Mental Health for All in Eastern and Southern Africa:
Greater Investment, Greater Access to Mental Health and Psychosocial Support
Joint Statement from Regional Directors of Eastern and Southern
Africa on the Occasion of World Mental Health Day
Saturday 10 October 2020
COVID-19 is an unprecedented public health crisis causing a magnitude of hardship not seen in recent history. Every region in the world has been affected. As the pandemic continues to claim lives and wreak socio-economic turmoil, fear of the virus and the isolation it is causing has profound mental health implications.
Around the globe, the mental health of millions is being affected. Concerns about health, bereavement, financial stability and feelings of helplessness have been widely reported across all age groups, across Eastern and Southern Africa, and globally. Physical distancing, self-isolation, and quarantine have triggered reactions of isolation, loneliness, anxiety, depression and loss of social contacts.
While it is encouraging to see governments across Eastern and Southern Africa increasingly considering mental health and psychosocial support services an integral part of their respective COVID-19 responses, we must continue to advocate for—and invest in—mental health and psychosocial services for all beyond the pandemic.
We are deeply concerned that millions of people across the region may fall into poverty because of the pandemic, undoing years of economic progress and development. As livelihoods are lost and existing systems and services face difficulties to continue providing previously available support, individuals, families and communities will bear the weight of the cumulative distress caused by the pandemic. The mental health and wellbeing of people on the move, for instance the economic migrants who have lost their jobs, have been eroded. We have already received worrying reports of increased feelings of despair among refugees in Kenya, Uganda and Sudan.
The levels of distress among the populations we serve are increasing to unacceptable levels.
This is especially true in communities in the region that are facing conflict and violence, where mental health and psychosocial needs were already high, and services scarce even before the pandemic. More than one in five persons in a conflict-affected area live with some form of mental health problems from mild depression to post-traumatic stress disorder according to the World Health Organization (WHO) and The Lancet. That is three times more than the general population worldwide suffering from these conditions. Conflict and disaster threaten community resources and undermine personal coping strategies and social connections that would normally support people.
Though the needs are immense, access to mental health and psychosocial services is often scarce in many parts of Africa. The statistics are staggering.
According to The Lancet, the continent has on average 1.4 mental health care workers for every 100,000 people, compared to a global average of nine per 100,000 people. This leads to less mental health care overall for communities. And UNICEF data shows that government social service workers, another key service provider for psychosocial support, are extremely limited with 15 social service workers for every 100,000 children in the region.
The WHO reports that 28 countries in Africa have had their prevention and promotion of mental health services and programmes severely affected by COVID-19. Community-based services and mental health prevention and promotion programmes, already limited in availability, are reported to be disrupted at a time when society needs them the most due to the adverse mental health impacts COVID-19.
We are also very concerned about reports that frontline health and social service workers as well as service providers at points of entry, such as border officials, face infection risks. They continue to experience stigma as a result of their contribution to pandemic response efforts and fear of infection by their communities. The efforts of these brave individuals are key to the response; as such, they deserve the support required to perform their duties while maintaining their well-being. Investing in mental health promotion and prevention measures for frontline workers is essential.
While everyone is affected, it is important to acknowledge the unprecedented impact of COVID-19 on women and children in the region.
The pandemic is deepening pre-existing inequalities and the division of labour at home has placed a heavier emotional burden on women. Within the region, woman make up a disproportionate percentage of workers in the informal sector and as such have been more affected by job loss.
Though we know that children are at a lower risk of developing severe symptoms as a result of infection, we should not underestimate the psychological impact and fear associated with the virus. Millions of children and adolescents have had their lives upended by months of school closures, loss of care givers or family members, increased violence at home and a lack of access to child protection services. We know that at the end of September 2020, 65 million children were still affected by
school closures in Eastern and Southern Africa. School closures remain a concern not only because of lost learning but also because of increased risk of violence and loss of nutrition from school meals and age-appropriate development.
These factors threaten children and adolescents’ overall mental health and psychosocial well-being as well as pose long-term risks to their ability to thrive; consequences that shall remain with us in the region for years to come if we do not follow an appropriate course of action.
Investing in mental health must take a ‘whole society’ approach. Doing so will yield massive returns to individuals, societies and economies because mental health is a foundation for development. We cannot afford not to act. With the impact of the COVID-19 pandemic, the need for us all to invest in mental health and psychosocial support is more acute than ever before.
This World Mental Health Day, our organizations are calling national governments across Eastern and Southern Africa to provide greater investment and greater access to tailored and holistic mental health and psychosocial support services.
Specifically, we call for:
- Increased advocacy, investment and recognition of mental health and psychosocial support interventions at community level and that they are integrated within health, nutrition, education and protection systems leaving no one behind.
- Increased attention and support to the early provision of basic psychosocial support services to populations affected by conflicts, natural disasters, migration, displacement and public health emergencies to prevent distress from developing into mental illness.
- Increased attention on community awareness against stigmatization of people who are experiencing mental health concerns, and those seeking mental health and psychosocial support; ensuring early detection and providing safe access to life-saving services, treatment in health facilities and free medication in all public health centres, including in remote and cross-border areas.
- Increasing focus on the protection of the mental health of frontline crisis responders (staff and volunteers).
- Increasing investment in human resources and capacity building to ensure that mental health and psychosocial services are provided by well-trained professionals.
- Increased investment in schools and surrounding communities to ensure that no child is isolated, and that mental health and psychosocial support services are available for children who need them.
We re-affirm our commitment to work closely with national governments, civil society and communities across Eastern and Southern Africa to ensure greater access to comprehensive, multi-layered, promotive, preventative, and curative mental health and psychosocial support services for all.