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COVID-19 mental health impact and responses in low-income and middle-income countries: reimagining global mental health
Open accessAbstract
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.
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“and the pressure of the pandemic on health-care systems in the future.”
From Strengthening public mental health during and after the acute phase of the COVID-19 pandemic (2022) · cites this paper as [5]
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“It has been the focus of recent calls for a paradigm change in the field of global mental health (106–108), particularly in the context of the COVID-19 pandemic (109).”
From Recovery from Severe Mental Health Problems: A Systematic Review of Service User and Informal Caregiver Perspectives (2021) · cites this paper as [109]
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“Digital technologies and Artificial Intelligence (AI) have been proposed as potential solutions to these challenges [Rudd and Beidas, 2020, Taylor et al., 2020, Kola et al., 2021].”
From Closing the accessibility gap to mental health treatment with a personalized self-referral chatbot (2024) · cites this paper as Kola et al., 2021
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Metadata
- Authors
- Kola, L., Kohrt, B. A., Hanlon, C., Naslund, J. A., Sikander, S., Balaji, M., Benjet, C., Cheung, E. Y. L., Eaton, J., Gonsalves, P., Hailemariam, M., Luitel, N. P., Machado, D. B., Misganaw, E., Omigbodun, O., Roberts, T., Salisbury, T. T., Shidhaye, R., Sunkel, C., Ugo, V., van Rensburg, A. J., Gureje, O., Pathare, S., Saxena, S., Thornicroft, G., & Patel, V.
- Affiliations
- University of Ibadan (NG)
- George Washington University (US)
- King's College London (GB)
- Harvard University (US)
- University of Liverpool (GB)
- Sangath (IN)
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz (MX)
- International Federation of Red Cross and Red Crescent Societies (CH)
- University of Sussex (GB)
- Michigan State University (US)
- Pravara Institute of Medical Sciences (IN)
- Corresponding author
- Kola, Lola
- ORCID
- 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
- Gureje, Oye
- Pathare, Soumitra
- Saxena, Shekhar
- Thornicroft, Graham
- Patel, Vikram
- Venue
- The Lancet Psychiatry
- Publisher
- Elsevier BV
- Published
- 2021-06
- Volume
- 8
- Issue
- 6
- Pages
- 535-550
- ISSN
- 2215-0366 (ISSN-L)
- PMC
- PMC9764935
- OpenAlex
- W3129779558
- Cited by
- 835
- References
- 147
- Citations by year
- 2026: 71 · 2025: 108 · 2024: 148 · 2023: 199 · 2022: 207 · 2021: 99
- FWCI
- 21.75
- Type
- journal article
- Language
- en
- Update notices
- erratum (2021-05-01)
- Open access
- bronze
- doi.org
- Licence
- Locations
- The Lancet Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Arca - Repositório Institucional da Fiocruz (submittedVersion, other-oa)
- Queen Mary Research Online (Queen Mary University of London) (submittedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
- Funders
- Wellcome Trust
- National Institutes of Health (5u19mh113211-05)
- Economic and Social Research Council (ES/T007125/1)
- National Institute of Mental Health (R01MH120649, U19 MH-113211, R01MH100470, R01MH127767)
- Fogarty International Center (K43TW011046)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Keywords
- COVID-19 pandemic, mental health, low- and middle-income countries, psychological distress, mental health services, global mental health, universal health coverage, task sharing, digital mental health, coercion in mental health care, child mental health, substance use disorders, psychosocial interventions, mental health system strengthening
- MeSH terms
- COVID-19, Developing Countries, Health Promotion, Health Services Accessibility, Humans, Mental Health, Mental Health Services, Socioeconomic Factors, Global Health, Telemedicine, Social Determinants of Health
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