Analisis Jurnal

* Kepaniteraan Klinik Senior /Maret 2021

** Pembimbing dr. Tumpak Saragih,Sp.KJ

POLICY BRIEF: COVID-19 AND THE NEED

FOR ACTION ON MENTAL HEALTH

Disusun Oleh:
Dinda Nurul Isnaini (G1A220044)*
Dinda Asri Aisyah (G1A220123)*

Pembimbing:
dr. Tumpak Saragih, Sp.KJ**

KEPANITERAAN KLINIK SENIOR

SMF/BAGIAN ILMU KEDOKTERAN JIWA
RUMAH SAKIT JIWA DAERAH PROVINSI JAMBI
FAKULTAS KEDOKTERAN DAN ILMU KESEHATAN
UNIVERSITAS JAMBI

TAHUN 2021
Kebijakan: Covid-19 Dan Perlunya Selain itu, kelompok populasi
Tindakan Terkait Kesehatan Mental tertentu menunjukkan tingkat psikologis
United Nations yang tinggi terkait COVID-19. Petugas
kesehatan garis depan dan responden telah
terpapar stres dan memastikan kesehatan
COVID-19 dan Perhatian Aksi untuk mental bagi petugas kesehatan merupakan
Kesehatan Mental faktor penting dalam mempertahankan
kesiapsiagaan COVID-19. Di setiap
Kesehatan mental yang baik penting komunitas, di sana banyak orang dewasa
untuk memfungsikan masyarakat sebaik- yang lebih tua dan orang dengan kondisi
baiknya kali. Hal ini harus menjadi kesehatan yang sudah ada sebelumnya yang
perhatian berbagai negara selama era ketakutan dan kesepian. Kesulitan
pandemi covid-19. Kesehatan mental dan emosional pada anak-anak dan remaja
kesejahteraan seluruh masyarakat sangat diperburuk oleh stres keluarga, isolasi sosial,
parah terkena dampak krisis ini dan menjadi dengan beberapa yang dihadapi peningkatan
prioritas yang harus ditangani dengan pelecehan, pendidikan terganggu dan
segera. Tekanan psikologis dalam populasi ketidakpastian tentang masa depan mereka,
adalah tersebar luas. Banyak orang yang terjadi pada titik kritis dalam perkembangan
tertekan akibat dampak kesehatan langsung emosional mereka. Wanita menanggung
dari virus dan konsekuensi dari isolasi fisik. beban stres yang besar di rumah serta
Banyak juga yang takut infeksi, meninggal, dampak yang tidak proporsional lebih
dan takut kehilangan anggota keluarga bagi umum.
individu telah jauh secara fisik dari orang
yang dicintai dan teman sebaya. Jutaan Meminimalkan Konsekuensi
orang menghadapi gejolak ekonomi hilang Untuk meminimalkan konsekuensi
atau berisiko kehilangan pendapatan dan kesehatan mental terhadap pandemi, penting
mata pencaharian mereka. Kesalahan untuk mempertimbangkan tiga tindakan
informasi yang sering terjadi dan rumor berikut ini yang direkomendasikan:
tentang virus dan ketidakpastian yang
mendalam tentang masa depan menjadi
sumber.
1. Terapkan Pendekatan Seluruh nasihat untuk kesejahteraan
Masyarakat untuk Mempromosikan, emosional
Melindungi Dan Mengawasi
Kesehatan Mental
Tindakan kesehatan mental 2. Memastikan ketersediaan luas
perlu dipertimbangkan komponen kesehatan mental darurat dan
penting dari respon nasional untuk dukungan psikososial
COVID-19. Pendekatan seluruh Kesehatan mental dan dukungan
masyarakat untuk kesehatan mental psikososial harus tersedia dalam
dalam COVID-19 berarti: keadaan darurat apa pun. Untuk
1. Kesehatan mental dan mencapai obyek selama pandemi
pertimbangan psikososial dalam COVID-19 dengan cara:
rencana respons nasional lintas 1. Mendukung aksi komunitas
sektor misalnya pendukung dapat memperkuat kohesi sosial
belajar dan memelihara dan mengurangi kesendirian,
lingkungan untuk anak-anak dan Misalnya pendukung kegiatan
remaja yang beraktivitas di rumah yang membantu orang dewasa
2. Menanggapi secara proaktif yang lebih tua terisolasi tetap
untuk mengurangi kesulitan terhubung
selama pandemi yang diketahui 2. Intervensi kesehatan mental
dapat membahayakan kesehatan dengan jarak jauh, misalnya
mental, misalnya kekerasan konseling secara telekomunikasi
dalam rumah tangga dan yang terjamin untuk garis depan
pemiskinan (kondisi ekonomi petugas kesehatan dan orang-
rendah) akut orang di rumah yang mengalamo
3. Membuat komunikasi menjadi depresi dan kecemasan
sensitive tentang potensi dampak 3. Memastikan perawatan langsung
terhadap kesehatan mental tanpa gangguan kondisi
masyarakat, misalnya dengan kesehatan mental yang parah
mengomunikasikan empati untuk sebagai layanan penting berlanjut
kesusahan orang-orang dan selama pandemik
 4. Melindungi dan universal, termasuk perawatan
mempromosikan hak asasi mental, neurologis dan gangguan
manusia orang - orang dengan penggunaan zat dan skema
kondisi kesehatan mental yang asuransi
parah dan disabilitas psikososial, 3. Membangun kapasitas sumber daya
misalnya memantau apakah manusia untuk menyampaikan
mereka memiliki akses yang kesehatan mental dan perawatan
sama selama COVID-19. sosial, misalnya diantara pekerja
komunitas sehingga mereka bisa
3. Dukungan pemulihan dari COVID-19 saling mendukungan
untuk membangun kesehatan mental 4. Menyelenggarakan layanan berbasis
masa depan komunitas untuk melindungi dan
Semua komunitas yang mempromosikan hak asasi manusia,
terkena dampak akan membutuhkan misalnya dengan melibatkan orang
pelayanan kesehatan mental yang yang pernah pengalaman hidup
berkualitas untuk mendukung dalam desain, implementasi dan
pemulihan masyarakat dari COVID- pemantauan layanan.
19,yakni dengan cara sebagai
berikut. Penerapan yang cepat bermanfaat kepada
1. Menggunakan momentum yang masyarakat menjadi lebih terlindungi dari
diminati saat ini dalam kesehatan dampak kesehatan mental selama COVID-
mental, misalnya dengan 19.
mengembangkan dan mendanai
pelaksanaan strategi nasional
Dampak COVID-19 pada Kesehatan
layanan re-organisasi yang
Mental Kesehatan Mental Secara
mengalihkan perhatian dari institusi
Global
ke komunitas jasa
2. Memastikan bahwa kesehatan Kesehatan mental adalah keadaan
mental menjadi bagian dari jaminan kesejahteraan mental di mana orang dapat
kesehatan mengatasi berbagai tekanan hidup dengan
baik, menyadari potensi diri, dapat berfungsi
secara produktif dan bermanfaat, serta dapat 3. Sekitar setengah dari semua kondisi
memberikan kontribusi kepada kesehatan mental dimulai pada usia
komunitasnya. 14 tahun, dan bunuh diri adalah

Kesehatan mental memiliki nilai penyebab utama ke-2 kematian pada

intrinsik yang besar karena berkaitan dengan orang muda berusia 15-29 tahun

inti dari apa yang menjadikan kita manusia: 4. Lebih dari 1 dari 5 orang yang

cara kita berinteraksi, terhubung, belajar, tinggal di lingkungan yang terkena

bekerja, dan mengalami penderitaan dan dampak konflik memiliki kondisi

kebahagiaan. Kesehatan mental yang baik kesehatan mental.

mendukung kemampuan individu untuk 5. Orang dengan kondisi mental yang

menampilkan perilaku sehat yang menjaga parah meninggal 10-20 tahun lebih

diri dan orang lain tetap aman dan sehat awal dari populasi umum.

selama pandemi. Kesehatan mental yang 6. Kurang dari separuh negara

baik juga memfasilitasi orang untuk melaporkan bahwa kebijakan

menjalankan peran kunci dalam keluarga, kesehatan mental selaras dengan hak

komunitas dan masyarakat, baik merawat asasi manusia

anak-anak dan orang dewasa yang lebih tua 7. Di negara berpenghasilan rendah dan

atau berkontribusi pada pemulihan ekonomi menengah antara 76% dan 85%

komunitas mereka. Kesehatan mental yang orang dengan kondisi kesehatan

baik sangat penting bagi setiap negara. mental tidak menerima pengobatan
untuk kondisi mereka, meskipun
Sebelum COVID-19 muncul,
terdapat bukti bahwa intervensi yang
statistik tentang kondisi kesehatan mental
efektif dapat dilakukan disampaikan
(termasuk neurologis dan substansi
dalam konteks sumber daya apa pun.
gangguan penggunaan, risiko bunuh diri dan
8. Secara global, ada kurang dari 1
disabilitas psikososial dan intelektual
profesional kesehatan mental untuk
terkait) sudah mencolok:
setiap 10.000 orang.
1. Perekonomian global merugi lebih
9. Pelanggaran hak asasi manusia
dari US $ 1 triliun per tahun karena
terhadap orang dengan kondisi
depresi dan kecemasan.
kesehatan mental yang parah tersebar
2. Depresi mempengaruhi 264 juta
orang di dunia.
 luas di semua tempat negara di kondisi kesehatan mental yang parah.
dunia. Pengaruh pandemi COVID-19 di mana
orang-orang berada di lingkungan tersebut.
Kesehatan mental adalah salah satu Banyak orang yang sebelumnya dapat
bidang yang paling terabaikan dalam mengatasi dengan baik, namun sekarang
kesehatan. Meski berdampak pada kesehatan tidak bisa mengatasinya karena beberapa
mental kondisi individu, keluarga dan penyebab stres yang dihasilkan oleh
masyarakat, hanya ada sedikit investasi pandemi. Mereka yang sebelumnya punya
dalam kesehatan mental, khususnya dalam sedikit pengalaman kecemasan dan
layanan berbasis komunitas. Negara-negara kesusahan, mungkin mengalami peningkatan
membelanjakan rata-rata hanya 2% dari jumlah dan intensita kecemasan. Hal ini
mereka anggaran kesehatan untuk kesehatan memepngaruhi kondisi kesehatan mental.
mental; rata-rata dibelanjakan oleh sektor Dan mereka yang sebelumnya memiliki
lain yang tidak diketahui. Bantuan kesehatan mental kondisi baik, mungkin
pembangunan internasional untuk kesehatan mengalami perburukan kondisi mereka dan
mental diperkirakan kurang dari 1% dari berkurangnya fungsi mereka. Bukti sejauh
semua pembangunan bantuan untuk ini menegaskan tersebar luas tekanan
kesehatan. Ini terlepas dari komorbiditas psikologis pada populasi yang terkena
fisik dan kondisi kesehatan mental untuk COVID-19, seperti yang dilaporkan dalam
penyakit seperti HIV / AIDS dan TB dan survei nasional.
sekarang untuk COVID-19.

