The mental health crisis is not a new phenomenon and has existed before the pandemic, However, the ongoing COVID pandemic has fueled this pre-existing mental health crisis (Kwabena Ameyaw et al., 2020). The COVID-19 pandemic along with the associated lockdown measures has propelled all countries into a never experienced before socio-economic transition, which is complex and challenging. As fear of fatalities is constantly being fuelled by daily rest of infection rates, there is growing anxiety and precautionary behaviour among individuals and families. As a result of prolonged quarantine, a sudden shift in employment and working conditions, socio-economic uncertainties, increase in household demands, restrictions on social interactions, and fatalities due to infection, there has been a rise in all forms of depression, anxiety, stress, and other psychological implications domestically as well. COVID-19 could be present in recovered persons differently and would shape underlying illness behaviour models. Therefore, the first section proposes the mainstream reintegration of recovered patients post-COVID-19 and its implications for mental health care and service delivery from the perspective of the African region. The second section of the proceeding adopted to reconcile the coping strategies needed for mass empowerment against COVID-19 in the African context (Tresita Paul V. & Uma Devi, 2021).
1. Defining the Mental Health Crisis
News media are rife with discussion of a “(C. Sanderson et al., 2020)” that has developed or intensified throughout the pandemic. But what do people mean by the term “(C. Sanderson et al., 2020)”? Crises are urgent or difficult situations. They are a set of facts or events that have recently occurred and have caused, or will likely cause, significant negative ramifications and consequences. More than vague feelings of disturbance, confusion, or peril, crises are concrete occurrences, comprised of factual events (e.g., a collapsed economy) or difficult development (e.g., Industrial Revolution). Such occurrences have direct consequences for everyday life, like leading to loss of jobs and homes, increased numeracy of crimes, lack of sanitary conditions, hunger due to lack of financial means, increased numbers of poor health (both physical and mental), and social inequalities (C. Sanderson et al., 2020). There is an overall destruction of life or a part of it, putting it at great risk and jeopardy. By definition, “(C. Sanderson et al., 2020)” is, thus, not simply interpreted as perturbation, but with implications of scale and serious detrimental consequences.
Most conversations regarding mental health crises either do not mention the term “(Minihan et al., 2020)” at all or do so in a way that is at odds with how the term is understood in other realms of note. Some allocate individual and collective feelings of disturbance and insecurity, possible effects on everyday life. However, what would count as proof for the existence of this state of “(Minihan et al., 2020)” is rarely elaborated (Minihan et al., 2020). Do heightened levels of anxiety and depression count as proof? In what way? Broader statistics, e.g. on suicide rates or murder cases? The historical meaning of the word “(Minihan et al., 2020)” is not considered. In these discussions, “(Minihan et al., 2020)” is used in a truncated sense, lacking sense of scale, scope, and consequences. The concept of crisis is treated as a more intense variant of simply “distress.” In so doing, conversations stop short of interesting and relevant considerations with respect to the pandemic’s effects on mental health.
2. Impact of the Pandemic on Mental Health
The COVID-19 pandemic has had a profound detrimental impact on mental health on a global scale. During the pandemic, widespread infection, risk of severe illness and death, social isolation, lockdowns and quarantines, unemployment and economic setbacks, social and racial injustice, and societal turmoil created an unprecedented ‘perfect storm’ of mental health influences (C. Morganstein, 2021). Evidence has emerged from multiple countries and, more recently, multiple longitudinal cohorts, suggesting a marked impact on population mental health during the COVID-19 pandemic, with an increased prevalence of depression, anxiety, post-traumatic stress disorder, loneliness, and suicidal ideation (McCartan et al., 2021). Such burgeoning data sets are critical to better understand the nature of the mental health challenges now emerging in the post-COVID-19 landscape. Nevertheless, many questions remain regarding how best to respond to the current phenomena, which have no historical parallel. After addressing the pandemic’s impact on population mental health, a call to action is made for prioritization of urgently needed proactive responses envisioned earlier in the pandemic.
2.1. Global Trends and Data
The COVID-19 pandemic is impacting population mental health at an unprecedented scale. Prior to the start of the pandemic, mental health worldwide was already a concern. Major depressive disorder and anxiety disorders were the leading causes of years lived with disability globally (McCartan et al., 2021). By April 2020, it became apparent that society was entering a new era and mental health had become a key concern. In April 2020, the Director-General of The World Health Organization (WHO) had phoned the heads of all the United Nations’ (UN) agencies, and with the headline that “We are entering a mental health crisis” asked them to speak about mental health in their agencies. In August 2020 Nature, the scientific journal, published the article “A third of people in the USA show signs of clinical anxiety or depression”. The “mental health pandemic” post-COVID-19, that was then inevitable, has in many parts of the world become a reality in early 2021 (C. Sanderson et al., 2020). During April, May, and June 2020, there were on average more than a thousand studies mentioned on COVID-19 in PubMed alone, a situation last experienced during the Spanish flu in 1918 – 1920. Only few, however, were focusing on the mental health impact. Every country started to experience the same unexpected dramatic and challenging changes in society, with an immediate massive impact on the difficult challenges in mental health.
