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Unmet mental health needs in the Region of the Americas are a leading source of morbidity and mo
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rtality, which result in tremendous health, social, and economic consequences. The COVID-19 pandemic has exacerbated the mental health crisis in the Region, necessitating urgent action at the highest levels of government and across sectors to build back better mental health now and for the future. This landmark report is the result of the PAHO High-Level Commission on Mental Health and COVID-19. It provides an analysis of the mental health situation in the Region, followed by a series of recommendations and corresponding actions to support countries in the Americas to prioritize and advance mental health using human rights- and equity-based approaches.
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RESULTS: Between 76 and 97% of the PHCS offered RMCAH services before the lockdown. Except in antenatal, delivery and adolescent care, there was a decline of between 2 and 6% in all the services dur
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ing the lockdown and up to 10% decline after the lockdown with variation across and within States. During the lockdown. Full-service delivery was reported by 75.2% whereas 24.8% delivered partial services. There was a significant reduction in clients' utilization of the services during the lockdown, and the difference between States before the pandemic, during, and after the lockdown. Reported difficulties during the lockdown included stock-out of drugs (25.7%), stock-out of contraceptives (25.1%), harassment by the law enforcement agents (76.9%), and transportation difficulties (55.8%). Only 2% of the PHCs reported the availability of gowns, 18% had gloves, 90.1% had hand sanitizers, and a temperature checker was available in 94.1%. Slightly above 10% identified clients with symptoms of COVID-19.
CONCLUSIONS: The large proportion of PHCs who provided RMCAH services despite the lockdown demonstrates resilience. Considering the several difficulties reported, and the limited provision of primary protective equipment more effort by the government and non-governmental agencies is recommended to strengthen delivery of sexual and reproductive health in primary health centres in Nigeria during the pandemic.
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The Global Movement for Mental Health has brought renewed attention to the neglect of people with menta
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l illness within health policy worldwide. The maltreatment of the mentally ill in many low-income countries is widely reported within psychiatric hospitals, informal healing centres, and family homes. International agencies have called for the development of legislation and policy to address these abuses. However such initiatives exemplify a top-down approach to promoting human rights which historically has had limited impact at the level of those living with mental illness and their families.
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The 2014-2015 outbreak of Ebola virus disease (EVD) in Liberia resulted in over 10,000 cases and 5,000 deaths. Recognizing the importance of addressing children’s trauma, the Ebola recovery and re
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storation trust fund (EERTF) funded the implementation of a Comfort for kids (C4K) program which encourages psychological healing, and promotes resilience in children who have experienced a crisis or disaster. The C4K program in Liberia was implemented between January 2015 and December 2016 in fifteen townships in Montserrado County through a collaboration between Mercy Corps Liberia, the World Bank’s Liberian health task team, and the government of Liberia. C4K primarily centers on the My Story workbook and associated classroom activities, which provide children with the opportunity to express their emotions about their experiences through drawing, writing, and facilitated discussion. C4K also provides capacity building for parents, teachers, and other caretakers on how to identify and more effectively respond to children’s trauma responses and to support their recovery
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Public Health Aspects of Mental Health Among Migrants and Refugees: A Review of the Evidence on Mental Health Care for Refugees, Asylum Seekers and Irregular Migrants in the WHO European Region
Priebe, S.; D. Giacco, and Rawda El-Nagib.
World Health Organization WHO; Regional Office Europe
(2016)
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Health Evidence Network Synthesis Report, No. 47
The increasing number of refugees, asylum seekers and irregular migrants poses a challenge for mental
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health services in Europe. This review found that these groups are exposed to risk factors for mental disorders before, during and after migration. The prevalence rates of psychotic, mood and substance use disorders in these groups are variable but overall are similar to those in the host populations; however, the rates of post-traumatic stress disorder in refugees and asylum seekers are higher.
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The COVID-19 pandemic and subsequent public health guidance to reduce the spread of the diseasehave wide-reaching implications for children’s health
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and wellbeing. Furthermore, paediatric emergency departments(EDs) have rapidly adapted provision of care in response to the pandemic. This qualitative study utilized insight frommultidisciplinary frontline staff to understand the changes in paediatric emergency healthcare utilization duringCOVID-19 the experiences of working within the restructured health system.
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Objectives: This paper reviews the mental health policies that have been implemented in Chile in response to the COVID-19 pandemic and the international context
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of countries' responses. Even before the start of the pandemic, there were significant barriers to access mental health services in Chile, coupled with a scenario of nationwide social unrest and protests that questioned the legitimacy of public institutions; now the rapidly worsening outbreaks of COVID-19 are exacerbating the pre-existing mental health crisis.
Methods: We conducted a bibliometric and content analysis of the Chilean mental health public policies implemented during the COVID-19 pandemic and then compared these policies with international experiences and emerging scientific evidence on the mental health impact of pandemics.