Dampak Covid-19 Pandemik Pada

Kesehatan Mental

Pesan utama dari Lancet Commission

tentang kesehatan mental global dan
perkembangan berkelanjutan adalah masalah
kesehatan mental ada di sepanjang kontinum
dari ringan, tekanan waktu terbatas hingga
 membuat ketagihan seperti game online.
Statistik dari Kanada melaporkan bahwa
20% dari populasi berusia 15-49 tahun
terjadi peningkatan konsumsi alkohol
selama pandemi.

Dampak jangka panjang dari era

pandemik terhadap kesehatan mental
masyarakat dampak tidak boleh diabaikan.
Sebagai akibat dari krisis ekonomi 2008,
terjadi peningkatan "Kematian karena
keputusasaan" tercatat diantara pekerja usia
15 – 49 tahun orang Amerika. Bunuh diri
dan penggunaan narkoba menyumbang
sebagian besar kematian, dengan hilangnya
Tidak mengherankan, level yang harapan karena kurangnya lapangan kerja
lebih tinggi dari biasanya berupa gejala dan meningkatnya ketimpangan. Efek
depresi dan kecemasan telah tercatat di COVID-19 pada otak menjadi perhatian.
berbagai negara. Sebuah studi besar di Manifestasi neurologis telah dicatat di
Negara Regional Amhara, Ethiopia, pada banyak negara pada orang dengan COVID-
bulan April 2020, melaporkan perkiraan 19. Apalagi, konsekuensi sosial dari
tingkat prevalensi 33% gejala yang pandemi dapat mempengaruhi
konsisten dengan gangguan depresi, perkembangan kesehatan otak pada anak-
peningkatan 3 kali lipat dibandingkan anak dan remaja dan kognitif penurunan
dengan perkiraan dari Ethiopia sebelum populasi yang lebih tua. Tindakan mendesak
epidemi. Untuk mengatasi pemicu stres, diperlukan untuk mencegah dampak jangka
orang-orang mungkin mengambil jalan panjang pada otak anggota termuda dan
untuk berbagai cara negatif untuk mengatasi, tertua dari masyarakat kita.
termasuk penggunaan alkohol, obat-obatan,
tembakau atau pengeluaran lebih banyak
waktu untuk perilaku yang berpotensi
Dampaknya pada kesehatan otak yaitu : pandemi telah mengganggu layanan di
1. COVID-19 dapat menyebabkan seluruh dunia. Faktor kunci yang
manifestasi neurologis, termasuk mempengaruhi layanan tersebut yaitu:
sakit kepala, gangguan indera 1. Infeksi dan risiko infeksi pada
penciuman dan perasa, agitasi, fasilitas jangka panjang, termasuk
mengigau, stroke dan meningo- panti jompo dan institusi kejiwaan
ensefalitis. 2. Hambatan untuk bertemu orang
2. Kondisi neurologis yang mendasari bertatap muka; staf kesehatan mental
meningkatkan risiko rawat inap terinfeksi virus
selama COVID-19, terutama untuk 3. Penutupan fasilitas kesehatan mental
orang dewasa yang lebih tua dengan mengubahnya menjadi
3. Stress, isolasi sosial dan kekerasan fasilitas perawatan untuk orang
di keluarga cenderung dengan COVID-19.
mempengaruhi kesehatan otak dan
perkembangan pada anak kecil dan Menurut Long Term Care Policy
remaja. Network sekitar setengah dari semua
4. Isolasi sosial, berkurangnya aktivitas kematian terkait COVID-19 di Australia,
fisik dan mengurangi stimulasi Belgia, Kanada, Prancis, Irlandia, Norwegia
intelektual meningkatkan risiko dan Singapura terjadi di antara penduduk
penurunan kognitif dan demensia fasilitas perawatan jangka panjang, dengan
pada orang dewasa yang lebih tua kematian tingkat mulai dari 14% hingga
64% . Layanan kesehatan mental pasien
Dampak Covid-19 terhadap Layanan rawat jalan di sekitar dunia juga sangat
Kesehatan Mental terpengaruh. Permintaan layanan kesehatan
Sebelum pandemi, di sebagian besar mental tatap muka telah menurun secara
komunitas dunia dan khususnya di banyak signifikan karena takut infeksi, terutama di
bidang kemanusiaan dan pengaturan konflik, kalangan orang tua. Banyak layanan terganti
terdapat keterbatasan akses ke perawatan dengan perawatan kesehatan mental. Ada
kesehatan mental yang berkualitas dan peningkatan fokus tentang bantuan mandiri
terjangkau. Akses ini kini semakin digital dan kesehatan mental digital layanan
berkurang karena COVID-19 karena dan program parenting (termasuk
penggunaan teknologi yang lebih mendasar diatur untuk kasus yang paling serius. Hal
seperti telepon dan SMS). Pendekatan ini juga penting bagi ahli IT, untuk
semacam itu bisa jadi efektif dan terukur, mengaktifkan mental staf kesehatan yang
meskipun keterbatasannya adalah populasi bekerja dari rumah untuk mengakses catatan
yang buta huruf, ekonomi rendah dan klinis elektronik sambil mempertahankan
orangtua yang memiliki sedikit akses kerahasiaan.
internet atau akses telekomunikasi , dan
pendekatan semacam itu bukanlah jawaban Beberapa contoh dukungan kesehatan
untuk semua kebutuhan kesehatan mental. mental dan psikososial selama pandemic
termasuk:
Pelayanan kesehatan mental harus 1. Di Lebanon, Kementerian Kesehatan
dicari cara inovatif untuk mengatur ulang Masyarakat telah meluncurkan
dan beradaptasi penyediaan layanan untuk rencana aksi secara komprehensif
memastikan kontinuitas perawatan selama menangani aspek kesehatan mental
pandemi. Kota dari Madrid, misalnya, dari COVID-19.
terpaksa dibangun kembali lebih dari 60% 2. Tim dari Mesir, Kenya, Nepal,
dari tempat tidur yang merawat kesehatan Malaysia dan Selandia Baru, di
mentalnya dengan COVID-19, mengurangi antaranya lainnya, telah melaporkan
jumlah orang dengan keadaan darurat pembuatan peningkatan kapasitas
layanan kesehatan mental sebesar 75%. saluran telepon darurat agar
Untuk menangani ini, layanan kesehatan kesehatan mental menjangkau orang
mental harus beradaptasi segera. Jika yang membutuhkan. Ini termasuk
memungkinkan, penderita kondisi parah laporan layanan itu telah membantu
dipindahkan ke klinik swasta untuk mengantarkan inovasi dirancang
memastikan kesinambungan perawatan untuk melanjutkan pasca pandemi.
sebagai tindakan solidaritas. Pembuat 3. Di Bahamas, baru-baru ini dilanda
kebijakan lokal diidentifikasi psikiatri bencana Badai Dorian, Pemerintah,
darurat merupakan layanan penting untuk PBB lembaga dan non-pemerintah
memungkinkan pekerja perawatan kesehatan berkumpul untuk menanggapi
mental untuk melanjutkan layanan rawat kesehatan mental dan konsekuensi
jalan selama telepon. Kunjungan rumah psikososial
 4. • Organisasi Kesehatan Mental (swasta) mendukung satu sama lain. Misalnya ada banyak
di Pakistan harus ditutup pusat pelatihan laporan di seluruh dunia dimana dewasa muda
kejuruan ekonomi pemberdayaan, tapi menjangkau dewasa tua yang terisolasi,
orang-orang dengan kondisi mental membantu mereka memenuhi kebutuhan dasar
yang selama ini mengikuti pusat mereka dan mengurangi kesepian mereka. Tanpa
pelatihan mulai menjahit masker kain disuruh, banyak fasilitas perawatan jangka
untuk petugas kesehatan untuk panjang telah menyiapkan cara bagi penghuni
mendukung komunitas mereka. untuk berbicara dengan anggota keluarga
5. • Di Nigeria, Asosiasi Nigeria dari
memastikan dukungan dan koneksi.
Psikiater, Asosiasi Perawat psikiatri,
Menyemangati petugas kesehatan garda depan
pekerja kesehatan klinis, serta LSM
setiap malam pada saat yang sama - dengan
kesehatan mental utama berkumpul
bertepuk tangan dan bersorak dari jendela dan
untuk membentuk Mitra Covid-19
balkon - melintasi kota di banyak negara
dalam perkumpulan kesehatan mental
menunjukkan solidaritas yang banyak dirasakan
ini. Mereka bekerja dengan pemerintah
dan ingin diekspresikan. Banyak sekali individu,
dan masyarakat sipil untuk menawarkan
meskipun terpaksa tinggal di rumah, mengambil
pelatihan tentang kesehatan mental,
kesempatan untuk terhubung kembali dengan
teleterapi dan penelitian.
jauh kerabat dan teman.
DUKUNGAN SOSIAL MASYARAKAT
Dalam pengaturan dengan akses
SELAMA PANDEMIK
internet, kesejahteraan mental telah didukung
Banyak kesulitan disebabkan oleh pandemi melalui pembuatan kelompok pendukung online
COVID-19 bermula dari dampaknya terhadap dan komunitas sosial untuk memerangi kesepian
hubungan sosial karena jarak fisik . Namun, ini dan kebosanan dan memperkuat keterhubungan
tidak berarti bahwa tidak ada ketahanan. Ada sosial, untuk menyebarkan pesan-pesan positif
banyak contoh dukungan komunitas yang tentang harapan dan persatuan, dan untuk
bermunculan. Memang, semua komunitas – memobilisasi sukarelawan komunitas untuk
bahkan mereka yang terpengaruh oleh kesulitan membantu mereka yang membutuhkan bantuan.
yang besar juga memberikan dukungan
Beberapa pengamatan positif tentang
psikososial secara natural dan sumber
solidaritas mungkin tidak tahan jika orang
ketahanan.
kehilangan harapan atau menjadi tidak toleran
Orang-orang di seluruh dunia terhadap tindakan jarak fisik, tapi
menunjukkan tindakan solidaritas dan pengalamannya adalah semua komunitas
menawarkan (tidak resmi) psikososial memiliki sumber daya yang berguna dan
tertanam yang perlu didukung. Pemerintah dapat semangat swadaya masyarakat untuk melindungi
mendukung materi untuk komunitas yang dan mempromosikan kesehatan mental.
berinisiatif memberikan konten yang bermanfaat
2. Populasi spesifik yang menjadi
karena itu penting, sekarang lebih dari
perhatian
sebelumnya, untuk mengaktifkan dan
Kelompok populasi tertentu
memperkuat dukungan lokal, khususnya untuk
telah terpengaruh oleh COVID-19.
orang-orang yang terpinggirkan, dan mendorong
 Responden pertama dan pekerja garis Dari Chili, Italia, Spanyol, Filipina, Uni
depan, terutama pekerja kesehatan Emirat Arab, Inggris Raya, dan Amerika
dan perawatan jangka panjang Serikat mendokumentasikan bagaimana
memainkan peran penting dalam tim yang berdedikasi memberikan
memerangi wabah dan menyelamatkan dukungan kesehatan mental
nyawa. Namun, mereka berada di bawah untuk petugas kesehatan. Semua negara
tekanan yang luar biasa, dihadapkan perlu memastikan bahwa bagian penting
pada beban kerja yang ekstrim, dari masyarakat ini terus memainkan
keputusan yang sulit, risiko terinfeksi peran penting dalam membantu
dan menyebarkan infeksi ke keluarga mengakhiri wabah. Panduan tentang
dan komunitas, dan menyaksikan bagaimana melakukan ini telah tersedia
kematian pasien. Stigmatisasi para untuk relawan Palang Merah dan Bulan
pekerja ini biasa terjadi di banyak Sabit Merah yang memainkan peran
komunitas. Ada laporan tentang upaya penting dalam respon di banyak negara.
bunuh diri dan kematian karena bunuh  Orang dewasa yang lebih tua dan
diri oleh petugas kesehatan. orang-orang dengan kondisi
kesehatan yang sudah ada
Kesehatan mental petugas kesehatan
Lselama pandemi COVID-19 sebelumnya berisiko besar mengalami
a• Di Kanada, 47% pekerja perawatan komplikasi yang mengancam jiwa dari
pkesehatan melaporkan kebutuhan COVID-19. Sekitar 8 dari 10 kematian
33
oakan dukungan psikologis. yang dilaporkan di AS dan Jerman
r • Di Republik Rakyat Cina, petugas terjadi pada orang yang berusia 65 tahun
akesehatan melaporkan tingkat atau lebih atau 70 tahun ke atas.. Dapat
depresi yang tinggi (50%), kecemasan
n(45%), dan insomnia (34%). 34 dimengerti bahwa banyak orang dewasa
yang lebih tua dan orang dengan kondisi
• Di Pakistan, sejumlah besar pekerja
dperawatan kesehatan telah yang sudah ada sebelumnya (misalnya,
Dmelaporkan tekanan psikologis penyakit jantung, hipertensi) saat ini
sedang (42%) hingga parah (26% ).35
 sangat khawatir terinfeksi virus dan  Remaja dan dewasa muda juga
tidak memiliki akses ke perawatan yang merupakan kelompok yang berisiko
tepat. Beberapa dari mereka, termasuk dalam krisis saat ini, karena sebagian
mereka yang memiliki gangguan besar kondisi kesehatan mental
kognitif, mungkin mengalami kesulitan berkembang selama periode kehidupan
mengakses saran tentang pencegahan ini. Banyak anak muda telah melihat
infeksi dan berisiko lebih tinggi masa depan mereka terpengaruh.
diisolasi. Kesepian merupakan faktor Misalnya, sekolah tutup, ujian belum
risiko utama kematian pada orang digelar, dan prospek ekonomi merosot.
dewasa yang lebih tua. Selain itu, orang Sebuah penelitian yang dilakukan
dewasa yang lebih tua telah dilaporkan dengan kaum muda dengan riwayat
menjadi korban stigma dan pelecehan. kebutuhan kesehatan mental yang
Ringkasan kebijakan PBB tentang orang tinggal di Inggris melaporkan bahwa
tua dan COVID-19 telah dirilis yang 32% dari mereka setuju bahwa pandemi
merinci rekomendasi tentang bagaimana telah membuat kesehatan mental mereka
menangani kebutuhan kelompok jauh lebih buruk. Sumber utama
populasi ini. kesusahan termasuk kekhawatiran
tentang kesehatan keluarga mereka,
 Banyak keadaan emosi dan perilaku sekolah dan penutupan universitas,
anak-anak telah terpengaruh selama hilangnya rutinitas dan kehilangan
penahanan menurut laporan oleh orang koneksi sosial. Penyediaan layanan
tua Italia dan Spanyol. Selain itu, anak- kesehatan mental harus mencakup
anak, termasuk remaja, berisiko tindakan khusus yang disesuaikan untuk
mengalami pelecehan selama pandemi. populasi ini.
Anak-anak penyandang disabilitas,  Wanita adalah populasi lain dengan
anak-anak dalam lingkungan yang padat perhatian khusus. Sebuah survei tentang
dan mereka yang tinggal dan bekerja di tingkat stres pada populasi India selama
jalanan sangat rentan. Ringkasan pandemi COVID-19 menunjukkan
Kebijakan PBB tentang dampak bahwa 66% wanita dilaporkan
COVID-19 pada anak telah diterbitkan mengalami stres dibandingkan dengan
secara khusus tentang topik ini dengan 34% pria. Selama situasi COVID-19
rekomendasi tentang cara menangani saat ini, ibu hamil dan ibu baru sangat