The concept of mental health crisis is systematically addressed. First, global trends and data related to the post-pandemic mental health impact, with gaps in the availability of scientific knowledge on the sheer size of the problem, the global direction of the pandemic, historical comparisons, and group-based risk factors, five components that closely define the dynamics of any pandemic are presented. Second, data and results related to the COVID-19 mental health impact in five regions of the world, with a focus on population-based studies, are provided, highlighting the scattered availability of scientific evidence on the mental health impact across the globe with clear needs to address such gaps in future research. Third, qualitative insights based on studies that give voice to the individuals experiencing the dramatic changes in mental health, with higher-order themes defined as stigmatization, drastic changes in life, loss of control, and social isolation, are highlighted. Altogether, the evidence provides a need for the world to be prepared for a repeat of today’s overwhelming issues in mental health.
3. Factors Contributing to the Mental Health Crisis
On top of the existing factors aggravating mental health, the pandemic has accentuated others, including social isolation and disconnection, financial hardship as well as discrimination, harassment, and stigma due to perceived violation of so-called behaviour norms. The momentary closure of workplaces, schools, universities, communities, and social arenas suddenly cut many individuals and families off from their supportive environments. Previous studies of other past epidemics or pandemics provided evidence of mental health effects due to social isolation (N. Hisham et al., 2020). Social isolation, characterized by a lack or reduction of social contacts, greatly increases the feelings of disconnection from the community and the social network. The sense of disconnection may have compounded the fear of the unknown, anxiety, and uncertainty (Pietrabissa & G. Simpson, 2020). As mental health generally deteriorates during a crisis, the most socially disadvantaged groups are often unable to seek help and access supportive services, which further widens the existing social and mental health inequalities. In low-income countries, social disconnection, as well as loneliness, is likely to increase in urban slums where the population, already living under stressful conditions, has been told to stay at home under lockdown rules.
3.1. Social Isolation and Loneliness
To understand the mental health crisis of social isolation and loneliness in the post-pandemic context, it is crucial to distinguish between these two factors. Social isolation refers to an objective state consisting of a lack of social connections, while loneliness is a subjective state associated with feelings of emptiness or lack of companionship. It is important to note that an individual can feel lonely while socially connected and, conversely, can be socially isolated without feeling lonely (N. Hisham et al., 2020). Throughout the COVID-19 pandemic, various forms of social distance measures were implemented to control the spread of the virus. These measures, while vital for public health and safety, significantly limited individuals’ social connections, leading to an increase in social isolation and loneliness.
Social isolation and loneliness impact mental health, with 37% of respondents indicating it as the most prevalent negative consequence of the COVID-19 pandemic. Additionally, concerns about getting infected with the virus were reported by 29% of respondents. Although much is known about the detrimental effects of social isolation and loneliness, these two factors still need to be explored and analyzed in terms of their unique impact on the mental health crisis given by the COVID-19 pandemic. The social isolation brought about by various social distancing measures during the pandemic affects all age cohorts, albeit to different extents. All the differences in the social landscapes experienced by equally all age cohorts translate into dimensions of social isolation experienced by individuals belonging to different cohorts. Understanding the individual impact of social isolation and loneliness in a myriad of sorts of challenges brought upon by the COVID-19 pandemic sets fertile ground for innovative responses to these challenges that can be tailored to specific needs (Ramkissoon, 2021).
4. Vulnerable Populations and Mental Health
In addressing the ongoing mental health crisis post-pandemic, it is crucial to shine a spotlight on vulnerable populations who are particularly affected, with children and adolescents at the forefront. Prolonged school closures, restricted social interactions with peers, and fears about contracting the virus have raised numerous concerns and stressors for this population (Marques de Miranda et al., 2020). The world has witnessed a rise in aggressive behaviors at schools, as well as an increase in other mental health concerns such as attention deficit hyperactivity disorder, autism spectrum disorder, and mood disorders (e.g. depression and anxiety). It is evident that the pandemic has taken a toll on mental health and brought to light the need for preventative measures and psychological support.
