Opinion: Now is the time to prioritize mental health

It is estimated that only 2% of people around the world have access to mental health and psychosocial support, or MHPSS. The question is, will COVID-19 offer us a chance to change this? Batten’s Kirsten Gelsdorf and Lucy Bassett provide critical insights into the barriers to progress in MHPSS interventions, and identify opportunities to prioritize and invest in new programs going forward.

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May is mental health awareness month, and for many of us these days, it’s rare that an hour goes by without someone sending us an article or a list of tips on how to address our anxiety, build our children’s resilience, or focus on wellness during this difficult time.

This may be one of the bright spots in the coronavirus crisis: For many in Europe and the United States, attending to our mental health is becoming a core part of our crisis response. But for millions of people around the world also caught in crises — whether those crises are hurricanes, conflicts, experiences of mass displacement, or other humanitarian catastrophes — it is estimated that only 2% have access to mental health and psychosocial support, or MHPSS. The question is, will COVID-19 offer us a chance to change this?

Although the mental health impacts of emergencies have long been recognized, formalized efforts to systematically address and mitigate these impacts only began in the early 2000s, when the United Nations and its humanitarian partners began developing and advancing guidelines concerning the protection and promotion of human well-being as well as the prevention and treatment of mental disorders.

Yet today, funds allocated to MHPSS in emergencies are still just a drop in the bucket of the total humanitarian response. Although 20% of emergency health care needs in crisis contexts involve mental or psychosocial health, less than 1% of all humanitarian funding is estimated to go toward meeting these needs. This is particularly concerning for the 52% of refugees who are children and face an increased risk of mental health and psychosocial problems. In young children, chronic trauma and adversity literally change the brain’s architecture, with lifelong negative physical and mental consequences.

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Significant barriers to implementing MHPSS in crisis contexts exist. Many programs still lack the necessary research to demonstrate their effectiveness, and not enough humanitarian actors have sufficient mental health training to support delivery of these programs. Often those leading the response are themselves struggling with threats to their own psychosocial well-being and lack the necessary support. This leaves us with a global humanitarian response picture where the majority of people in need of MHPSS are left without these critical services.

But we now have a chance to change some of these trajectories and there are bright spots emerging. This week, the United Nations Secretary-General António Guterres spoke out and asked international actors to help those struggling with mental and psychosocial needs. He related that depression and anxiety “are some of the greatest causes of misery in our world” and how we need to stand by and help “frontline healthcare workers, older people, adolescents and young people, those with pre-existing mental health conditions and those caught up in conflict and crisis.”

Similarly, a little over a week ago the U.N. launched its revised COVID-19 Global Humanitarian Response Plan, which asks for about $6.7 billion to fund to fight against the pandemic and support the needs of communities already caught in crisis. As a hopeful sign in the fight for mental health support, the appeal explicitly aims to address the increased mental health and psychosocial needs at a time when these critical services are either interrupted or suffering from limited resources.

It also calls attention to MHPSS needs in various contexts. For example, in Venezuela, the quarantine may not only increase the risk of gender-based violence for people living in close quarters but also limit information about and access to critical mental health and psychosocial services. Syrians who have fled civil war are now facing the pandemic as another uncontrollable threat. And in many crises there is concern that children may get separated from their parents because of border closures, quarantine or illness, leaving them with unimaginable trauma and anxiety.


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