risiko dan kebutuhan anak. mungkin merasa cemas karena kesulitan
mengakses layanan dan dukungan sosial
 serta ketakutan akan infeksi. Dalam fisik) untuk orang-orang dalam situasi
beberapa tatanan keluarga ada beban kemanusiaan, seperti pengungsi atau
yang meningkat karena tugas-tugas orang terlantar yang tinggal di barak
pengasuhan tambahan seperti atau pemukiman yang ramai. Hal ini
homeschooling dan merawat kerabat meningkatkan risiko infeksi COVID-19
yang lebih tua. Seperti pelecehan masa dan menimbulkan stres tingkat tinggi.
kanak-kanak, situasi stres dan Belum ada data kesehatan mental terkait
pembatasan gerak meningkatkan COVID-19 yang tersedia untuk orang-
kekerasan terhadap perempuan. orang dalam situasi kemanusiaan dan
Diperkirakan secara global 31 juta kasus konflik, tetapi data tentang migran
tambahan kekerasan berbasis gender mengkhawatirkan. Inter-Agency
dapat terjadi jika pembatasan berlanjut Standing Committee (IASC) telah
setidaknya selama 6 bulan. Ringkasan merekomendasikan serangkaian
Kebijakan PBB telah diterbitkan dengan tindakan utama untuk meminimalkan
secara khusus mengamati dampak dan mengatasi dampaknya. COVID-19
COVID-19 pada perempuan dan tentang kesehatan mental dan
perempuan. langkah-langkah yang perlu psikososial. Kelompok Referensi IASC
diambil sekarang untuk mengatasi tentang Kesehatan Mental dan
dampak ini. Dukungan Psikososial mendukung
 Orang-orang dalam situasi kelompok koordinasi dukungan
kemanusiaan dan konflik yang kesehatan mental dan psikososial di
kebutuhan kesehatan mentalnya sering lebih dari 20 keadaan darurat
terabaikan membutuhkan lebih banyak kemanusiaan untuk memperkuat respons
perhatian. Bukti menunjukkan bahwa kemanusiaan lokal dalam menghadapi
dalam situasi konflik, 1 dari 5 orang COVID- 19.
49
memiliki kondisi kesehatan mental.
Situasi pandemi dapat memperburuk 3. Tindakan Yang Disarankan
kondisi kesehatan mental yang ada, Dampak pandemi telah dan
menimbulkan kondisi baru dan akan terus berdampak pada kesehatan
membatasi akses ke layanan kesehatan mental. Penerapan tindakan yang
mental yang sudah langka tersedia. direkomendasikan di bawah ini oleh
Selain itu, seringkali sulit untuk pembuat keputusan nasional akan
mematuhi langkah-langkah pencegahan membantu meminimalkan dan
infeksi (seperti menjaga jarak secara mengatasi konsekuensi berikut:
1. Terapkan Pendekatan Seluruh membantu melindungi kesehatan
Masyarakat Untuk mental orang.
Mempromosikan, Melindungi, Segala sesuatu perlu dilakukan
Dan Memelihara Kesehatan untuk melindungi orang dari
Mental kesulitan terkait pandemi yang
Penyertaan pertimbangan diketahui dapat membahayakan
kesehatan mental dan psikososial kesehatan mental. Tindakan
dalam respons nasional COVID- perlindungan sosial dan keuangan
19 sangat penting karena diperlukan untuk mencegah orang
meningkatkan kualitas program, dari dampak kehilangan mata
meningkatkan keterampilan pencaharian atau prospek ekonomi
mengatasi orang selama krisis, dan memperdalam ketidaksetaraan.
mengurangi penderitaan, dan Kesempatan belajar alternatif perlu
kemungkinan akan mempercepat ditawarkan kepada anak-anak dan
pemulihan dan pembangunan remaja di luar sekolah. Pencegahan
kembali komunitas. Selama dan ganti rugi kekerasan dalam
pandemi, pengambil keputusan rumah tangga - baik terhadap
pemerintah lintas sektor (kesehatan, perempuan, anak-anak, orang
keamanan, layanan sosial, dewasa yang lebih tua, atau
pendidikan, komunikasi) harus penyandang disabilitas - harus
mempertimbangkan bagaimana menjadi bagian penting dari rencana
tindakan mereka berdampak pada tanggapan COVID-19 nasional.
kesehatan mental. Misalnya, Kerangka kerja nasional untuk
tindakan darurat tinggal di rumah menangani diskriminasi terhadap
(serta pencabutan tindakan ini) perlu pekerja perawatan kesehatan dan
direncanakan dan diterapkan di orang yang pernah atau pernah
berbagai sektor sedemikian rupa terjangkit COVID-19 harus dibuat
sehingga meminimalkan efek pada dan diterapkan di negara-negara
kesejahteraan mental orang. tempat diskriminasi tersebut ada.
Keterlibatan dan akuntabilitas Penting untuk memastikan
kepada warga negara dalam upaya perlindungan dan perawatan orang-
bersama untuk menahan virus orang di institusi - baik yang
mendorong penerimaan tindakan dijalankan oleh sektor sosial atau
tersebut dan kemungkinan akan kesehatan.
 Lebih lanjut, penting bagi kesepian dan mempromosikan
pemerintah dan aktor lain untuk kesejahteraan psikologis yang
berkomunikasi tentang COVID- harus didukung. Mekanisme
19 dengan cara yang dukungan komunitas dan relawan
mempromosikan kesehatan yang sudah ada sebelumnya dan
mental dan kesejahteraan yang baru muncul yang
psikososial. Untuk mengurangi menargetkan orang-orang yang
penyebaran virus dan kecemasan rentan perlu diperkuat. Ini termasuk
dalam populasi, pemerintah dan dukungan untuk orang dewasa yang
aktor lain, termasuk outlet media, lebih tua, pekerja perawatan
perlu berkomunikasi secara teratur kesehatan garis depan, dan orang-
tentang pandemi, memberikan orang yang kehilangan mata
informasi berbasis bukti terkini pencaharian mereka. Upaya yang
dalam bahasa yang mudah membantu orang yang terisolasi
dipahami, dapat diakses, dan tetap terhubung, mengurangi
inklusif bagi masyarakat. semua kesepian (terutama pada orang
orang melalui saluran yang mereka dewasa yang lebih tua) dan
gunakan.53 Komunikasi semacam mengurangi kebosanan (terutama
itu harus dikomunikasikan dengan pada anak-anak dan remaja) harus
empati dan mencakup nasihat dipromosikan. Kesempatan bagi
tentang kesejahteraan emosional. orang yang berduka untuk berduka
Kecemasan yang tidak se/mestinya dengan aman harus dipastikan,
yang disebabkan oleh komunikasi dengan menghormati tradisi budaya
yang tidak konsisten, tidak dapat mereka. Organisasi berbasis
dipahami, atau mengancam perlu komunitas dan anggota masyarakat
dihindari. sipil lainnya dapat memainkan peran
2. Memastikan Ketersediaan Yang kunci dalam memperkuat dukungan
Luas Untuk Kesehatan Mental psikososial komunitas.
Darurat Dan Dukungan Akses dukungan jarak jauh
Psikososial perlu ditingkatkan untuk segala
Aksi masyarakat yang kebutuhan kesehatan mental.
memperkuat kohesi sosial, Ketika orang dipaksa untuk tinggal
solidaritas dan sehat di rumah, dukungan mungkin
menghadapinya, mengurangi dilakukan dari jarak jauh (misalnya
melalui telepon, teks atau video), pengobatan tatap muka untuk
tergantung pada konteks dan kondisi ringan atau sedang harus
kebutuhan orang tersebut. Intervensi diambil berdasarkan kasus per
psikologis cenderung sama kasus. Misalnya, perawatan
efektifnya apakah disampaikan kesehatan mental prenatal dan ibu
secara tatap muka atau melalui selalu menjadi prioritas meski
telepon atau video. Materi swadaya kondisinya tidak parah. Namun,
berkualitas tinggi (buku-buku 54 atau perawatan langsung untuk orang
program digital) dapat efektif bagi dengan gangguan mental,
banyak orang, terutama jika neurologis, atau penyalahgunaan zat
penyampaiannya dipandu oleh yang parah (misalnya, psikosis,
penolong terlatih.55 Kesempatan ini depresi berat, delirium, epilepsi,
untuk memperkenalkan inovasi ketergantungan zat) dan disabilitas
perawatan kesehatan mental yang psikososial harus tersedia.
dapat membantu meningkatkan Perawatan secara langsung perlu
kinerja layanan kesehatan mental di diberikan dengan cara yang aman,
masa depan. Namun, ketika dengan alat pelindung diri yang
menerapkan intervensi jarak jauh relevan.
berbasis teknologi, perawatan Perhatian prioritas perlu
diperlukan untuk memastikan diberikan untuk melindungi dan
kerahasiaan dan kesetaraan dalam mempromosikan hak asasi
akses. manusia orang dengan kondisi
Kesehatan mental dan kesehatan mental yang parah dan
perawatan sosial untuk orang- disabilitas psikososial; hak mereka
orang dengan kondisi kesehatan sering diabaikan dalam keadaan
mental yang parah dan disabilitas darurat besar. Orang dengan
psikososial harus menjadi bagian COVID-19 dan kondisi kesehatan
dari definisi layanan esensial di mental harus mendapatkan akses
semua negara. Pemerintah mungkin yang sama ke perawatan kesehatan
perlu memutuskan untuk tidak dan sosial seperti orang lain dengan
melanjutkan perawatan rutin untuk COVID-19, tanpa diskriminasi,
semua kondisi kesehatan karena termasuk dalam penilaian triase.
risiko infeksi. Keputusan untuk Tindakan kesehatan masyarakat
memulai atau melanjutkan yang membatasi pergerakan orang
 harus berlaku sama untuk semua perlu dibangun di seluruh sektor
orang, baik mereka memiliki kesehatan, sosial dan pendidikan
kondisi kesehatan mental atau tidak. untuk menangani kesehatan mental,
terutama di negara-negara
3. Dukungan Pemulihan dari Covid- berpenghasilan rendah dan
19 Dengan Membangun Layanan menengah. Program berbasis bukti
Kesehatan Mental Untuk Masa yang mempromosikan kesejahteraan
Depan psikososial membutuhkan anggaran
Kesehatan mental yang sesuai. Keadaan darurat dapat
membutuhkan investasi keseluruhan menjadi katalisator untuk
yang jauh lebih besar. Masalah yang membangun kembali layanan
berlangsung lama dan berkelanjutan kesehatan mental yang lebih baik,
adalah bahwa kesehatan mental - di berkelanjutan. Orang dengan
seluruh sektor kesehatan, sosial, pengalaman hidup dari kondisi
pendidikan, dan lainnya - sangat kesehatan mental harus dilibatkan
kekurangan dana. Negara-negara dalam penguatan layanan kesehatan
menghabiskan rata-rata hanya 2% mental. Investasi sekarang akan
dari anggaran kesehatan mereka mengurangi dampak kesehatan
untuk kesehatan mental. Mengingat mental dari COVID-19 dan akan
meningkatnya kebutuhan jangka membantu memastikan bahwa
panjang yang disebabkan oleh negara-negara lebih siap untuk
pandemi, inilah saatnya untuk membantu penduduknya agar tetap
mengatasi ketidaksetaraan dan sehat secara mental, darurat atau
mengatur layanan berbasis tidak.
masyarakat yang terjangkau dan Krisis saat ini telah sekali lagi
efektif serta melindungi hak asasi mengungkap risiko yang melekat
manusia sebagai bagian dari rencana dan semakin tinggi dari kehidupan
pemulihan nasional COVID-19. institusional. Banyak negara telah
Perawatan kesehatan mental harus menunjukkan bahwa rumah sakit
dimasukkan dalam paket tunjangan jiwa dapat ditutup dengan aman
perawatan kesehatan dan skema begitu perawatan tersedia di
asuransi untuk memastikan masyarakat. Sebagai bagian dari
kebutuhan kesehatan mental yang rencana jangka panjang untuk
penting tercakup. Kapasitas staf meningkatkan kualitas, jangkauan
dan efektivitas biaya dari layanan UNFPA, UNHCR, UNICEF,
kesehatan jiwa, dianjurkan untuk UNODC, WHO dan Kantor Utusan
mengalihkan investasi dari Sekretaris Jenderal untuk Pemuda -
pelembagaan ke perawatan meningkatkan kesehatan mental dan
kesehatan mental yang terjangkau respons psikososial mereka untuk
dan berkualitas di masyarakat. mendukung orang untuk
Penelitian perlu menjadi bagian mengatasinya COVID-19.
dari upaya pemulihan. Setiap Badan PBB akan meningkatkan
program untuk mengurangi atau penyertaan kesehatan mental dan
mengatasi masalah kesehatan dukungan psikososial dalam
mental yang disebabkan oleh pekerjaan mereka lintas sektor di
pandemi perlu dipantau dan negara-negara untuk meningkatkan
dievaluasi. Selain itu, penting untuk efektivitas dan dampak keseluruhan
memahami sejauh mana dari respons COVID-19 dan
konsekuensi kesehatan mental kegiatan pemulihan mereka.
(termasuk dampak neurologis dan Dimasukkannya kesehatan mental
penggunaan zat) COVID-19 dan dalam mekanisme respons COVID-
efek sosial dan ekonomi pandemi, 19 PBB yang ada sangat penting
berkonsultasi langsung dengan dalam Rencana Kesiapsiagaan dan
populasi yang terkena dampak. Respons WHO yang diperbarui,
Mengingat temuan yang Rencana Respons Kemanusiaan
diantisipasi, penelitian semacam itu Global yang diperbarui dan
kemungkinan akan memperkuat Kerangka Kerja PBB untuk Respons
upaya advokasi untuk kesehatan Sosial-ekonomi Segera terhadap
mental. Akuisisi pengetahuan yang COVID-19 dan Sekretaris -
cepat akan membutuhkan penetapan General's UN COVID-19 Response
prioritas penelitian, koordinasi and Recovery Fund.
penelitian, berbagi data terbuka dan Dukungan kesehatan mental dan
pendanaan. psikososial memiliki relevansi
dengan kesehatan, perlindungan dan
APA YANG PBB DAPAT layanan sosial, nutrisi, tenaga kerja,
LAKUKAN pendidikan, keadilan, dan domain
Berbagai badan PBB - termasuk pemerintahan lainnya. Di banyak
ILO, IOM, UNDP, UNESCO, negara, badan-badan PBB
membantu pemerintah nasional
dalam menetapkan strategi nasional
dan mekanisme koordinasi
multisektoral nasional dalam
penanggulangan pandemi. Mereka
dapat memastikan bahwa kesehatan
mental dipertimbangkan sepenuhnya
di seluruh kesehatan, tanggapan
sosial dan ekonomi, serta rencana
pemulihan pemerintah. Selain itu,
Resident and Humanitarian
Coordinator PBB dapat memastikan
bahwa kesehatan mental dan
dukungan psikososial disertakan
dalam koordinasi dan perencanaan
baik sekarang maupun untuk jangka
panjang. Kesehatan mental akan
tetap menjadi perhatian utama
bahkan ketika negara-negara
muncul dari pandemi dan memulai
sosial dan ekonomi. pemulihan.
 Policy Brief:
COVID-19 and the
Need for Action
on Mental Health