Further compounding the problem is the underutilization of mental health services by youth. The pandemic has exacerbated the existing disparities within mental health care, particularly affecting vulnerable populations such as Hispanic and Black youth. Studies have shown that youth of color are more likely to experience issues related to lockdowns, such as feelings of sadness or loneliness, as well as a lack of access to mental health services (Boden et al., 2021). Approximately one in five children have a diagnosable mental disorder, but it is estimated that only 20 percent of them receive care. Besides, these disparities have been long-standing issues deeply rooted in systemic inequities such as poverty, racism, and violence. Academic achievement gaps, unemployment, and housing instability are also part of the multifaceted picture of disadvantage and distress facing children of color.
4.1. Children and Adolescents
Children and adolescents may be particularly vulnerable groups during the pandemic and post-pandemic periods. Children and adolescents have unique mental health vulnerability in the post-pandemic period, specific considerations are required in the design and development of interventions. Children are at a stage when they develop social-emotional skills, coping strategies, and emotional and behavioural regulation. Adolescents has been a new social domain of life in the transition to adulthood because they typically develop cognitive abilities and are beginning to abandon parental control. The COVID-19 pandemic has disrupted these developmental tasks and seriously compromised mental well-being, especially among underprivileged children and adolescents. This highlights the children, adolescents, and psychological stage when interest groups should collaboratively advocate and develop appropriate interventions in a timely manner (Marques de Miranda et al., 2020).
In addition to mental health concerns, the pandemic-related school closures could also harm the cognitive and linguistic development of young children. Nevertheless, interventions designed specifically to improve the mental health of children and adolescents in the post-pandemic period have not yet been systematically reviewed. Young children, pre-schoolers, and kindergartners, are more likely to believe that the pandemic is going to be a long-lasting event. It should be noted that an age 0-5 years old classification system and tokens to remember COVID-19 pandemic-related vocabulary were used in some interventions targeting young children (Binagwaho & Senga, 2021).
5. Innovative Approaches to Addressing Mental Health Needs
The pandemic caused unprecedented stress and strain on global mental health systems. A covert threat with immediate impact on physical health, societal uncertainties, and rapidly changing circumstances in daily life elicited an understandable widespread psychological response. However, the development of national and local mental health responses in the immediate pandemic period was reactive and generally poorly conceived, piecemeal, and slow to arrive (Taylor, 2022). There are promising treatment resources that could be accessed by large numbers of people, including those living in remote settings. However, it is anticipated that there will remain challenging populations that require more intensive treatment for mental health problems and that some patients will require inpatient hospitalization for severe cases.
In the early months of the COVID-19 pandemic, a program was rapidly deployed that had been designed to reach community members as well as the response for at-risk groups. The program had four main components: 1) public programs on TV and radio discussing COVID-19-related psychological problems, 2) 24-h hotline consultations, 3) online video consultation sessions (using Zoom) between health care providers and community members, and 4) on-site crisis intervention for COVID-19 confirmed, suspected, or quarantined cases showing some levels of psychological distress. A survey completed after nationwide publicity about the available support resources estimated that 12.6% of individuals reached tried these resources. Overall program access was skewed toward more educated individuals and lower program engagement levels within the elderly. The merits of the program are a topic for further research; however, the program may be insufficient for the treatment of all types of pandemic-related psychopathology. For instance, people with clinically diagnosed mental health disorders often require more extensive and intensive treatment options that are best left in the hands of trained professionals.
5.1. Telemedicine and Online Therapy
Telemedicine and online therapy are fundamental to addressing mental health needs in the aftermath of the pandemic. The COVID-19 pandemic has profoundly affected population mental health, leading to increased levels of psychological stress, anxiety, and depression. Timely treatment is necessary, particularly with the emergence of new variants and community outbreaks. Fortunately, there are effective preventive interventions that could be made available to many people with relatively minimal effort. Novel digital platforms for the delivery of mental health resources—including telemedicine and online therapy—have the potential to address psychological needs and prevent severe mental health difficulties in millions of people (Taylor, 2022).
Telemedicine and online therapy are responsive to the current mental health crisis, and assist in addressing mental health needs in the face of the ongoing pandemic and its aftermath. They have the potential to ultimately reshape the availability of preventive interventions drastically and save many people from experiencing extensive distress and personal adversity. However, the collateral damage from the pandemic extends beyond the immediate holistic concerns addressed here. Significant population-level behavioral and psychological changes are also anticipated, and a response to this burgeoning public mental health crisis is urgent. Without immediate intervention, the proliferation of mental health difficulties following the pandemic will be magnified by telecommunication disruption, economic disadvantage exacerbated by ongoing public health initiatives, and rapid dissemination of misinformation and fear (Smith et al., 2022).
