COVID-19 mental health impact and responses in low-income and middle-income countries: reimagining global mental health.
COVID-19 mental health impact and responses in low-income and middle-income countries: reimagining global mental health.
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DOI：
10.1016/s2215-0366(21)00025-0
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发表时间：
2021-06
影响因子：
64.3
通讯作者：
Patel, Vikram
中科院分区：
文献类型：
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作者：
Kola, Lola;Kohrt, Brandon A.;Hanlon, Charlotte;Naslund, John A.;Sikander, Siham;Balaji, Madhumitha;Benjet, Corina;Cheung, Eliza Yee Lai;Eaton, Julian;Gonsalves, Pattie;Hailemariam, Maji;Luitel, Nagendra P.;Machado, Daiane B.;Misganaw, Eleni;Omigbodun, Olayinka;Roberts, Tessa;Salisbury, Tatiana Taylor;Shidhaye, Rahul;Sunkel, Charlene;Ugo, Victor;van Rensburg, Andre Janse;Gureje, Oye;Pathare, Soumitra;Saxena, Shekhar;Thornicroft, Graham;Patel, Vikram
大多数全球人口生活在低收入和中等收入国家(LMIC)，这些国家历来只获得了全球精神卫生资源的一小部分。新冠肺炎疫情在这些国家中的许多国家迅速蔓延。这篇综述分四个部分考察了新冠肺炎大流行对低收入中等收入国家心理健康的影响。首先，我们回顾了有关大流行对心理健康影响的新兴文献，这些文献显示心理苦恼的比率很高，并有精神健康障碍增加的早期预警迹象。其次，我们评估了不同国家的应对措施，注意到一些国家在应对心理健康问题上做出了迅速和多样化的反应，特别是通过制定国家精神卫生服务新冠肺炎应对计划、实施世卫组织指南和部署数字平台，这标志着对心理健康重要性的可喜认识。第三，我们认为，这一大流行病提供了重新设想全球精神卫生的机会，特别是通过将力量平衡从高收入国家转向低收入中等收入国家，从狭隘的生物医学方法转向以社区为导向的心理社会观点，确定干预和研究的优先事项。最后，我们提出了在低收入中等收入国家重建更好的精神卫生系统的概念的愿景，重点是关键战略；特别是，将精神卫生完全纳入全民健康覆盖计划，通过任务分担增加获得心理社会干预的机会，利用数字技术完成各种精神卫生任务，消除精神卫生保健中的胁迫，并满足被忽视人群的需求，如儿童和药物使用障碍者。我们的建议不仅与小岛屿发展中国家的心理健康和卫生系统的运作有关，而且与受新冠肺炎大流行影响的高收入国家的人口心理健康和卫生系统运作有关，这些国家在精神卫生保健的质量和获得机会方面存在巨大差异。
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.