13 M AY 2 0 2 0
 EXECUTIVE SUMMARY:
COVID-19 and the
Need for Action
on Mental Health
Although the COVID-19 crisis is, in the first
instance, a physical health crisis, it has the
seeds of a major mental health crisis as well,
if action is not taken. Good mental health is
critical to the functioning of society at the best
of times. It must be front and centre of every
country’s response to and recovery from the
COVID-19 pandemic. The mental health and
wellbeing of whole societies have been severely
impacted by this crisis and are a priority to be
addressed urgently.
Psychological distress in populations is
widespread. Many people are distressed due
to the immediate health impacts of the virus
and the consequences of physical isolation.
Many are afraid of infection, dying, and
losing family members. Individuals have been
physically ­distanced from loved ones and
peers. Millions of people are facing economic
turmoil having lost or being at risk of losing
their income and livelihoods. Frequent mis-
information and rumours about the virus and
deep uncertainty about the future are common
sources of d
­ istress. A long-term upsurge in the
number and severity of mental health problems
is likely.
2 EXECUTIVE SUMMARY | UNITED NATIONS POLICY BRIEF: COVID-19 AND THE NEED FOR ACTION ON MENTAL HEALTH
Moreover, specific populations groups are
showing high degrees of COVID-19-related psy-
chological distress. Frontline healthcare work-
ers and first responders have been exposed to
numerous stressors and ensuring the mental
health of healthcare workers is a critical factor
in sustaining COVID-19 preparedness, response
and recovery. In every community, there
are numerous older adults and people with
pre-existing health conditions who are terrified
and lonely. Emotional difficulties among
children and adolescents are exacerbated by
family stress, social isolation, with some facing
increased abuse, disrupted education and
uncertainty about their futures, occurring at
critical points in their emotional development.
Women are bearing a large brunt of the stress
in the home as well as disproportionate impacts
more generally. And people caught in fragile
humanitarian and conflict settings risk having
their mental health needs overlooked entirely.
During the past few months, there have been
efforts initiated to support people in distress
and to ensure care for people with mental health
conditions. Innovative ways of providing mental
health services have been implemented, and
initiatives to strengthen psychosocial support
have sprung up.
Yet, because of the size of the problem, the
vast majority of mental health needs remain
unaddressed. The response is hampered by the
lack of investment in mental health promotion,
prevention and care before the pandemic.
This historic underinvestment in mental health
needs to be redressed without delay to reduce
immense suffering among hundreds of millions
of people and mitigate long-term social and
economic costs to society.
MINIMIZING CONSEQUENCES
To minimize the mental health consequences
of the pandemic, it is important to consider
urgently the following three recommended
actions:
1. APPLY A WHOLE-OF-SOCIETY APPROACH
TO PROMOTE, PROTECT AND CARE FOR
MENTAL HEALTH
Mental health actions need to be considered
essential components of the national response
to COVID-19. A whole-of-society approach for
mental health in COVID-19 means:
• including mental health and psychosocial
considerations in national response plans
across relevant sectors, for example support-
ing learning and nurturing environments for
children and young people who are confined
at home;
• responding proactively to reducing pandem-
ic-related adversities that are known to harm
mental health, for example domestic violence
and acute impoverishment; and
• crafting all communications to be sensitive
of their potential impact on people’s mental
EXECUTIVE SUMMARY | UNITED NATIONS POLICY BRIEF: COVID-19 AND THE NEED FOR ACTION ON MENTAL HEALTH
health, for example by communicating empa-
thy for people’s distress and including advice
for their emotional well-being.
2. ENSURE WIDESPREAD AVAILABILITY
OF EMERGENCY MENTAL HEALTH AND
PSYCHOSOCIAL SUPPORT
Mental health and psychosocial support must
be available in any emergency. Achieving this
objective during the COVID-19 pandemic means:
• supporting community actions that
strengthen social cohesion and reduce
­loneliness, for example supporting
activities that help isolated older adults
stay connected;
• investing in mental health interventions
that can be delivered remotely, for example
quality-assured tele-counselling for frontline
health-care workers and people at home with
depression and anxiety;
• ensuring uninterrupted in-person care for
severe mental health conditions by formally
defining such care as essential services to be
continued throughout the pandemic; and
• protecting and promoting the human rights of
people with severe mental health conditions
and psychosocial disabilities, for example, by
monitoring whether they have equal access to
care for COVID-19.
3. SUPPORT RECOVERY FROM COVID-19 BY
BUILDING MENTAL HEALTH SERVICES FOR
THE FUTURE
All affected communities will need quality men-
tal health services to support society’s recovery
from COVID-19, and this requires investment in
the following:
• using the current momentum of interest
in mental health to catalyze mental health
reforms, for example by developing and
3
 funding the implementation of national
services re-organization strategies that
shift care away from institutions to commu-
nity services;
• making sure that mental health is part of
universal health coverage, for example by
including care for mental, neurological and
substance use disorders in health care
benefit packages and insurance schemes;
• building human resource capacity to deliver
mental health and social care, for example
4 EXECUTIVE SUMMARY | UNITED NATIONS POLICY BRIEF: COVID-19 AND THE NEED FOR ACTION ON MENTAL HEALTH
among community workers so that they can
provide support; and
• organizing community-based services that
protect and promote people’s human rights,
for example by involving people with lived
experience in the design, implementation
and monitoring of services.
Rapid implementation of these recommended
actions will be essential to ensure people and
societies are better protected from the mental
health impact of COVID-19.
1. Impact of COVID-19
on Mental Health