6. Building Resilience and Coping Strategies
The “mental health crisis” catchphrase comes readily to mind again. As a result of the pandemic’s behavioral and societal modifications, new global norms will emerge, and efforts will be made to uphold these norms. However, COVID-19 prevention measures have exposed the fragility of human mental stability (S. Baldwin et al., 2021). Individuals frequently inquire about personal defense mechanisms and how to protect children from psychological consequences when discussing panic, grief, anguish, anxiety, and unrest. To get protection, it is necessary to take effective measures against potentially dangerous reasons. Interestingly, many people seek specific, pragmatic advice on how to cope with these emotional consequences. It is better to ask people to stop something rather than to ask them to do something, such as exercising recreationally, sleeping better, or gradually relaxing. The former requires substantial effort, which is somewhat feasible, whereas the latter has been alluded to as impossible. Simply taking consideration and discussing the situation has a protective effect. People are generally aware of the consequences of their worries; understanding them reduces their impact (C. Sanderson et al., 2020). People need to discuss panic and emotions of loss concerning the deaths of loved ones, their own deaths, or how isolation and absence of normal routines are reflected in feelings of unfounded guilt.
6.1. Mindfulness and Meditation Techniques
Mindfulness is deceptively simple, requiring little more than a comfortable position and an ability to breathe, yet it can be immensely powerful. Students can benefit from simply taking a moment to stop what they are doing, breathe deeply, and calmly and quietly listen to the world around them: the sounds, the smells, and the sensations. After a moment, they can be encouraged to reflect on how they feel. This practice takes very little time but can help mental well-being, especially after some training. Nevertheless, staff and students often feel they are too busy to stop. A core challenge in promoting mindfulness is to prevent it being seen as a nice thing to do when one has the time: the activities need to be widely promoted and tied to enhancing resilience and coping strategies in the current crisis. There needs to be a recognition that asking individuals to be resilient is important, but focusing on what can be done at the collective level is also crucial.
The wider, organizational changes within institutions may be having unintended consequences on people’s mental health and experiencing a collective loss (Kanekar & Sharma, 2020). One risk is that mental well-being is sacrificed in the emphasis on the immediate response to the crisis rather than preparing for recovery. Such a focus may hinder students’ and staff’s coping strategies following the pandemic. Furthermore, while individuals can be encouraged to promote greater mindfulness activities, many may find it daunting or difficult to undertake without a structured approach. As a result, it is crucial for institutions to fund mental well-being training, implementation, or research staff. Staff and students may not wish to acknowledge a mental health crisis as it could be seen as a systemic failure. There is no set protocol available for institutions grappling with a sudden increase in self-harm or mental health-related issues after a pandemic (Behan, 2020).
7. Supporting Mental Health in the Workplace
The COVID-19 pandemic has brought focus to one of the most neglected yet pressing concerns of this century – mental health problems. A pervasive, widespread, and chronic menace, mental health encompasses a spectrum of conditions affecting sentiments, thoughts, and behaviors, with depressed mood being the most common. This has engendered questions regarding disciplines being neglected, as a plethora of relevant industrial workers have untold tales of mental health concerns resulting from the pandemic (Giorgi et al., 2020).
The pandemic has resulted in a non-psychotic definition of mental health problems among industrial workers. Addressing the mental health needs of industrial workers will need concerted efforts from various stakeholders and mental health professionals. Mental health services have a significant preventive and curative role in addressing mental health concerns. There are a number of mental health services career programs for the industrial sector, consisting of screening for psychological stress, brief interventions like psycho-education, training mental health service providers in general health settings, training industrial sector managers, mental health service availability in the community, building resilience, involving health workers with public mental health services, targeted intervention for vulnerable groups like migrants, tele-psychiatry for low resource intact, building community and social support for industries, mental health helplines, coping skills training (Chatterjee et al., 2021).
7.1. Employer Responsibilities
There is increasing concern about the mental health of employees and employers and their responsibilities in this regard. The COVID-19 pandemic has disrupted work routines, responsibilities, and life planning on a global scale, leading to prolonged fears of exposure to infection and interruptions to daily life (Giorgi et al., 2020). In turn, these disruptions can trigger psychological distress such as anxiety, adjustment disorders, panic, depression, and post-traumatic stress disorder (PTSD). Employees generally have expectations about their employment stability, remuneration during sick leave, and the availability of treatment support. However, during the pandemic, changes such as income loss, layoffs, work-from-home arrangements, and other unforeseen changes strained the employee-employer relationship.
In a conventional model, mental health is a responsibility of individuals, and if they suffer from mental disorders, it is their responsibility to seek treatment. However, in a social model, a person’s coping abilities and the environment in which they live are considered equally important. Employers commit themselves to a work environment, culture, and practices that support employee mental health. More broadly, the workplace is seen as a priority setting for mental health (Chatterjee et al., 2021). The nature of work determines economic health and, to a significant extent, the psychological health and well-being of everyone at work. Such policies should have a clear employer vision, mission, objectives, and strategies regarding the promotion and protection of employee mental health at work.
