The second paper, titled ‘Policy and public health implications for mental health after the COVID-19 pandemic’, took a wider view of population-level mental health and the effects of different policy responses. It found that the policies that benefitted mental health included wage subsidies and furlough schemes, eviction bans, school and university-based mental health services, support for survivors of domestic violence and adapted community interventions in low-resource settings.
However, the researchers found that these policies were unevenly lamented around the world, and that digital and economic divides often widened inequalities.
The recommendations from the second paper include:
- Mental health be treated as a core criterion in economic and social policy making
- Embed mental health in social protection and recovery plans
- Integrate clear, trusted communications strategies into disaster planning
- and develop financial models that protect mental health budgets during crises.
The study was carried out by 43 experts from around the world, brought together by MQ Mental Health Research and the Lancet Standing Commission on the COVID-19 Pandemic and Mental Health.
Professor Peter B. Jones, Professor of Psychiatry at Cambridge University and the Commission Co-chair, says
“It was a privilege to work with the Commission members who became so immersed in a rapidly accumulating and ultimately vast evidence base. To have extracted sense and meaningful recommendations is rewarding but the biggest impact will come from their implementation.”
“The effects of the pandemic on mental health services and the need for care where nuanced. It is true that we were all in the same storm, but not in the same boat.”
“The construct of candidacy as a mechanism through which people with mental health disorders stopped seeking help, and mental health services stopped providing care during the pandemic. It holds real promise for guiding responses to future emergences. Protecting health services should not be the aim if it is at the expense of the people who need them.”
Together, the papers show that there was no single global “mental health catastrophe”, but there were clear surges in distress early in the pandemic, deepening inequalities, and serious disruptions to mental health care. The evidence shows that many of the most harmful effects were driven less by the virus itself than by long-standing structural problems in mental health systems and wider social inequalities which the pandemic exposed and intensified.
Professor Etheldreda Nakimuli-Mpungu, Professor of Epidemiology at the London School of Hygiene and Tropical Medicine and the Commission Co-chair said:
“In low-resource settings, COVID-19 showed that mental health suffers most when people lose income, food, safety, schooling, and trust — and improves when governments protect livelihoods and communities. The lesson is clear: mental health must be built into social protection, community services, and crisis planning from the start. If we rely only on specialist services after harm has occurred, we will always be too late.”
The authors also highlighted a need for more long-term, cross-national research, especially in low and middle-income countries, to understand the enduring mental health effects of the pandemic and policy choices.
In summary – the commission recommends that policy makers embed mental health in social protection and recovery plans for future disasters, and invest in blended digital and community based services that reduce, rather than widen, inequalities.
You can learn more about this research by listening to the Lancet’s ‘In conversation’ podcast with interviews from the commission co-chairs Peter Jones and Ethel Nakimuli-Mpungu.