way we interact, connect, learn, work and expe-

THE GLOBAL MENTAL
HEALTH CONTEXT
Mental health is a state of mental well-being in
which people cope well with the many stresses
of life, can realize their own potential, can
function productively and fruitfully, and are able
to contribute to their communities.1
Mental health has large intrinsic value as it
relates to the core of what makes us human: the
rience suffering and happiness. Good mental
health supports the capability of individuals to
display healthy behaviour that keeps themselves
and others safe and healthy during the pan-
demic. Good mental health also facilitates that
people perform in key roles within families, com-
munities and societies, whether taking care of
children and older adults or contributing to their
community’s economic recovery. Good mental
health is critical to each country’s response to,
and recovery from, COVID-19.

Before COVID-19 emerged, statistics on mental health conditions (including neurological and sub-
stance use disorders, suicide risk and associated psychosocial and intellectual disabilities) were
already stark:
• The global economy loses more than US$ 1 trillion per year due to depression and anxiety.
• Depression affects 264 million people in the world.
• Around half of all mental health conditions start by age 14, and suicide is the second leading cause
of death in young people aged 15-29.
• More than 1 in 5 people living in settings affected by conflict have a mental health condition.
• People with severe mental conditions die 10-20 years earlier than the general population.
• Fewer than half of countries report having their mental health policies aligned with human rights
conventions.2
• In low- and middle- income countries between 76% and 85% of people with mental health conditions
receive no treatment for their condition, despite the evidence that effective interventions can be
delivered in any resource context.3
• Globally there is less than 1 mental health professional for every 10,000 people.
• Human rights violations against people with severe mental health conditions are widespread in all
countries of the world.

1 https://www.who.int/en/news-room/fact-sheets/detail/mental-health-strengthening-our-response

2 Of the 139 countries that have mental health plans and policies in place, fewer than half report having these aligned with human rights
conventions. Source: WHO (https://www.who.int/news-room/facts-in-pictures/detail/mental-health)
3 https://www.who.int/news-room/fact-sheets/detail/mental-disorders

IMPACT OF COVID-19 | UNITED NATIONS POLICY BRIEF: COVID-19 AND THE NEED FOR ACTION ON MENTAL HEALTH 5
 Mental health is one of the most neglected areas
of health. Despite the impact of mental health
conditions on individuals, families and society,
there has been little investment in mental health,
particularly in community-based services.
Countries spend on average only 2% of their
health budgets on mental health; the average
spent by other sectors is unknown but expected
to be a tiny fraction of that. International
development assistance for mental health is
estimated to be less than 1% of all development
assistance for health.4 This is despite the
well-documented comorbidity of physical and
mental health conditions for diseases such as
HIV/AIDS and TB; and now for COVID-19.5
FIGURE 1
National surveys in 2020
reveal high prevalence of distress
in the population during COVID-19
People's Rep.
of China 35%
Iran
60%
USA
45%
IMPACT OF THE COVID-19
PANDEMIC ON MENTAL HEALTH
When crises affect people’s lives and communi-
ties, high levels of stress are expected. Adversity
is a well-established risk factor for short and
long-term mental health problems.6 Research
on past epidemics has highlighted the negative
impact of outbreaks of infectious diseases on
people’s mental health.7,8,9
A key message from the Lancet Commission
on global mental health and sustainable
development10 is that mental health prob-
lems exist along a continuum from mild,
time-limited distress to severe mental
health conditions. The COVID-19 pandemic
influences where people are situated on
that continuum. Many people who previ-
ously coped well, are now less able to cope
because of the multiple stressors generated
by the pandemic. Those who previously had
few experiences of anxiety and distress,
may experience an increase in number
and intensity of these and some have
developed a mental health condition. And
those who previously had a mental health
condition, may experience a worsening of
their condition and reduced functioning.

