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The editors of PLOS Medicine together with Guest Editors Vikram Patel, Daisy Fancourt, Toshi A Furukawa, and Lola Kola announce a forthcoming special issue devoted to the impact of the COVID-19 pandemic on global mental health.
On March 11, 2020, the World Health Organisation (WHO) declared the COVID-19 outbreak a global pandemic, just months after the first known cases were identified in December, 2019. Two years on, the world has been transformed by the SARS-CoV-2 virus: lockdowns and physical distancing have decimated social support structures for many, while loss of income, loneliness, disruptions in routine health care and reductions in physical activity have widened pre-existing health inequities. As the COVID-19 pandemic continues to evolve, a hidden pandemic of mental health disorders is already underway.
Prior to the pandemic, the global mental health landscape was already stark. The second leading cause of death in young people aged 15–29 years is suicide, and 76–85% of people with mental health conditions in low- and middle-income countries (LMICs) receive no care from the health system for their condition. According to a recent report from the WHO, the first year of the pandemic resulted in a 25% increase in the prevalence of anxiety and depression globally. Young people are more at risk of suicide and self-harm injuries and the mental health of women has worsened. With the pandemic likely to result in a 5–8% contraction in global economic growth, up to 100 million people may be pushed into extreme poverty, compounding pre-existing mental health issues and adding to the existing burden in countries with limited healthcare provision. In children and adolescents, lengthy school closures are likely to have a powerful adverse impact on cognitive development and mental health. Increased anxiety associated with the uncertainties caused by the pandemic has turned some people towards addictive behaviours and substance misuse.
Clearly, the public health emergency posed by COVID-19 requires coordinated joint efforts from national governments, global health communities and all mental health stakeholders in the public and private sectors. The United Nations and WHO intend to increase mental health and psychosocial support (MHPSS) in their COVID‑19 response efforts across sectors. Similarly, guidelines pertaining to mental health have been created by the Inter-Agency Standing Committee, the International Organisation for Migration, and the Africa Centres for Disease Control and Prevention. The pandemic has witnessed a dramatic increase in awareness and concern about mental health, and fuelled rapid adoption of digital technologies for care, notably telemedicine platforms and self-care apps. That said, there remain large unmet needs for care which, along with the rising incidence of mental health problems, are fuelling the global mental health crisis which existed even before the pandemic.
Although globally relevant, the mental health burden of the pandemic will not be equal in terms of lived experience. Key populations of interest include young people, women and girls, older or less physically mobile adults at heightened risk of social isolation, those with pre-existing mental health conditions, and healthcare workers exposed to the frontlines of the pandemic. Furthermore, the mental health and wellbeing of people who are already victim to existing social inequities (be they demographic, socioeconomic, or cultural) are likely to experience a larger share of the adverse mental health impacts. Individuals with neurodevelopmental disorders and learning difficulties are at elevated risk. Additionally, increasing numbers of people are experiencing long Covid, which is being shown to have both physical and psychological ramifications.
As we move into the third year of the pandemic, governments in some countries are reducing or even removing pandemic restrictions and declaring the pandemic endemic. However, psychiatric consequences are enduring. Further, the pandemic situation remains volatile, with new variants of variable infectivity and lethality still emerging and remaining uncertainty over access to vaccines, booster vaccines and other candidate compounds for antivirals. These factors are all influential for global mental health. How countries and populations adapt to challenges such as recessions, social discontent, and damaged healthcare systems even when the pandemic is over will also have differential impacts on mental health. As such, the topic of the global mental health impact of COVID-19 is likely to be one of long-term relevance.
Others have already made the case for viewing the pandemic as an opportunity to reimagine global mental health and ‘build back better’. In this forward-looking Special Issue, PLOS Medicine and our Guest Editors wish to invite work with the potential to mitigate the mental health consequences of the current pandemic and strengthen the global response to future pandemics. Work that examines contextual differences in the mental health impacts of the pandemic and strives to elucidate underlying mechanisms is of great interest. For the purposes of the Special Issue, the term mental health is used in a multidisciplinary sense. Studies across disciplines including psychiatry and psychology, neuroscience, behavioural, developmental, and social science will all be considered, as will others where we feel they present a clinically meaningful advance. Areas of special interest include:
- Vulnerable populations and the pandemic’s impact on existing inequities in global mental health, including studies that provide novel insight into the extent of the mental health crisis (in terms of, e.g., severity and duration).
- Health system responses to increased demand for mental health care services, including work that addresses efforts to preserve continuity of care.
- Evaluations of policy interventions which may have had positive effects on mental health (e.g., the influence of cash transfers in alleviating mental ill health related to economic hardship) or harmful effects on mental health (e.g., school closures and lockdowns).
- Mental health consequences of the pandemic from a life course perspective, such as ecological data concerning the impact of school closures on child and adolescent mental health, through to the impact of social isolation on older or mobility-impaired adults.
- Public mental health, which goes beyond disease specific areas, to addressing ongoing day to day challenges of the pandemic at population levels and in public arenas (e.g., mental health in the workplace, schools’ mental health programmes, an agenda on social inclusion and social belongingness for older populations, and building resilience in young people).
Research designs that will be considered include, but are not limited to, randomised controlled trials, natural experiments, and quasi-experimental studies. We also welcome observational research, including studies that leverage large longitudinal cohort data and electronic medical record datasets. Survey-based and cost-effectiveness analyses are also welcomed. Mixed methods studies will also be considered, as will systematic reviews and meta-analyses.
Please submit your manuscript at: http://journals.plos.org/plosmedicine/s/submit-now. The deadline is 15 July 2022.
Presubmission inquiries are not required, but do please indicate your interest in the special issue in your cover letter. Questions about the special issue can be directed to email@example.com.
Image credit: Ümit Bulut/ Unsplash.