World Mental Health Day: mental health services chronically underfunded

World Mental Health Day: mental health services chronically underfunded
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October 10 marks World Mental Health Day, and this year the World Health Organization (WHO) is highlighting the urgent need to increase investment in these chronically underfunded services.

The COVID-19 crisis has caused disruptions to mental health services in 93% of countries according to a new WHO survey of 130 countries, underscoring the urgent need for increased funding. As the pandemic continues, even greater demand will be placed on national and international mental health programmes that have suffered from years of chronic underfunding.

The survey was published ahead of WHO’s Big Event for Mental Health  ̶  a global online advocacy event on 10 October to call for increased mental health investments in the wake of COVID-19.

Before the COVID-19 pandemic, countries were spending less than 2% of their national health budgets on mental health, already struggling to meet the demand for these services before the crisis hit. Now, COVID-19 is increasing that demand due to people losing loved ones, isolation, anxiety, and COVID-19 neurological and mental complications, such as delirium and stroke.

Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, said: “Good mental health is absolutely fundamental to overall health and well-being. COVID-19 has interrupted essential mental health services around the world just when they’re needed most. World leaders must move fast and decisively to invest more in life-saving mental health programmes  ̶  during the pandemic and beyond.”

Pre-COVID-19 estimates reveal that nearly US$1trn (€0.85trn) in economic productivity is lost annually from depression and anxiety alone. However, studies show that every $1 spent on evidence-based care for depression and anxiety returns $5.

Disruptions to mental health services

The WHO survey evaluated how the provision of services has changed due to COVID-19 and how countries are adapting to overcome these challenges.

The survey found widespread disruption to a number of different health services, with over 60% of countries reporting disruptions to mental health services for vulnerable people, including children and adolescents (72%), older adults (70%), and women requiring antenatal or postnatal services (61%). 67% saw disruptions to counselling and psychotherapy; 65% to critical harm reduction services; and 45% to opioid agonist maintenance treatment for opioid dependence. 35% reported disruptions to emergency interventions, including those for people experiencing prolonged seizures; severe substance use withdrawal syndromes; and delirium, often a sign of a serious underlying medical condition. 30% reported disruptions to access for medications for mental, neurological, and substance use disorders, and around three-quarters reported at least partial disruptions to school and workplace mental health services.

The survey revealed that 70% of countries have adopted telemedicine or teletherapy to overcome disruptions to in-person services, however, there are significant disparities in the uptake of these interventions, with more than 80% of high-income countries reported using telemedicine and teletherapy to bridge gaps, compared with less than 50% of low-income countries.

Essential services

To help maintain essential services, the WHO has issued guidance to countries, recommending that they allocate resources to mental health as an integral component of their response and recovery plans, and to monitor changes and disruptions in services so that they can address them as required.

89% of countries reported that mental health and psychosocial support is part of their national COVID-19 response plans, however, only 17% of these have full additional funding for covering these activities.

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