0 20 40 60 80 100
The evidence thus far confirms widespread
% of distressed individuals psychological distress in COVID-19 affected pop-
ulations, as reported in national surveys.11,12,13

4 Gilbert et al, 2015

5 Kong X et al, 2020
6 Dohrenwend, 2000
7 Shultz et al, 2015
8 Tsang et al, 2014
9 Yip et al, 2010
10 L ancet Commission on global mental health and sustainable development, 2018
11 Qiu et al, 2020
12 Jahanshahi et al, 2020
13 Kaiser Family Foundation, 2020

6 IMPACT OF COVID-19 | UNITED NATIONS POLICY BRIEF: COVID-19 AND THE NEED FOR ACTION ON MENTAL HEALTH
People’s distress is understandable given
the impact of the pandemic on people’s lives.
During the COVID-19 emergency, people are
afraid of infection, dying, and losing family
members. At the same time, vast numbers
of people have lost or are at risk of losing
their livelihoods, have been socially isolated
and separated from loved ones, and, in some
countries, have experienced stay-at-home
orders implemented in drastic ways. Women
and children have also experienced increased
domestic violence and abuse. Widespread
misinformation about the virus and prevention
measures and deep uncertainty about the
future are additional major sources of distress.
Repeated media images of severely ill people,
dead bodies and coffins add to the fear. The
knowledge that people may not have the
opportunity to say goodbye to dying loved ones
and may not be able to hold funerals for them
further contributes to distress.
Not surprisingly, higher-than-usual levels of
symptoms of depression and anxiety have been
recorded in various countries. A large study in
Amhara Regional State, Ethiopia, in April 2020,
reported an estimated 33% prevalence rate of
symptoms consistent with depressive disorder,14
a 3-fold increase compared to estimates from
Ethiopia before the epidemic.15
To deal with the stressors, people may resort
to different negative ways of coping, including
use of alcohol, drugs, tobacco or spending
more time on potentially addictive behaviours
such as online gaming. Statistics from Canada
report that 20% of the population aged 15-49
14 Ambaw et al, unpublished data, 2020
15 Bitew, 2014
16 https://www150.statcan.gc.ca/n1/pub/11-627-m/11-627-m2020029-eng.htm
17 Case & Deaton, 2020
18 Patel, in press
19 Dimbylow, 2020
IMPACT OF COVID-19 | UNITED NATIONS POLICY BRIEF: COVID-19 AND THE NEED FOR ACTION ON MENTAL HEALTH
increased their alcohol consumption during the
pandemic.16
The long-term impact of the crisis on people’s
mental health and in turn the mental health
impact on society should not be overlooked. As
a result of the 2008 economic crisis, a rise in
“deaths of despair” was recorded among work-
ing age Americans.17 Suicide and substance-use
related mortality accounted for most of these
deaths, which were linked to loss of hope due
to the lack of employment and rising inequality.
As the economic burden of COVID-19 rises, a
similar toll on people’s mental health may be
anticipated, 18 with a major impact on individuals,
families and the wider society.
“Having my treatment come
to such an abrupt end was
devastating ... I was far from
stable, and the prospect of
suddenly having my support
withdrawn was frightening.” 19
Effects of COVID-19 on the brain are of concern.
Neurological manifestations have been noted
in numerous countries in people with COVID-19.
Moreover, the social consequences of the
pandemic may affect brain health development
in young children and adolescents and cognitive
decline in the older population. Urgent action
is needed to prevent long-term impact on the
brains of both the youngest and eldest members
of our society.
7

Impact on brain health:
• COVID-19 can cause neurological mani-
festations, including headache, impaired
sense of smell and taste, agitation, delir-
ium, stroke and meningo-encephalitis.20
• Underlying neurological conditions
increase the risk of hospitalization for
COVID-19, especially for older adults.21
• Stress, social isolation and violence in
the family are likely to affect brain health
and development in young children and
adolescents.22
• Social isolation, reduced physical activ-
ity and reduced intellectual stimulation
increase the risk of cognitive decline and
dementia in older adults.23
IMPACT OF COVID-19 ON
MENTAL HEALTH SERVICES
Before the pandemic, in most communities of
the world and particularly in many humanitarian
and conflict settings, there was already limited
access to quality, affordable mental health care.
This access has now been further diminished
due to COVID-19 as the pandemic has disrupted
services around the world. Key factors affecting
services are: infection and risk of infection in
long-stay facilities, including care homes and
psychiatric institutions; barriers to meeting
people face-to-face; mental health staff being
infected with the virus; and the closing of mental
health facilities to convert them into care facili-
ties for people with COVID-19.24
According to the International Long-Term
Care Policy Network approximately half of
all COVID-19- related deaths in Australia,
Belgium, Canada, France, Ireland, Norway
and Singapore occur among residents of
long-term care facilities, with mortality
rates ranging from 14% to 64%. 25 Many of
these long-term facilities are homes cater-
ing for people with dementia.
Outpatient mental health services around
the world have also been severely affected.
Demand for face-to-face mental health services
has significantly decreased because of fear of
infection, particularly among older people.26
Many services have had to switch to remote
mental health care.27 There is increased focus
on digital self-help and digital mental health
services and parenting programmes (including
the use of more basic technologies such as the
telephone and SMS). Such approaches can be
effective and scalable, though their limitation
is that illiterate, poor and older populations
have much less internet or telecommunications
access, and such approaches are not an answer
for all mental health needs. Other modalities of
care continue to be important.

20 Mao et al, 2020; Helms et al 2020; Sedaghat & Karimi, 2020, Spinato et al, 2020, Toscano et al, 2020, Moriguchi et al, 2020; Klok et al,
2020; Virani et al, 2020
21 Garg S et al, 2020
22 https://unsdg.un.org/resources/policy-brief-impact-covid-19-children
23 WHO, 2019
24 Sani et al, 2020
25 https://ltccovid.org/wp-content/uploads/2020/04/Mortality-associated-with-COVID-17-April-1.pdf
26 Khoury & Karam, 2020
27 Fagiolini et al, 2020

8 IMPACT OF COVID-19 | UNITED NATIONS POLICY BRIEF: COVID-19 AND THE NEED FOR ACTION ON MENTAL HEALTH

Mental health services have had to find
innovative ways to reorganize and adapt
service provision to ensure continuity
of care during the pandemic. The city of
Madrid, for example, was forced to recon-
vert over 60% of its mental health beds to
care for people with COVID-19, reducing
the number of people attending emergency
mental health services by 75%. To deal with
this, mental health services had to adapt
quickly. Where possible, people with severe
conditions were moved to private clinics
to ensure continuity of care as an action of
solidarity. Local policy-makers identified
emergency psychiatry an essential ser-
vice to enable mental health-care workers
to continue outpatient services over the
phone. Home visits were organized for the
most serious cases. It was also necessary
to partner with IT experts, to enable mental
health staff working from home to access
electronic clinical records while maintaining
confidentiality.28
Mental health and psychosocial support
delivered at the community level have also been
critically impacted. For instance, groups, associ-
ations and community-based initiatives that used
to bring people together regularly before the pan-
demic (e.g., senior citizens clubs, youth groups,
sports clubs, organizations for people with
lived experience and their families, mutual-help
groups for alcohol and drug dependence, cultural
programmes) — offering social support, meaning
and a sense of belonging — have not been able to
meet for several months.29
Many organizations offering protection and
psychosocial support to specific populations at
increased risk (see section 2) are unable to cope
28 Arrango et al. 2020,
29 Flint et al, 2020
30 Lee, 2020
IMPACT OF COVID-19 | UNITED NATIONS POLICY BRIEF: COVID-19 AND THE NEED FOR ACTION ON MENTAL HEALTH
with increasing needs, while movement restric-
tions and fear of contagion impede service
delivery. In the same way, school-based mental
health services have been seriously affected
and many of these services are not able to
provide adequate care using remote methods.30
The m
­ illions of children who were already out
of school and live or work on the streets and
routinely faced severe and persistent rights
violations, are even more vulnerable to these
additional stressors and lack access to services.
Sustaining and strengthening mental health
services and programmes must be a priority
to address current and future mental health
needs and help prevent a rise in mental ill health
in the future. The response to the pandemic
is an opportunity to improve the scale and
cost-­effectiveness of various mental health
interventions.
Some examples of mental health and
­psychosocial support during the pandemic
include:
• In Lebanon, the Ministry of Public Health
has launched an action plan comprehen-
sively addressing mental health aspects
of COVID-19.
• Teams from Egypt, Kenya, Nepal,
Malaysia and New Zealand, among
others, have reported creating increased
capacity of emergency telephone lines
for mental health to reach people in need.
This includes reports of services that
have helped usher in innovations that are
designed to continue post-pandemic.
• In the Bahamas, recently devastated by
Hurricane Dorian, the Government, UN
agencies and non-governmental
continues
9
 continued from previous page
organizations are coming together
to respond to the mental health and
psychosocial consequences of the
COVID-19 pandemic.
• A mental health non-governmental
organization in Pakistan had to close
vocational training centres for economic
empowerment, but people with mental
health conditions who had been attend-
ing the training centres started sewing
cloth face-masks for health responders
to support their communities.
• In Nigeria, the Nigerian Association
of Psychiatrists, the Association of
Psychiatric nurses, clinical health work-
ers as well as major mental health NGO’s
came together to form the Covid19
Partners in Mental Health. They work
with both government and civil society to
offer training on mental health, telether-
apy and research.
COMMUNITY SOCIAL SUPPORT
DURING THE PANDEMIC
Much of the adversity caused by the COVID-19
pandemic stems from the impact on social
connections because of physical distancing. Yet,
this does not mean that there is no resilience.
There are many examples of emerging commu-
nity supports. Indeed, all communities — even
those affected by horrendous hardship — contain
naturally-occurring psychosocial support and
sources of resilience.
People around the world are showing actions
of solidarity and offering informal psychosocial
10 IMPACT OF COVID-19 | UNITED NATIONS POLICY BRIEF: COVID-19 AND THE NEED FOR ACTION ON MENTAL HEALTH
support to one other. For example, there are
numerous reports around the world of younger
adults reaching out to isolated older adults,
helping them address their basic needs and
reducing their loneliness. Without prompting,
many long-term care facilities have set up ways
for residents to speak with family members to
ensure support and connection. The celebration
of frontline health-care workers every evening
at the same time — by clapping and cheering
from windows and balconies — across cities
in numerous countries shows the solidarity
that many feel and seek to express. Numerous
individuals, while forced to stay at home, have
taken the opportunity to re-connect with distant
relatives and friends.
In settings with internet access, people’s mental
well-being has been supported through the
creation of online support groups and social
communities to combat loneliness and boredom
and reinforce social connectedness, to dissemi-
nate positive messages of hope and unity, and to
mobilize community volunteers to assist those
who need help.
Some of the positive observations on solidarity
may not endure if people lose hope or become
intolerant towards physical distancing measures,
but the experience is that all communities
have helpful, embedded resources that need to
be supported. Governments can make funds
available for helpful community initiatives
because it is important, now more than ever, to
activate and strengthen local support, especially
for marginalized people, and encourage a spirit
of community self-help to protect and promote
mental well-being.
2. Specific Populations
of Concern

