Achieving SDGs by addressing mental illness
Mental health is one of the most neglected areas of health globally. This was true before the prevalence COVID-19 as well, but the pandemic has further worsened the situation. According to the World Health Organisation (WHO), the COVID-19 pandemic has disrupted or, in some cases, halted critical mental health services in 93 per cent of countries worldwide, while the demand for mental healthcare is increasing.
Given the chronic nature of the disease, this translates to a significant economic impact worldwide. Countries spend less than two per cent of their health budgets on mental health. It is expected that in the next 10 years, depression will put more burden on nations than any other disease. According to a World Bank report, the numbers related to mental health are staggering. As of February 2021, nearly 1 billion people live with a mental disorder and in low-income countries, more than 75 per cent of people with the disorder do not receive treatment. Every year, close to 3 million people die due to substance abuse. Every 40 seconds, a person dies by suicide. About 50 per cent of mental health disorders start by the age of 14.
Globally, the Coronavirus has had a major impact on human lives, including health, economic, employment, psychological, and overall well-being. COVID-19, besides causing respiratory, neurological, and cardiovascular diseases, has had a significant impact on mental health. Major mental health disorders, including depression, anxiety, and stress, have risen in parallel with the increasing prevalence of the pandemic. Many population groups, including children, the elderly, those with chronic illnesses, and healthcare workers, have been affected.
In the APAC region, prevalence of depression ranged between 4.9 per cent and 43.1 per cent, anxiety from 7.0 to 43.0 per cent, and stress from
3.4 per cent to 35.7 per cent. As COVID-19 continues to severely affect the psychosocial well-being of the population at large, countries have developed and revised policies, guidelines, and introduced new initiatives to curb mental health issues among their citizens.
More than 1,000 psychiatrists, general practitioners and healthcare professionals from 10 countries and regions including Malaysia, Singapore, Thailand, the Philippines, Hong Kong and Taiwan of China, came together online on June 26, 2021 at the third Asia Pacific Psychiatry Symposium and suggested that people with severe mental illness should be prioritised in vaccine allocation strategies, and during the vaccination process they should continue to receive treatment with antipsychotics.
The experts also recommended that patients suffering from both a mental illness and COVID-19 can continue using psychotropic medication, but need to consider the possibility of drug interactions between psychotropic drugs and medication for COVID-19 treatment, with effects such as respiratory sedation caused by psychotropic medication.
Given the acute period of COVID-19, as well as the co-occurrence of climate change and natural disasters, a network was formed in June 2020 in the APAC region called the Asia Pacific Disaster Mental Health Network, which is supported by the WHO Thematic Platform for Health Emergency and Disaster Risk Management (Health EDRM).
The pandemic has exposed the vulnerabilities of health systems globally. For health systems to achieve sustainability, strong primary health care is essential. The primary healthcare services can only be considered strong if they address both components of health: physical and mental. Therefore, mental health services must be integrated into health systems as opposed to only being provided in a silo. They need to be included in the basic healthcare benefits packages.
The World Bank noted that scale up and speed in addressing mental illness are essential to achieving the Sustainable Development Goals (SDGs) of ensuring healthy lives and the well-being for all at all ages by 2030. Failure to do so could have devastating socio-economic impacts. Investing in health reaps the benefits both within and outside of the health sector.
The healthcare systems in the region should also invest in universal health coverage, so that better healthcare can be served to everyone, regardless of their socioeconomic background.