8. Policy Recommendations for Governments
There is an urgent need for governments to invest in mental health services. According to a scoping review examining the policy responses of multiple governments on mental health recovery during the pandemic, there is an emphasis on preventing current issues in mental health impacting the population (McCartan et al., 2021).
While many nations were focusing on the containment of COVID-19 during 2020, U.S. experts were sounding the alarm that the pandemic’s impact on mental health could exceed the physical toll stemming from the virus itself. A multi-pronged approach for minimizing the pandemic’s mental health impacts is presented in this work (R. Carbone, 2020). Creating policies that proactively prevent the mental health crisis is critical, as addressing mental well-being after the fact can often feel reactive and afterthought.
8.1. Investment in Mental Health Services
The COVID-19 pandemic has had a profound effect on all aspects of day-to-day life, resulting in detrimental physical, economic, and mental well-being impacts. Many countries have witnessed a dramatic rise in the prevalence and intensity of anxiety, stress, and depressions, as revealed by multiple national and international studies investigating these emerging mental health challenges. Special groups, including health care workers, vulnerable populations, and individuals with pre-existing mental health issues, have experienced heightened mental health adversities.
The World Health Organization and other agencies have called for governments to increase the scope of mental health recovery efforts. Despite evidence that mental health services have not been prioritized, without safeguarding the mental health of populations, the COVID-19 pandemic recovery will be precluded. Investment in routine mental health surveillance is essential in a post-pandemic phase to facilitate population mental health needs assessment and inform suicide surveillance after disasters. Transformative policy measures are needed to bolster a population’s mental well-being (McCartan et al., 2021).
9. Community-Based Interventions
Considering the growing unmet mental health needs, coupled with the limitations and stigma surrounding mental health treatment, there is renewed interest in community-based interventions. These interventions utilize local resources and networks of volunteering individuals to collaboratively address mental health needs while also fostering community solidarity, resilience, and activism (G. Castillo et al., 2019). One model of community-based interventions that has spread internationally and has been endorsed by the World Health Organization is the “Peer Support” program or “social networks for mental health.” The origins of this model date back to the 1960s in the United States with consumer activist movements and the self-help groups they initiated (Tasnim Rodela et al., 2020). At the core of this model is the use of trained lay citizens, who themselves have mental health problems, to assist peers with similar experiences find adequate mental health care and promote recovery through informal social interaction.
Such programs can take various forms depending on the cultural context and resources available. They can be set up in local communities (neighborhoods, workplaces, schools) or at a larger scale (cities, regions, or countries) through new and existing community-based organizations (formal or informal), ranging from associations, and shops, to informal visits. They can also be conducted online. In all cases, peer support programs would preferably involve a range of social activities that would stimulate social interaction and thereby question peer group’s isolation or adherence to maladaptive coping strategies (e.g., substance misuse).
In addition to wellbeing promotion, peer support programs may also include other activities adapted to the needs of the local target population. These would include supporting peer group identification and access to structural resources such as employment, housing, and education—with a focus on fighting inequalities. The role of the communities is key: it is envisioned that newly trained peer supporters, whose own needs would have been addressed in a first phase (i.e., after emergencies or major disruptions), would then reach out to other vulnerable individuals in their local context.
9.1. Peer Support Programs
As community members across the world begin to think about “what comes next,” there has been a rising interest in potential community-driven public health responses. Community-based approaches to addressing the impacts of COVID-19 on mental health will be critical to bolster, develop, and maintain strategies that support mental well-being in a quarantine and pandemic context. In this article, the focus is on peer support programs (Mpango et al., 2020) , as they offer an invaluable approach to mental health that is particularly relevant to COVID-19. Concerns about isolation and the effects on mental health have been accumulating since COVID-19 lockdowns began across the globe (S. Baldwin et al., 2021).
Peer support in health systems refers to a diverse range of programs that promote the involvement of service users and their families in providing support to others with a comparable experience in navigating health systems and managing their health condition. The pandemic increased interest in peer support with growing awareness of the value of collective lived experience in building more responsive and resilient health and community systems. Peer support has been shown to enhance mental health, self-management, and engagement with health services in the aftermath of stressful and traumatic events. It is evidence-based, cost-effective, and an essential strategy for addressing the challenges posed by COVID-19 in mental health systems globally. The interest in developing peer support approaches to mental health surfaced worldwide due to the COVID-19 pandemic and its aftermath. Promoting individual peer-to-peer support has been a rapid response to loneliness triggered by a lockdown.
