmatising language.
People with mental illness need to be part of policy discussions in ways we learnt from HIV/AIDS activists, who stressed there should be “no actions for us without us.” This means an inclusive and participatory approach to mental health support is critical.
Many anti-stigma programmes have been outlined over the years. Most have limited effect. The successful ones are those that have been supported for several years, adapted to local norms, culture, and needs, and carefully evaluated for their impact.
We believe this is the time to support such programmes. Their success could help people living with mental illness seek help early and create the kind of community support outlined in several of the commission’s case studies. Governments need to invest in mental and emotional wellbeing in order to ensure everyone has the opportunity to contribute meaningfully to their community. Businesses need to invest in mental health to ensure productive and competitive workforces that are aligned with the company’s values and purpose.
We see major opportunities for private-public partnerships to design and fund such efforts at scale. Digital media offers the chance to reach the unreached with messages and relevant support, in ways that respect privacy and ensure dignity. And the growth of digital technologies for mental health care allows millions of people living in low- and middle-income countries with rudimentary services to access quality services and support. Several of the pros and cons of digital mental health care were discussed in a meeting hosted by Re:solve Global Health, Dalberg, and Northwell Health during the 2022 United Nations General Assembly (UNGA).
This is the time to build on greater global awareness about the importance and neglect of mental health. Let us, with greater effort, tackle stigma and discrimination through private-public partnerships and digital innovations that are context-specific. The GlobeScan poll provides some insight into that context.
The opinions expressed are those of the authors and do not necessarily reflect the position of Re:solve Global Health.
Chris Coulter is the CEO of GlobeScan, an insights and advisory firm. He is a co-author of two books, All In: The Future of Business Leadership (2018) and The Sustainable Business Handbook (2022), and has a podcast, The All In Sustainable Business Podcast.
Derek Yach is an independent global health consultant with more than 30 years’ experience with organisations including the World Health Organization (WHO), World Economic Forum and Yale University. He serves on several advisory boards and has authored or co-authored more than 200 articles covering the breadth of global health.