WHO survey: Pandemic disrupting mental health services in most countries

Essential mental health services have been disrupted or halted in 93% of the countries in the world owing to Covid-19 pandemic despite a growing demand, says a new WHO survey.

Countries must respond fast and aggressively to invest more in life-saving mental health programmes both during and after the pandemic, it recommends.

The survey of 130 countries provides the first global data showing the devastating impacts of Covid-19 on access to mental health services. It also focuses on the urgent need for increased funding to address the issues.

Over 60% of the surveyed countries reported interruptions in mental health services for vulnerable groups, including children and adolescents (72%), older adults (70%), and women requiring antenatal or postnatal services (61%), according to the survey.

Sixty-seven percent saw disruptions in counselling and psychotherapy while 65% in critical harm reduction services and 45% in opioid agonist maintenance treatment for opioid dependence.

More than a third (35%) reported disruptions in emergency interventions, including for those experiencing prolonged seizures, severe substance use withdrawal syndromes, and delirium, often a sign of a serious underlying medical conditions.

Thirty percent reported interruptions in access to medications for mental, neurological and substance use disorders.

Around three-quarters reported at least partial disruptions to school and workplace mental health services (78% and 75% respectively).

While many countries (70%) have adopted telemedicine or teletherapy to overcome disruptions to in-person services, there are significant disparities in the uptake of these interventions.

More than 80% of high-income countries reported deploying telemedicine and teletherapy to bridge gaps in mental health, compared to less than 50% of low-income countries.

The survey was published ahead of WHO's "Big Event for Mental Health" – a global online advocacy event on 10 October that is scheduled to bring together world leaders, celebrities, and advocates to call for increased mental health investments in the wake of Covid-19.

Prior to the pandemic, countries were spending less than 2% of their national health budgets on mental health and struggling to meet their populations' needs, according to a report published on the WHO website.

After the pandemic broke out, the demand for mental health services keeps rising.

Bereavement, isolation, loss of income and fears are triggering mental health conditions or exacerbating existing ones. Many people may be facing increased levels of alcohol and drug use, insomnia and anxiety, said the WHO report.

Meanwhile, Covid-19 itself can lead to neurological and mental complications, such as delirium, agitation, and stroke. People with pre-existing mental, neurological or substance use disorders are also more vulnerable to Covid-19 infection, the report added.

WHO has issued guidance to countries on how to maintain essential services, including mental health services, during Covid-19 and recommends that countries allocate resources to mental health as an integral component of their response and recovery plans.

The organisation also urges countries to monitor changes and disruptions in services so that they can address them as required, said the report.

Although 89% of countries reported in the survey that mental health and psychosocial support is part of their national Covid-19 response plans, only 17% have full additional funding to cover these activities.

All this highlights the need for more money for mental health. Spending 2% of national health budgets on mental health is not enough. International funders also need to do more: mental health still receives less than 1% of international aid earmarked for health, according to the report.