10. The Role of Education in Mental Health Awareness
Mental Health is one of the major concerns due to ongoing global resistance against the spread of COVID-19 infection and enhanced awareness of avian influenza, new variants of corona-type viruses, epidemical monsoons, green excess growth of bush vegetation, and limited intake of seasonal fruits and vegetables in remote areas. Recent earthquakes, tsunamis, floods, and the Russia-Ukraine war have directly or indirectly affected the mental health of many across the globe (S. Baldwin et al., 2021). Mental health problems affect school performance, including attendance, school dropout, classroom participation, psycho-social functioning, and academic achievement. It is difficult for children with poor mental health both at school and on the playground.
Therefore, mental health should be included in school curricula. School mental health programs have been considered one of the practical and appropriate approaches to resolving psychosocial problems since parents, teachers, and children spend a lot of time together. Providing mental health education is proposed as a feasible way to cultivate mental health literacy among school personnel, thereby reducing children’s stigmatization about mental health problems and increasing their help-seeking behavior (Choi, 2023). Knowledge and awareness play a key role in the awareness of mental health problems in the community, followed by more acceptance stigmas. Enhanced awareness of mental health problems by providing education and training would not only diminish the prevalence of moral-related and avoidable consequences but also foster support in communities and for mental care patients.
10.1. Incorporating Mental Health into School Curricula
Focusing on incorporation into school curricula, the post-pandemic mental health crisis can be addressed through education at school levels. Education has the potential to change society fundamentally, and the destructive impact of the pandemic on students, parents, and educational professionals’ mental health should drive educational systems to champion mental health awareness. Numerous programs and initiatives promote mental health literacy (MHL) and well-being (WB) in educational settings; however, they need to be more extensive or systematic, particularly in developing countries (Choi, 2023). It is evident that a curriculum inclusion could help to improve knowledge and awareness regarding mental health and WB in joined efforts with communities, families, and broader social contexts. Such an educational intervention would specifically focus on fostering knowledge on mental difficulties, risks, and solutions and would inform students on available services and the importance of help-seeking behaviors.
Schools can play a crucial role in mitigating or even preventing the impact of crises, hardships, and adversities on mental health and WB. They can create a safe environment that promotes well-being and support (Yu et al., 2022). A combination of universal mental health literacy education, well-being promotional interventions, early risk detection, and universal accessibility to social and psychological services is considered the most effective community-based approach. Mental health and well-being preventive initiatives could be the most effective and societally beneficial educational measures taken after the pandemic.
11. Stigma Reduction and Advocacy Efforts
The stigma surrounding mental health issues is a critical factor preventing individuals from seeking help. Due to misunderstanding and misrepresentation, people with mental disabilities are often victimized, neglected, and marginalized. A negative perception of mental illness can arise from bias, stereotypes, and discriminatory behavior. This impediment worsens a community’s mental health status, as healthy individuals may feel ashamed of their sickness and fear the repercussions of coming forth. Without help, their condition only worsens. A caring community focuses on combatting stigma and creating a safe atmosphere for discussions that can encourage treatment-seeking. Collective action is required. Group members can join the popularity of mental disability awareness events, petitions, and campaigns. A progressive and inclusive environment will foster a priority of mental health and disease awareness (Sue Berdell, 2016).
Public efforts refer to those that present accurate information concerning mental illness and raised awareness of mental health problems. This awareness aims to address the prevailing misconceptions that surround people with mental disabilities. Efforts include dissemination of materials that promote accurate information. Handicap sports events, art shows, and other creative endeavors portraying people with disabilities in a positive light are also encouraged. Furthermore, individuals with experience in caring for or having a mental illness can share their stories. Positive and inspiring stories are an excellent way to confront fears and misconceptions while uplifting those burdened with mental disabilities. Efforts should also address the prejudice that exists against family members and caregivers. For any of the efforts to be effective, they must be coupled with advocacy for policy changes. The cooperation of community leaders, such as politicians, educators, and health officials is essential (Shoib et al., 2022).
11.1. Public Awareness Campaigns
Public awareness campaigns are vital in reducing stigma attached to mental health and advocating for mental well-being. Campaigns aiming to raise public awareness of mental health issues have proliferated since the 1980s. Awareness of campaigns can have positive effects on stigma reduction. Most campaigns have been designed to raise general public awareness of mental health issues and improve social acceptance of mental health service users. Focus on examining the designs and outcomes of a specific mental health awareness campaign launched by the government agency, the Maryland Department of Health, the Behavioral Health Administration, called “Real Life, Real People.” This was the first large-scale public service announcement (PSA) campaign focusing on three specific topics of mental health: depression, anxiety, and early psychosis. The campaign was designed to increase knowledge and change attitudes towards mental health and disability. The media strategies employed include television, radio, print, poster, and internet advertisements (C. Morganstein, 2021).
