This is the fourth part of a IH Blog series, Global Mental Health: Burden, Initiatives and Special Topics.
Part IV – Global Mental Health Agenda and Pandemic Preparedness
The COVID-19 pandemic has exposed a need to improve preparedness for mental health care services provision in the context of pandemics. The mental health burden associated with COVID-19 and prior pandemics is pervasive, highlighting a critical need for preparedness plans to incorporate a mental health response. As discussed in our previous blog, there are initiatives related to global mental health and COVID-19 that are being implemented, but a fully adaptive and comprehensive approach is needed to mitigate mental health consequences.
The agenda and priority setting of international governing bodies provides the foundation for establishing and implementing comprehensive preparedness plans and approaches. For the first time in 2015, the United Nations (UN) established mental health as a priority by including substance abuse and mental health in the 2030 Agenda for Sustainable Development. A total of 17 Sustainable Development Goals (SDGs) were created and adopted by all UN Member States. Mental health is specifically a part of SDG 3: “Ensure healthy lives and promote well-being for all at all ages.” Within Goal 3, two targets are directly related to mental health. Target 3.4 states: “by 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.” Target 3.5 focuses on drug addiction, proposing that countries: “strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol.”
In 2013, the World Health Assembly published a Comprehensive Mental Health Action Plan for 2013-2020 in response to the growing burden of mental illness. In the action plan’s foreword, Director-General Dr. Margaret Chan stated that mental health is a fundamental part of WHO’s definition of health. The action plan was extended to 2030 at the 72nd World Health Assembly to align with the UN’s 2030 Agenda for Sustainable Development. The plan’s framework is intended to be adapted at the regional level in order to address regional priorities and circumstances.
With this action plan, all WHO Member States committed to contributing efforts to meet the global targets around improving mental health. The plan includes four objectives around effective leadership and governance, service provision in community-based settings, promotion and prevention, and strengthening research. Each objective is broken down into specific, measurable targets and their respective indicators. This structure allows countries to monitor progress and impact and report these data back to WHO to monitor progress and impact. The full action plan, published in 2013, can be read here. This article by the Lancet, also published in 2013, summarizes the plan.
WHO has created practical tools that national authorities can use to improve mental health service resilience during and after public health emergencies such as the WHO Recovery Toolkit. These resources can help national authorities develop or update national pandemic preparedness plans. Even though there has been increased prioritization of global mental health by the UN and WHO, there is significant work to be done on integrating mental health into emergency preparedness and pandemic planning.
Given the current global agenda, the revision and implementation of preparedness planning that supports care for mental health is critical. With revised multisector pandemic preparedness plans that incorporate new and emerging evidence, we could lessen the lingering mental health effects of future pandemics. A recently published JAMA article highlights the need for prevention and early intervention to proactively prepare for an increase in mental health conditions from the COVID-19 pandemic. The authors mention the necessity of having mechanisms in place for surveillance, reporting and intervention, as well as bolstering mental health systems in preparation for increased service demands.
About the Authors:
Elena Schatell MPH (c) MMS (c)
Elena Schatell is a current student at Arcadia University enrolled in the Dual Master of Public Health/Master of Medical Science in Physician Assistant Program. She aims to promote public health in underserved communities as a future physician assistant. Her current public health interests include access to mental health services, stigma surrounding mental illness, and the relationship between faith and mental health. She has interned at the National Alliance for Mental Illness (NAMI) national office in Arlington, Virginia, working closely with the Advocacy and Public Policy team on conducting research on service barriers and state mental health policy. During her time at NAMI, she also authored articles for the Advocate magazine and blog.
Dr. Heather F. McClintock PhD MSPH MSW
Dr. McClintock is an IH Section Member and Assistant Professor in the Department of Public Health, College of Health Sciences at Arcadia University. She earned her Master of Science in Public Health from the Department of Global Health and Population at the Harvard School of Public Health. Dr. McClintock received her PhD in Epidemiology from the University of Pennsylvania with a focus on health behavior and promotion. Her research broadly focuses on the prevention, treatment, and management of chronic disease and disability globally. Recent research aims to understand and reduce the burden of intimate partner violence in Sub-Saharan Africa. Prior to completing her doctorate she served as a Program Officer at the United States Committee for Refugees and Immigrants and a Senior Project Manager in the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania. At the University of Pennsylvania she led several research initiatives that involved improving patient compliance and access to quality healthcare services including the Spectrum of Depression in Later Life Study and Integrating Management for Depression and Type 2 Diabetes Mellitus Study.