Results: Our analysis of the policies identifies five crucial points of action developed in Chile: (i) an established framework to address mental health in emergency and disaster situations; (ii) a timely COVID-19 Mental Health Action Plan; (iii) inclusion of mental health in the public health agenda; (iv) development of a presidential strategy during the pandemic for comprehensive mental health and well-being; and (v) emerging research assessing the mental health implications of COVID-19.
Conclusions: In Chile, the public policy responses to address the mental health consequences of the COVID-19 pandemic has been characterized by the coordinated implementation of mental health plans, ranging from a health sectoral initiative to inter-agency and intersectoral efforts. However, it is imperative that increased funding is allocated to mental health, and efforts should be made to promote the participation of people with lived experiences and communities in the design and implementation of the proposed actions. This aspect could be of key importance to social peace and community recovery after the pandemic.
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PLoS Med 10(1): e1001366. https://doi.org/10.1371/journal.pmed.1001366
Published: January 8, 2013
Availability and Accessibility of Treatment for Persons with Mental Illness Through a Community Mental Health Programme
Dr. Janardhan N Navaneetham, Shravya Raghunandan, D M Naidu, H Hampanna
Disability, CBR & Inclusive Development Journal (DCIDJ)
(2011)
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This article describes experiences in implementing a community mental health and development project in a rural district in southern India, including the position
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of persons with mental illness when the project was initiated, the challenges faced and the strategies that were developed to overcome these challenges. The authors conclude that when services are locally available, persons with mental illness can be treated and rehabilitated within their own community. They can live with dignity and their rights are respected. There is a great need for inclusion of persons with mental illness in the existing developmental activities and in disabled persons’ organisations.
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Poverty, HIV and other disease burdens, coupled with common mental disorders including alcohol and other substance use disorders, posttraumatic stress disorder, clinical and postnatal depression, distress, and anxiety, impact how caregivers meet the
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needs of children. When mental health is not considered or addressed, there can be a significant impact on an individual, their family and the community.
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For children orphaned or made vulnerable by HIV (OVC)
Across the Western Pacific Region COVID-19 is placing enormous strain on health and economic systems apart from direct threats to personal health safety and livelihood the pandemic also has signific
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ant implications on mental health and psychosocial well being adversity is an established risk factor for mental health problems thus the impact of COVID-19 on mental health is expected to be large diverse and far reaching mental health and psychosocial support mhpss are essential components of a public health response to COVID-19 this guidance note provides 10 activities that may be integrated in national COVID-19 response and mitigation plans
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Bhana A et al. Journal of the International AIDS Society 2021, 24(S2):e25713
The overall objective of the framework is to support WHO and Members States in meaningful engagement of people living with NCDs, and mental
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health and neurological conditions to co-create and enhance related policies, programmes and services. This framework will contribute to advancing understanding, knowledge and action on meaningful engagement and related participatory approaches from an evolving evidence base. It provides practical guidance and actions for transitioning from intention to action to operationalize meaningful engagement.
The aim of the framework is to guide people working at WHO and in Member States in ensuring meaningful engagement with individuals with lived experience. WHO will advocate for, provide technical assistance and operationalize implementation at its three levels (headquarters, regional and country offices) and will support Member States in implementation at national level through established processes and procedures.
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Experiences and recommendations from the International Red Cross and Red Crescent Movement.
Measures imposed by governments to prevent the spread of the disease, including lockdown restrictions, quarantines, physical distancing, and their economic
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and social consequences, further increase this distress and the risk of mental health problems.
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BMC Health Services Research 14(1):42 · January 2014
The objective of this international comparative study is to describe and compare the mental
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health policies in seven countries of Eastern Europe that share their common communist history: Bulgaria, the Czech Republic, Hungary, Moldova, Poland, Romania, and Slovakia.
The burden of totalitarian history still influences many areas of social and economic life, which also has to be taken into account in mental health policy. We may observe that after twenty years of health reforms and reforms of health reforms, the transition of the mental health systems still continues. In spite of many reform efforts in the past, a balance of community and hospital mental health services has not been achieved in this part of the world yet.
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The document is primarily meant to inform mental health and psychosocial support (MHPSS) staff, such as: psychologists, psychosocial counsellors, social workers, psychiatrists, psychiatric nurses, a
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nd others who are involved providing individual or group counselling, psychotherapy and/or psychiatric treatment for Syrians
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Mental Health and Psychosocial Support (MHPSS) in the context of the crises in Syria and Iraq
Sigmund Freud Privatuniversität; BAff; Charité; et al.
Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH
(2017)
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Guiding framework for development cooperation, Working paper 2017.
This document was drawn up on the basis of expert publications and inputs from partners in the
GIZ regional programme Psychosocial Support for Syrian and Iraqi Refugees and Interna
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lly
Displaced People1 in order to serve as guidance in the design, implementation and assessment of
psychosocial support measures for refugees in the context of the crises in Syria and Iraq. It is
aimed at actors from the MHPSS sector working with refugees in the Middle East and at ministries
and academic/scientific institutions in the context of the Syria and Iraq crises.
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