Public awareness campaigns usually have a common characteristic—they target the stigma surrounding mental illness and disability. The various stigma campaigns have identified that stigma reducers are a crucial component of campaign development. Campaigns should utilize mass media vehicles to increase reach and thereby a campaign’s ability to produce change. Awareness initiatives—reducing stigma, addressing health disparities, and leading to social change—premise that by educating the public about mental health issues, social perceptions about mental health can be reframed towards a more accurate and less stigmatizing view, thereby reshaping societal attitudes to foster a more supportive climate for mental health issues and concerns (Sue Berdell, 2016).
12. Intersectionality and Mental Health
Gender is a core determinant of mental health. Gender not only shapes socialization patterns of coping mechanisms but also works as a lens through which adverse life experiences are interpreted, processed, and given meaning. These processes have significant implications for both physical and mental health (Bhugra et al., 2021). On the one hand, gender differences in sociodemographic variables and various structural factors may lead to gender differences in mental health problems. On the other hand, these same differences may also affect access to mental health services compliance, adherence, satisfaction, and outcomes.
Moreover, pandemic-related outcomes, such as COVID-19 infection and life disruption, do not manifest randomly at the individual level; they are shaped by systemic inequalities (M. Shroff et al., 2022). Research on income and wealth disparities demonstrates how economic inequality creates health disparities.
The term intersectionality was coined by black feminist scholar Kimberlé Crenshaw to denote the complex intersection of gender and race that shapes women of color’s oppression and marginalization. Since then, intersectionality has emerged as a robust concept that offers a framework for understanding how multiple social identities interact to produce unique experiences of discrimination, disadvantage, or privilege. Although discussions of intersectionality abound, health researchers have been slow to engage with the concept. One obstacle has been the lack of easily operationalized research metrics. This study endeavors to narrow this gap by documenting the role of intersectionality in the pandemic’s effect on self-reported mental health outcomes. By bringing to light the ways in which gender intersects with other social identities to produce distinct experiences, this study aims to illuminate the diversity of lived experiences, processes, and group challenges, thereby advocating for more inclusive, gender-sensitive approaches to assessing and addressing mental health needs.
12.1. Gender and Mental Health
Addressing mental health needs post-pandemic requires carefully considering how gender dynamics affect mental health. Gender-sensitive assessments and public health efforts are needed to create a more inclusive response. The COVID-19 pandemic has had devastating impacts on people’s health and wellbeing. While initial efforts focused on COVID-19 prevention, many nations now recognize the importance of addressing the pandemic’s collateral impacts, particularly concerning well-being, social connection, and the rise in anxiety and depression (Ransing et al., 2020). Such issues highlight the importance of mental health, and while the pandemic has affected everyone, it has not done so evenly. Gender is one of the many intersecting considerations influencing how the COVID-19 pandemic and its aftermath affect mental health.
There is a need to understand these dynamics better and consider them in efforts to respond to mental health needs after the pandemic. At the individual level, the concept of gender refers to an individual’s experience with masculinity, femininity, and other gender identities (M. Shroff et al., 2022). These experiences can shape the mental health needs of an individual. At the structural level, the concept of gender captures societal norms and expectations surrounding masculinity and femininity. Gender results in unequal power relations that shape how access to resources is mediated, mediating inequities in the mental health impacts of the COVID-19 pandemic and response. Gender-sensitive assessments are needed to consider how gender dynamics affect mental health in assessing mental health needs post-pandemic. Gender-sensitive approaches to mental health involve going beyond focusing only on the well-being of women and recognizing how masculinities (and violence) affect the mental health of diverse people with different gender identities. They further involve recognizing how policy responses disproportionately harm individuals with different genders. Considerations of gender can enhance public health assessments, studies of pandemic impacts, or more general efforts to build a healthier and more equitable world after the pandemic. Gender-sensitive assessments of health are a crucial tool to make such efforts more inclusive and tailored.
13. Ethical Considerations in Mental Health Care
Complicated considerations of confidentiality and privacy issues arise with the use of new technologies in mental health care. Even prior to the pandemic, bureaucratic regulations pertaining to confidentiality and privacy both facilitated and hampered the provision of mental health care. Traditional in-person practices were well-understood in terms of respecting confidentiality and privacy. The extensive use of new technologies in mental health care since the onset of the COVID-19 pandemic has led to questioning of these earlier understandings. New practices have arisen, and interests in mental health care provision in general have shifted. Amidst these shifting practices, it is crucial to uphold ethical standards and protect individuals. Not everyone has the same weight of responsibility to uphold these foundational ethics, such as privacy, fairness, and respect for persons, in mental health care (PAUL CHIN & PALCHIK, 2020).
