| Description | Islamabad, Pakistan (S Sikander PhD); Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK (S Sikander); Wellcome–DBT India Alliance, Sangath, New Delhi, India (M Balaji MSc, P Gonsalves MSc, V Patel); Division of Epidemiology and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico (C Benjet PhD); The Reference Centre for Psychosocial Support, International Federation of the Red Cross and Red Crescent, Hong Kong Special Administrative Region, China (E Y L Cheung PhD); The Red Cross of the Hong Kong Special Administrative Region of China, Hong Kong Special Administrative Region, China (E Y L Cheung); CBM Global and Centre for Global Mental Health, London, UK (J Eaton MBBS); School of Psychology, University of Sussex, Brighton, UK (P Gonsalves); Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, East Lansing, MI, USA (M Hailemariam PhD); Transcultural Psychosocial Organization Nepal, Kathmandu, Nepal (N P Luitel MPhil); Centre for Data and Knowledg Integration for Health, CIDACS–FIOCRUZ, Bahia, Brazil (D B Machado PhD); Mental Health Service Users Association Ethiopia, Addis Ababa, Ethiopia (E Misganaw MA); Global Mental Health Peer Network, Pretoria, South Africa (E Misganaw); Pravara Institute of Medical Sciences, Loni, India (R Shidhaye PhD); Global Mental Health Peer Network, Johannesburg, South Africa (C Sunkel); Mentally Aware Nigeria Initiative, Lagos, Nigeria (V Ugo MBBS); United for Global Mental Health, London, UK (V Ugo); Centre for Rural Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa (A J van Rensburg PhD); Centre for Health Systems Research and Development, Faculty of Humanities, University of the Free State, Bloemfontein, South Africa (A J van Rensburg); Centre for Mental Health Law and Policy, Indian Law Society, Pune, India (S Pathare PhD); Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA (S Saxena MD). | pt_BR |
| Abstract | Most of the global population live in low-income and middle-income countries (LMICs), which have historically received a small fraction of global resources for mental health. The COVID-19 pandemic has spread rapidly in many of these countries. This Review examines the mental health implications of the COVID-19 pandemic in LMICs in four parts. First, we review the emerging literature on the impact of the pandemic on mental health, which shows high rates of psychological distress and early warning signs of an increase in mental health disorders. Second, we assess the responses in different countries, noting the swift and diverse responses to address mental health in some countries, particularly through the development of national COVID-19 response plans for mental health services, implementation of WHO guidance, and deployment of digital platforms, signifying a welcome recognition of the salience of mental health. Third, we consider the opportunity that the pandemic presents to reimagine global mental health, especially through shifting the balance of power from high-income countries to LMICs and from narrow biomedical approaches to community-oriented psychosocial perspectives, in setting priorities for interventions and research. Finally, we present a vision for the concept of building back better the mental health systems in LMICs with a focus on key strategies; notably, fully integrating mental health in plans for universal health coverage, enhancing access to psychosocial interventions through task sharing, leveraging digital technologies for various mental health tasks, eliminating coercion in mental health care, and addressing the needs of neglected populations, such as children and people with substance use disorders. Our recommendations are relevant for the mental health of populations and functioning of health systems in not only LMICs but also high-income countries impacted by the COVID-19 pandemic, with wide disparities in quality of and access to mental health care. | pt_BR |
