Addressing mental health during COVID-19

May 22, 2020


I don’t usually remember my dreams. Last night was different. I dreamt I got the dreaded coronavirus.

It was a rather ridiculous dream--my only symptom was male-pattern baldness--but then I thought about how everyone’s having COVID-19 dreams, in part because everyone’s having COVID-19 anxiety, and how for some that anxiety spirals into something much worse.

In April a close family member was also having COVID-19 dreams. She went from anxiety to severe insomnia to conspiratorial delusions to a preliminary telemedicine diagnosis of a mental health disorder requiring counselling and medication.

She, like so many of us, had been alone in her apartment. She lives one floor above an emergency health centre. The constant sirens and distress sounds spurred a mental health crisis that weeks of medication, therapy, and family support have still not overcome.

With the effects of COVID-19 on our physical health increasingly documented, we can no longer collectively fail to notice its effects on our mental health. My family’s experience is only remarkable for how unremarkable it is. COVID-19 has the seeds of a major mental health crisis. Early reporting from Ireland shows a tenfold increase in the number of people seeking online counselling.

Some people are showing high degrees of psychological distress, such as healthcare workers, older adults, people with pre-existing conditions, children, thosee in precarious domestic situations, and fragile humanitarian and conflict settings. Together these groups make up maybe most of humanity; these are our friends, family, neighbours, they’re us.

Most of the discussion about addressing COVID-19-related mental health problems is focused on what we can do as individuals. The World Health Organization has published a helpful document. This WHO infographic is less detailed, but easy to digest.

The advice is consistent with what has always helped mental health; staying connected, keeping busy, getting physical activity, staying calm, managing information intake, maintaining a routine, and sleeping well.

But while this is important, much more action needs to be taken regarding policy. Our neglect of mental health is obvious from the insufficient commitments we devote to it; the crisis response is now hampered by our lack of investment in mental health promotion, prevention and care before the pandemic.

We know we need large-scale changes. Yet because of the scale of the problem, the vast majority of mental health needs remain unaddressed.  

Last week UN Secretary-General António Gutteres launched a policy brief on the need for more action on mental health.

He outlined three priorities:

  • Apply a whole-of-society approach to promote, protect and care for mental health
  • Ensure widespread availability of emergency mental health and psychosocial support
  • Support recovery from COVID-19 by building mental health services for the future

These recommendations are as good or better than any medical prescription; they will fundamentally change millions of lives.

In the last week before the lockdowns began, UNDP and the World Health Organization (WHO) held our first joint mission to develop a national mental health investment case in the Philippines. With support from the Russian Federation, we have have developed a methodology and will deliver such investment cases in four countries this year. Work in Uzbekistan began last week.

The cases are not so much about assigning a value to mental health, but about finding and prioritizing the best  approaches. By focusing on cost-effective interventions and scaling them up, while identifying and addressing gaps, we can make good on our promise to leave no one behind.

COVID-19 has instilled a level of fear and anxiety in us all. As it has isolated us physically, we have felt isolated mentally. We have all felt feelings of depression as we missed friends, family and loved ones.

Yet for many of us, these feelings are just a small glimpse into what it is like to be living with anxiety, depression or other mental health challenges. For many, these issues were a daily struggle before COVID-19 and they will be afterwards--perhaps made worse by the pandemic.

WHO Director-General Dr Tedros Adhanom Ghebreyesus’s consistent plea has been for nations’ coronavirus responses to be based on empathy. “Compassion is a medicine,” he said in March. That compassion and solidarity applies just as much to our own approaches to mental health. Solidarity with those enduring mental health challenges, and a demand that we are all entitled to mental health services, must be a rallying cry for us all.