With the new unlicensed practices in mental health technology in a post-911 America, there is a sobering realization: the privacy rights of individual Americans are diminished unless challenged by the courts, and people have effectively lost the right to free and private speech. As philosophers start thinking about these more complicated challenges for privacy and confidentiality in the expanding realm of mental health technologies that share mental content, it is paramount that ethical principles concerning privacy and confidentiality be applied to mental health technology in a way that protects individuals from their detriment (Sediqzadah et al., 2021).
13.1. Confidentiality and Privacy Issues
Confidentiality and privacy issues are commonly concerns relating to mental health care, and such ethical considerations are now more significant than ever due to the COVID-19 pandemic. As face-to-face interactions become increasingly rare as a result of the pandemic, people suffering from mental health problems may become more isolated and vulnerable, escalating their predicaments. Fortunately, however, in such times of difficulties, many allies are attempting their utmost efforts to provide different kinds and sorts of supports to those in need. Nevertheless, in order for such supports and interventions to be effective, there is a need for those concerned support services and interventions to “be morally acceptable by their nature and design,” which advocates for the issue of privacy protection on the side of their design (Jiang, 2020). Such side-effects may further deprive those individuals suffering from mental health issues from receiving the necessary help.
Mental health care is such a domain dealing with extremely sensitive personal matters, and thus such ethical considerations may seem even more pressing when it comes to mental health care services (PAUL CHIN & PALCHIK, 2020). Aiming to ensure that support services and interventions for mental health contain ethically necessary frameworks and safeguards to comply with the above advocacy, the design and implementation intention of certain support services and interventions will be presented. These services and interventions consist of two applications which serve similar supportive functions but have very different characteristics. One serves more as a proactive intervention, while the other one is more for passive and retroactive monitoring. Following the service and intervention designs, considerations regarding confidentiality and privacy will also be discussed to provide insight into the design of ethically credible mental health care support services and interventions.
14. The Future of Mental Health Care Post-Pandemic
Addressing the mental health crisis faced by individuals worldwide as the COVID-19 pandemic subsides is a growing focus of concern worldwide. Mental health experts have been sounding the alarm bells about the worsening mental health crisis, yet few organizations are looking to answer the question of how the crisis can be tackled (Taylor, 2022). Over the past three years, dramatic changes have occurred concerning the form and content of mental health and health support services provided worldwide. However, examining lessons learned from the pandemic regarding how to tailor future mental health services to address future crises and needs is not currently topical. There appears to be a technological race to develop solutions that utilize technology to address the crisis, with more hope for the effectiveness of such solutions than might be warranted (Gavin et al., 2020).
In the wake of the COVID-19 pandemic, there is currently little cross-national or global understanding of how people, services, and institutions are harnessing technology to address future or ongoing mental health needs. As emerging, emerging, and low-income countries come out of pandemic-times crises, there are widely diverse mental health needs and health-related education and support technologies in use. There is unprecedented freedom as to the future form of services and their likely content, with a spectrum of technological solutions available to meet that future form. Understanding how that future is likely to be sculpted by low- and high-tech choices, combinations, and policies, as well as the roles that existing services and presently unanticipated solutions will play, is warranted.
14.1. Technological Advancements in Mental Health
Advancements in technology have had a growing impact on the field of mental health. The health sector has quickly adopted new technologies that have fundamentally changed the way health care is delivered (B. Roth et al., 2021). Numerous eHealth services, such as telemedicine, electronic health records, health monitoring tools, and wearable fitness trackers, have been made available, automating workflows, storing and evaluating health data, and improving communication between patients and medical institutions. Due to the rapid and global proliferation of telehealth solutions catalyzed by the COVID-19 pandemic, the digital transformation of healthcare has spread throughout the industry. Telehealth services help remote medical assessment and access to a virtual medical consultation, including video telephone, text message exchanges, and collaboration among different health institutions.
Global efforts to foster the use of digital technologies in clinical care have expanded since the World Health Organization (WHO) launched the Global Observatory for eHealth in 2005, followed by the Global Strategy on eHealth. Technological advancements sufficiently met the requirements for better and safer health services. Emerging technologies such as nanotechnology, robotics, wearables, remote monitoring, artificial intelligence, machine learning, big data, the Internet of Things (IoT), augmented and virtual reality, and blockchain have the potential to revolutionize mental health care before and after transformations to health systems worldwide. With these technologies, professionals in this field can manage services more efficiently and effectively, offering preventive, diagnostic, therapeutic, and rehabilitative services that are more accessible and impactful (Woodward et al., 2019).
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