Specific populations groups have been affected
by COVID-19 in different ways. Some of these are
highlighted in this brief:
> First responders and frontline workers,
particularly workers in health and long-term
care play a crucial role in fighting the outbreak
and saving lives. However, they are under
exceptional stress, being faced with extreme
workloads, difficult decisions, risks of becom-
ing infected and spreading infection to families
and communities, and witnessing deaths of
patients. Stigmatization of these workers is
common in too many communities.31 There
have been reports of suicide attempts and
suicide death by health-care workers.32
Mental health of healthcare workers during
COVID-19 pandemic
• In Canada, 47% of health-care workers
reported a need for psychological support.33
• In the People’s Republic of China, healthcare
workers reported high rates of depression
(50%), anxiety (45%), and insomnia (34%).34
• In Pakistan, large numbers of health-care
workers have reported moderate (42%) to
severe (26%) psychological distress.35
Reports from Chile, Italy, Spain, the Philippines,
the United Arab Emirates, the United Kingdom
and the United States of America document how
dedicated teams provide mental health support
for health-care workers. All countries need to
ensure that this vital section of society continues
to play its critical role in helping to end the
outbreak. Guidance on how to do this has been
made available for Red Cross and Red Crescent
volunteers who play an important part in the
response in many countries.36
> Older adults and people with pre-existing
health conditions are at substantial risk of
life-threatening complications from COVID-19.
Approximately 8 out of 10 reported deaths in
the USA and Germany occurred in people aged
65 years or older37 or 70 years and older,38
respectively. It is understandable that many
older adults and people with pre-existing
conditions (e.g., heart disease, hypertension)
are currently extremely worried about being
infected with the virus and not having access to
appropriate care. Some of them, including those
with cognitive impairments, may have difficulty
accessing advice on infection prevention and
are at higher risk of isolation. Loneliness is a
major risk factor for mortality in older adults.39

31 IFRC, UNICEF, & WHO, 2020

32 https://www.theguardian.com/us-news/2020/apr/28/dr-lorna-breen-new-york-er-coronavirus
33 https://potloc.com/blog/en/potloc-study-canadian-health-workers-insights-front-lines-covid-19-pandemic/
34 Lai et al, 2020
35 Tamizuddin Nizami, unpublished data, 2020
36 https://pscentre.org/wp-content/uploads/2020/03/IFRC-Brief-guidance-note-on-caring-for-volunteers-in-COVID-19.pdf
37 https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/older-adults.html
38 https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Situationsberichte/2020-04-25-en.pdf?__blob=publicationFile
39 Rico-Uribe et al, 2018

SPECIFIC POPULATIONS | UNITED NATIONS POLICY BRIEF: COVID-19 AND THE NEED FOR ACTION ON MENTAL HEALTH 11
 Moreover, older adults have been reported to
be victims of stigma and abuse. A UN policy
brief on older persons and COVID-19 has
been released that details recommendations
on how to address the needs of this popu-
lation group.40

> Many children’s emotional state and behav-
iour has been affected during confinement
according to reports by Italian and Spanish
parents.41 Moreover, children, including ado-
lescents, are at particular risk of abuse during
the pandemic. Children with disabilities,
children in crowded settings and those who
live and work on the streets are particularly
vulnerable. A UN Policy Brief on the impact
of COVID-19 on children has been published
specifically on this topic with recommen-
dations on how to address children’s risks
and needs.42
A committee of UN and non-UN agencies
has published the book My Hero is You 43
to help children aged 6-11 years cope with
their worries about COVID-19. Based on
interviews with more than 1700 children,
parents, caregivers and teachers from
around the world, the book’s messages have
resonated with children from different back-
grounds and cultures. The book is being
translated into more than 100 languages
and is reaching children affected by conflict
and forced displacement in Bangladesh,
Greece, Iraq, Nigeria, Syria, and Yemen.44

FIGURE 2

Parents’ reports of children’s difficulties during COVID-19 confinment (Italy and Spain)

Feelings of Loneliness 31%

Nervousness 38%
Difficulty

Restlessness 39%

Irritability 39%

Difficulty Concentrating 77%

0 20 40 60 80 100

Percentage of children

40 h
 ttps://www.un.org/development/desa/ageing/wp-content/uploads/sites/24/2020/04/POLICY-BRIEF-ON-COVID19-AND-OLDER-
PERSONS.pdf
41 Orgilés et al, 2020
42 https://unsdg.un.org/sites/default/files/2020-04/160420_Covid_Children_Policy_Brief.pdf
43 h
 ttps://interagencystandingcommittee.org/iasc-reference-group-mental-health-and-psychosocial-support-emergency-settings/
my-hero-you
44 https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19--22-april-2020

12 SPECIFIC POPULATIONS | UNITED NATIONS POLICY BRIEF: COVID-19 AND THE NEED FOR ACTION ON MENTAL HEALTH
> Adolescents and young people are also an
at-risk group in the present crisis, as most
mental health conditions develop during this
period of life. Many young people have seen
their futures impacted. For example, schools
have been closed, examinations have not been
held, and economic prospects have dimin-
ished. A study carried out with young people
with a history of mental health needs living in
the UK reports that 32% of them agreed that
the pandemic had made their mental health
much worse.45 The main sources of distress
included concerns about their family’s health,
school and university closures, loss of routine
and loss of social connection. Provision of
mental health services must include specific
actions tailored for this population.46
> Women are another population with specific
concerns. A survey on stress levels in the
Indian population during the COVID-19 pan-
demic indicated that 66% of women reported
being stressed as compared to 34% of men.
During the current situation of COVID-19,
pregnant and new mothers are especially likely
to be anxious due to difficulties accessing
services and social support and fear about
infection. In some family arrangements there
is an increased burden due to additional duties
of caregiving such as homeschooling and tak-
ing care of older relatives. As with childhood
abuse, the situation of stress and restrictions
on movement increases violence towards
women. It has been estimated that globally
31 million additional cases of gender-based
violence can be expected to occur if the
restrictions continue for at least 6 months.47
A UN Policy Brief has been published looking
specifically at the impact of COVID-19 on
women and the measures that need to be
taken now to address this impact.48
> People in humanitarian and conflict settings
whose mental health needs are often
overlooked require more attention. Evidence
indicates that in conflict settings 1 in 5
people have a mental health condition.49 The
situation of the pandemic may exacerbate
existing mental health conditions, induce new
conditions and limit access to the already
scarce mental health services available.
Moreover, it is often difficult to adhere to
measures for infection prevention (such as
physical distancing) for people in humanitar-
ian settings, such as refugees or internally
displaced people living in crowded camps or
settlements. This increases risks for COVID-
19 infection and generates high levels of
stress50. No COVID-19-related mental health
data are available yet for people in humanitar-
ian and conflict settings, but data on migrants
are worrisome.51 The Inter-Agency Standing
Committee (IASC) has recommended a range
of key actions to minimize and address the
impact of COVID-19 on mental health and psy-
chosocial well-being.52 The IASC Reference
Group on Mental Health and Psychosocial
Support is supporting mental health and
psychosocial support coordination groups in
more than 20 humanitarian emergencies to
strengthen the local humanitarian response
in the face of COVID-19.

