Strengthening public mental health during and after the acute phase of the COVID-19 pandemic.
Strengthening public mental health during and after the acute phase of the COVID-19 pandemic.
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DOI：
10.1016/s0140-6736(22)00523-2
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发表时间：
2022-05-14
期刊：
影响因子：
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通讯作者：
Adefolarin AO
中科院分区：
文献类型：
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作者：
Kola L;Kumar M;Kohrt BA;Fatodu T;Olayemi BA;Adefolarin AO
新冠肺炎大流行的演变性质及其现有的压力，以及高度可传播的SARS-CoV-2变种的出现，继续挑战着世界各地人类的应变能力。2022年3月，世卫组织重申了大流行对全球心理健康和福祉的重大影响；在大流行的第一年，全球焦虑和抑郁增加了25%，年轻人自杀和自残的风险增加。1、2新冠肺炎康复者的长期预后、3对普通人群的长期影响、4以及未来大流行对卫生保健系统的压力也存在不确定性。5需要各国政府、全球卫生界、社会和私营部门以及主要利益攸关方群体采取联合行动，以满足与这一大流行病有关的神经精神病学和长期力量和资产建设需求。更新的《世卫组织2013年至20306年度精神卫生综合行动计划》概述了公共卫生战略和可实现的目标，以在未来几年精神卫生服务全民健康覆盖的背景下促进精神卫生和预防精神障碍，以实现联合国可持续发展目标。然而，执行行动计划的能力和资源仍然不足。7行动计划最初的四个目标包括领导和治理、通过卫生和社会关怀伙伴关系有效覆盖、预防和促进战略以及加强心理健康研究数据库。在更新版中，6新增了四项目标，确认世卫组织致力于倡导应对新冠肺炎大流行的精神卫生应对方向。有了通过社区基础设施扩大服务的新目标，将精神健康纳入公共卫生应急规划以确保人口安全，并承诺将全球精神健康研究的产出翻一番。随着俄罗斯入侵乌克兰，这些额外的战略现在具有更深的意义，与全球其他持续的冲突和人道主义危机一起，正在加剧人类的痛苦，迫使人们逃离。因此，我们建议将重点放在及时和快速的证据生成上，以实现世卫组织行动计划的总体目标。我们的建议以人口层面的重点为中心，为推动促进和预防一般人口的精神健康提供关键证据，并注重解决社会经济弱势群体在获得服务和服务质量方面的差距。在新冠肺炎大流行急性期期间和之后解决不同人口群体福祉的努力将需要制定、测试和实施精神卫生方案，在卫生紧急情况下利用社区资源作为基础设施，以制定与UHC8有关的具体证据，以及如何解决精神卫生治疗差距。流行病学研究探索新冠肺炎遏制措施和缓解措施对普通人群心理健康的影响，将为当前和未来人道主义危机中的服务发展和心理社会反应提供信息。关于SARS-CoV-2对有生活经验的人的大脑、认知和功能的影响的信息将有助于为受影响的个人设计神经和精神治疗计划，并为未来可能出现的更致命的感染提供指示。有必要增加研究，以确定支持心理健康的循证干预措施。…
The evolving nature of the COVID-19 pandemic with its incumbent stresses and the emergence of highly transmissible SARS-CoV-2 variants continue to challenge human resilience worldwide. In March, 2022, WHO reiterated the substantial impact of the pandemic on mental health and wellbeing globally; in the first year of the pandemic, there was a 25% increase in anxiety and depression globally and young people are at increased risk of suicide and self-harm injuries. 1, 2 There are also uncertainties about the long-term prognosis of people who recovered from COVID-19, 3 its long-term effects on the general population, 4 and the pressure of the pandemic on health-care systems in the future. 5 Joint actions from governments, the global health community, social and private sectors, and key stakeholder groups are required to address the neuropsychiatric and long-term strength and asset-building needs associated with the pandemic. The updated WHO Comprehensive Mental Health Action Plan 2013–20306 outlined public health strategies and achievable goals to promote mental health and prevent mental disorders in the context of universal health coverage (UHC) for mental health services in the coming years, to meet the UN Sustainable Development Goals. However, the ability and resources to implement the action plan remain inadequate. 7 The original four objectives of the action plan include leadership and governance, effective coverage through the partnership of health and social care, prevention and promotion strategies, and strengthening of the research database in mental health. In the updated version, 6 four additional targets affirm WHO’s commitment to championing the direction of mental health response to the COVID-19 pandemic. There are new targets on service expansion through community infrastructures, the integration of mental health into public health emergency planning for population safety, and a pledge to double the global output of mental health research. These additional strategies carry an even deeper meaning now with the Russian invasion of Ukraine, which along with other ongoing conflicts and humanitarian crises globally is exacerbating human suffering and forcing people into exodus. We therefore make recommendations to focus on timely and rapid evidence generation to address the overall objectives of the WHO action plan. Our proposals are centred on a population-level focus, providing key evidence to drive mental health promotion and prevention for the general population, and a focus on addressing disparities in access and quality of services for socioeconomically disadvantaged groups. Efforts to address the wellbeing of different population groups during and after the acute phase of the COVID-19 pandemic will require developing, testing, and implementing mental health programmes that use community resources as infrastructure during health emergencies to develop concrete evidence related to UHC8 and how to address mental health treatment gaps. Epidemiological studies that explore the impacts of COVID-19 containment measures and mitigation efforts on mental health in the general population will inform service development and psychosocial response in current and future humanitarian crises. Information on the effects of SARS-CoV-2 on the brain, cognition, and functioning9 in people with lived experience will help design neurological and psychiatric treatment plans for affected individuals and provide pointers to more virulent infections that might emerge in the future.There is a need to increase research that identifies evidence-based interventions that support psychological wellbeing …