King's College London

King’s researchers have collaborated with academics and people with lived experience of mental ill health across the world, including the USA, Nigeria, China, Mexico, Pakistan, India, Nepal, Brazil, and South Africa, on a review to examine the global mental health impact of Covid-19.

The review, published in Lancet Psychiatry, calls for an overhaul of the field of global mental health as we emerge from the Covid-19 pandemic. It examines the global mental health implications of the Covid-19 pandemic in four parts: the impact of the pandemic on mental health; the responses in different countries; the opportunity that the pandemic presents to reimagine global mental health; and the authors’ future vision for mental health systems.

The impact of Covid-19 in low and middle-income countries

Emerging reports on the impacts of Covid-19 have demonstrated an increase in mental health difficulties since the pandemic. However, most research has focused on high-income countries, highlighting a need for better understanding of the impact of Covid-19 on low-income and middle-income countries (LMICs).

As part of the review, the authors highlighted the importance of social, economic, and structural factors on both the risk of contracting Covid-19 and the subsequent mental health difficulties. The impact of the pandemic is therefore likely to be unevenly distributed, exacerbating existing inequalities and disproportionately affecting those who are already disadvantaged.

Historically, LMICs have received a fraction of the global resources for mental health care, despite making up most of the global population. Since the start of the pandemic, there have been growing efforts to develop guidance, policies, and resources for LMICs to address mental health concerns. However, access to resources, such as remote psychological services, is not easy in many LMICs. The review has highlighted the need to improve the global distribution of mental health resources to combat the impact of Covid-19.

 

A Global Approach to Health

Global solidarity in the face of the pandemic is essential to provide safety nets that can reduce the disproportionate impact of Covid-19 among people in low-resource settings.

In their review, the authors argue that the pandemic has challenged the assumption that the best public health strategies originate in high-income countries, and they call for a global approach to health by harnessing insights and supporting leadership by LMIC researchers, organisations, and activists. They also set out a vision for localising and democratising mental health strategies by recognising the central importance of substantive community engagement, peer support, and participatory action.

The authors conclude with a call to strengthen health systems to better address people’s psychosocial needs, protect human rights, prioritise at-risk groups, and integrate mental health into employment, economic, and education policies. They urge us to use the disruption of the pandemic to reassess how societies organise themselves to promote better mental health.

 

Kola, L. et al. (2021). COVID-19 mental health impact and responses in low-income and middle-income countries: Reimagining global mental health. The Lancet Psychiatry. DOI: https://doi.org/10.1016/S2215-0366(21)00025-0