45 Young Minds, 2020

46 https://www.unicef.org/coronavirus/how-teenagers-can-protect-their-mental-health-during-coronavirus-covid-19
47 U NFPA, 2020 https://www.unfpa.org/press/new-unfpa-projections-predict-calamitous-impact-womens-health-covid-19-pandemic-­
continues
48 h
 ttps://www.unwomen.org/-/media/headquarters/attachments/sections/library/publications/2020/policy-brief-the-impact-of-covid-19-
on-women-en.pdf?la=en&vs=1406
49 Charlson et al, 2019
50 Subbaraman, 2020
51 Liem & Hall, unpublished data, 2020
52 https://interagencystandingcommittee.org/iasc-reference-group-mental-health-and-psychosocial-support-emergency-settings/
briefing-note-about

SPECIFIC POPULATIONS | UNITED NATIONS POLICY BRIEF: COVID-19 AND THE NEED FOR ACTION ON MENTAL HEALTH 13
 3. Recommended
actions
The impacts of the pandemic already have and
will continue to have profound mental health con-
sequences. Implementation of recommended
actions below by national decision-makers will
help minimize and address these consequences:
1. APPLY A WHOLE-OF-SOCIETY APPROACH
TO PROMOTE, PROTECT AND CARE FOR
MENTAL HEALTH
Inclusion of mental health and psychosocial
considerations in COVID-19 national response
is essential because it improves quality of
programming, enhances coping skills of people
during the crisis, reduces suffering, and is likely
to speed up the recovery and rebuilding of
communities. During the pandemic, government
decision-makers across sectors (health, security,
social services, education, communications)
must consider how their actions impact mental
health. For example, stay-at-home emergency
measures (as well as the lifting of these
measures) need to be planned and implemented
across sectors in such a manner that they
minimize effects on people’s mental wellbeing.
Engagement of and accountability to citizens
in the shared endeavour of containing the virus
fosters acceptance of such measures and is
likely to help protect people’s mental health.
Everything needs to be done to protect people
from pandemic-related adversities that are
known to harm mental health. Social and
53 https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public
14 RECOMMENDED ACTIONS | UNITED NATIONS POLICY BRIEF: COVID-19 AND THE NEED FOR ACTION ON MENTAL HEALTH
financial protection measures are necessary to
prevent people from the impact of losing liveli-
hoods or economic prospects and deepening
inequalities. Alternative learning opportunities
need to be offered to children and adolescents
out of school. Prevention and redress of
domestic violence — whether against women,
children, older adults, or persons with disability
— should be a key part of national COVID-19
response plans. National frameworks to address
discrimination against health-care workers and
people who have or have had COVID-19 must
be established and implemented in countries
where such discrimination exists. It is important
to ensure protection and care of people in
institutions — whether they are run by the social
or health sector.
Further, it is important for governments and
other actors to communicate about COVID-19 in
ways that promote mental health and psycho-
social well-being. To reduce the spread of the
virus and anxiety in the population, governments
and other actors, including media outlets, need
to communicate regularly about the pandemic,
providing up-to-date evidence-based information
in plain language that people understand, acces-
sible and inclusive to all people through channels
that they use.53 Such communication should be
communicated with empathy and include advice
on emotional well-being. Undue anxiety caused
by inconsistent, incomprehensible or threatening
communication needs to be avoided.
2. ENSURE WIDESPREAD AVAILABILITY
OF EMERGENCY MENTAL HEALTH AND
PSYCHOSOCIAL SUPPORT
Community action that strengthens social
cohesion, solidarity and healthy coping,
reduces loneliness and promotes psychosocial
well-being should be supported. Pre-existing
and emerging community and volunteer
support mechanisms targeting vulnerable
people need to be strengthened. This includes
supports for older adults, frontline health-care
workers, and people who have lost their
livelihoods. Efforts that help isolated people
stay connected, reduce loneliness (especially in
older adults) and reduce boredom (especially in
children and adolescents) should be promoted.
Opportunities for the bereaved to mourn safely
should be ensured, with respect for their
cultural traditions. Community-based organi-
zations and other members of civil society can
play a key role in strengthening community
psychosocial supports.
Access to remote support needs to be scaled
up for any mental health need. When people
are forced to stay at home, support may be
remote (e.g. through telephone, text or video),
depending on the context and the person’s
needs. Psychological interventions tend to be
equally effective whether they are delivered
face-to-face or through phone or video. High
quality self-help materials (books 54 or digital
programmes) can be effective for many people,
especially if their delivery is guided by a trained
helper.55 This is an opportunity to introduce
innovations to mental health care that can
help improve the performance of future mental
54 https://www.who.int/publications-detail/9789240003927
55 WHO, 2015
56 Resnick & Gooding, 2020
57 WHO & UNICEF, 2020
58 Weissbecker et al, 2020
59 https://www.un.org/sites/un2.un.org/files/sg_policy_brief_on_persons_with_disabilities_final.pdf
RECOMMENDED ACTIONS | UNITED NATIONS POLICY BRIEF: COVID-19 AND THE NEED FOR ACTION ON MENTAL HEALTH
health services. However, when implementing
remote, technology-based interventions,
care is required to ensure confidentiality and
equity in access.56
Mental health and social care for people
with severe mental health conditions and
psychosocial disabilities must be part of the
definition of essential services in all countries.
Governments may need to decide not to
continue routine care for all health conditions
because of risk of infection. The decision to
initiate or continue in-person treatment for mild
or moderate conditions should be taken on a
case-by-case basis. For example, prenatal and
maternal mental healthcare is always a priority
even when the condition is not severe. However,
in-person care for people with severe mental,
neurological or substance use disorders
(e.g., psychosis, severe depression, delirium,
epilepsy, substance dependence) and psycho-
social disabilities must be available. In-person
care needs to be delivered in a safe manner,
with relevant personal protective equipment.57
Priority attention needs to be given to
protecting and promoting the human rights of
people with severe mental health conditions
and psychosocial disabilities; their rights are
frequently neglected in major emergencies.58
People with both COVID-19 and mental health
conditions should get equal access to health
and social care as other people with COVID-19,
without discrimination, including in triage
assessments. Public health measures that limit
people’s movement should apply equally to
all people, whether they have a mental health
condition or not.59
15
 3. SUPPORT RECOVERY FROM COVID-19 BY
BUILDING MENTAL HEALTH SERVICES FOR
THE FUTURE
Mental health requires much larger overall
investment. An ongoing, longstanding issue
is that mental health — across health, social,
education and other sectors — has been heavily
underfunded. Countries spend on average only
2% of their health budgets on mental health.
Given the increased long-term needs caused by
the pandemic, this is the time to address inequity
and organize affordable community-based
services that are effective and protective of
people’s human rights as part of any national
COVID-19 recovery plan.60 Mental health
care must be included in health care benefit
packages and insurance schemes to ensure
essential mental health needs are covered.
Capacity of staff needs to be built across health,
social and educational sectors to address
mental health, especially in low and middle
income countries. Evidence-based programmes
that promote psychosocial wellbeing require
appropriate budgets. Emergencies can be a
catalyst for building back better, sustainable,
mental health services. 61 People with lived
experience of mental health conditions should
to be involved in the strengthening of mental
health services. Investments now will reduce
the mental health impact of COVID-19 and will
help ensure that countries are better prepared to
help their populations to stay mentally healthy,
emergency or not.
The current crisis has once again exposed the
inherent and heightened risks of institutional
living. Many countries have shown that mental
60 https://apps.who.int/iris/bitstream/handle/10665/310981/WHO-MSD-19.1-eng.pdf?ua=1
61 WHO, 2013
62 WHO, 2014
63 Holmes et al, 2020
64 https://interagencystandingcommittee.org/system/files/2020-05/Global%20Humanitarian%20Response%20Plan%20%28GHRP%29-
COVID19_MayUpdate.pdf
16 RECOMMENDED ACTIONS | UNITED NATIONS POLICY BRIEF: COVID-19 AND THE NEED FOR ACTION ON MENTAL HEALTH
hospitals can be safely closed once care is
available in the community.62 As part of a longer-
term plan to improve the quality, reach and
cost-effectiveness of mental health services, it
is recommended to shift investments away from
institutionalization to affordable, quality mental
health care in the community.
Research needs to be part of recovery efforts.
Any programmes to reduce or address mental
health problems created by the pandemic
need to be monitored and evaluated. Also, it is
important to understand the extent of the mental
health consequences (including the neurological
and substance use impact) of COVID-19 and the
social and economic effects of the pandemic,
directly consulting with the affected populations.
Given the anticipated findings, such research
will likely strengthen advocacy efforts for mental
health. Rapid knowledge acquisition will require
establishment of research priorities, 63 research
coordination, open-data sharing and funding.
WHAT THE
UNITED NATIONS CAN DO
A range of UN agencies — including ILO, IOM,
UNDP, UNESCO, UNFPA, UNHCR, UNICEF,
UNODC, WHO and the Office of the Secretary-
General’s Envoy on Youth — are scaling up their
mental health and psychosocial response to
support people to cope with COVID-19.64
UN agencies will increase inclusion of mental
health and psychosocial support in their work
across sectors in countries to improve the over-
all effectiveness and impact of their COVID-19
response and recovery activities. The inclusion
of mental health in existing UN COVID-19
response mechanisms is critical in the updated
WHO Strategic Preparedness and Response
Plan, 65 the updated Global Humanitarian
Response Plan 66 and the UN Framework for
the Immediate Socio-economic Response to
COVID-1967 and the Secretary-General’s UN
COVID-19 Response and Recovery Fund.68
Mental health and psychosocial support have
relevance to health, protection and social
services, nutrition, labour, education, justice and
other domains of government. In numerous
countries, the UN agencies are assisting national
governments in establishing national strategies
and national multisectoral coordination
mechanisms on the pandemic response.
They can make sure that mental health is fully
considered across governments’ health, social
and economic responses and recovery plans.
Moreover, UN Resident and Humanitarian
Coordinators can ensure that mental health and
psychosocial support is included in coordination
and planning both now and for the longer term.69
Mental health will remain a core concern even
as countries emerge from the pandemic and
embark on social and economic recovery.

65 WHO, in press
66 h
 ttps://interagencystandingcommittee.org/system/files/2020-05/Global%20Humanitarian%20Response%20Plan%20%28GHRP%29-
COVID19_MayUpdate.pdf
67 https://unsdg.un.org/resources/un-framework-immediate-socio-economic-response-covid-19
68 https://www.un.org/sites/un2.un.org/files/sg_response_and_recovery_fund_fact_sheet.pdf
69 In December 2019, the executive heads of UN humanitarian agencies together with their counterparts in the Red Cross and Red Crescent
Movement and civil society, formally committed to treat mental health and psychosocial support as a cross-cutting issue in all human-
itarian emergencies with relevance especially to health, protection, education, nutrition and camp coordination and camp management
clusters/sectors.

RECOMMENDED ACTIONS | UNITED NATIONS POLICY BRIEF: COVID-19 AND THE NEED FOR ACTION ON MENTAL HEALTH 17