The expectation that we can be immersed in suffering and loss and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet.” – Dr. Naomi Rachel Remen.
On World Mental Health Day, October 10, it will have been more than 18 months since the start of the COVID-19 pandemic. This year, the theme of World Mental Health Day is “Mental Health Care for All: Let’s Make It a Reality” (##WorldMentalHealthDay).
In some countries, life is returning to something close to “normal.” In other countries, rates of transmission and hospital admissions remain high, continuing to disrupt the lives of families and communities.
In all countries, the pandemic has had a major impact on mental health. Some groups, including health and other frontline workers, students, people living alone and those with pre-existing mental health conditions, have been particularly affected. A World Health Organization (WHO) survey conducted in mid-2020 clearly showed that services for mental, neurological and substance use disorders had been significantly disrupted during the pandemic.
“The COVID-19 pandemic has been a stark reminder of the importance of integrating mental health into preparedness and response plans for public health emergencies,” said Dévora Kestel, Director of the Department of Mental Health and Substance Use at WHO.
The Sixty-Sixth World Health Assembly, consisting of Ministers of Health of 194 member states, adopted the WHO’s Comprehensive Mental Health Action Plan 2013-2020 in May 2013. In 2019, the action plan was extended until 2030 by the Seventy-second World Health Assembly. Then in 2021, the Seventy-fourth World Health Assembly endorsed updates to the action plan, including updates to the plan’s options for implementation and indicators.
This updated Comprehensive Mental Health Action Plan 2013-2030 builds upon its predecessor and sets out clear actions for member states, the WHO Secretariat and international, regional and national partners to promote mental health and well-being for all, to prevent mental health conditions for those at-risk and to achieve universal coverage for mental health services. While the updated action plan includes new and updated indicators and implementation options, the original four major objectives remain unchanged: more effective leadership and governance for mental health; the provision of comprehensive, integrated mental health and social care services in community-based settings; implementation of strategies for promotion and prevention; and strengthened information systems, evidence and research.
Mental Health Facts and Figures from WHO
The facts about mental health
- Close to 1 billion people have a mental disorder and anyone, anywhere, can be affected.
- Depression is a leading cause of disability worldwide and is a major contributor to the overall global burden of disease. Globally, it is estimated that 5% of adults suffer from depression.
- Globally, one in seven 10-19-year-olds experience a mental disorder. Half of all such disorders start by age 14 years but most are undetected and untreated.
- People with severe mental disorders such as schizophrenia tend to die 10-20 years earlier than the general population.
- One in every 100 deaths is by suicide. It is the fourth leading cause of death for young people aged 15-29 years.
- The COVID-19 pandemic has had a considerable impact on people’s mental health.
The care gap
- Despite the universal nature and the magnitude of mental ill health, the gap between demand for mental health services and supply remains substantial.
- Relatively few people around the world have access to quality mental health services.
- The serious gaps that still exist in mental health care are a result of chronic under-investment over many decades in mental health promotion, prevention and care.
- Stigma, discrimination and human rights abuses of people with mental health conditions remain widespread.
The economic cost
- The lost productivity resulting from depression and anxiety, two of the most common mental disorders, costs the global economy US$1 trillion each year.
- The investment deficit
- On average, countries spend just 2% of their national health budgets on mental health. This has changed little in recent years.
- Despite an increase of development assistance for mental health in recent years, it has never exceeded 1% of development assistance for health.
The good news
- Some of the most common mental health conditions, depression and anxiety, can be treated with talking therapies, medication or a combination of these.
- For every US$1 invested in scaled-up treatment for depression and anxiety, there is a return of US$5.
- For every US$1 invested in evidence-based treatment for drug dependence, there is a return of up to US$7 in reduced crime and criminal justice costs.
- Generalist health workers can be trained to diagnose and treat mental health conditions.
- Regular health checks of people with severe mental disorders can prevent premature death.
- The quality of life of people living with conditions such as autism and dementia can be greatly improved when their caregivers receive appropriate training.
- The rights of people living with mental health conditions can be protected and promoted through mental health legislation, policy, development of affordable, quality community-based mental health services and the involvement of people with lived experience.
The Need to Scale Up on Mental Health Services Recognized
During the World Health Assembly in May 2021, governments from around the world recognized the need to scale up quality mental health services at all levels and endorsed WHO’s Comprehensive Mental Health Action Plan 2013-2030, including the Plan’s updated implementation options and indicators for measuring progress.
World Mental Health Day presents an opportunity for government leaders, civil society organizations and many others to talk about the steps they are already taking and that they intend to take in support of this goal.
In the United States, the National Alliance on Mental Illness (NAMI) and participants across the country are advocating for better access to quality mental health care.
Since 1990, when the U.S. Congress officially established Mental Illness Awareness Week for the first full week of October, advocates have worked together to sponsor activities, large and small, to educate the public about mental illness. This MIAW, NAMI is highlighting our “Together for Mental Health” campaign, which focuses on the importance of improving the mental health care system.
Each day throughout the week (Oct. 3 – 9), NAMI is spreading awareness about some of the most common barriers to mental health care people with mental illness face. The organization is raising the voices of those with lived experience and sharing their compelling stories and by calling on advocates to take action to reimagine our crisis response system.
“Over the pandemic, our movement has grown stronger by the day,” said Daniel H. Gillison Jr., NAMI CEO. “We may be at an inflection point of mainstream acceptance that anyone can be vulnerable to mental health concerns. As a society, we have become more open to discussing mental health and providing support for each other.”
The NAMI HelpLine — a free, nationwide peer-support service, which is available Monday – Friday, 10 a.m. – 10 p.m. ET, by phone at 1-800-950-NAMI (6264), via the “Chat with us” web widget, or by email at info@nami.org for support and resources. There are also HelpLine information and referral resources available 24/7 online at www.nami.org/help in the NAMI HelpLine Knowledge Center and the NAMI Resource Library. In a crisis, please text “NAMI” to 741-741 to connect with a trained crisis counselor for free, 24/7 support via text message.
Taking Care of Yourself and Others Is Key to Mental Health Care for All
World Mental Health Day is about more than advocacy and while it shines a light on mental health for one day or one week, mental health is an ongoing effort and challenge. Many professionals in the mental health field are using it as an opportunity to empower people to look after their own mental health and provide support to others.
Sarah Lundeen Bonnette, LISW-S, created presentation to help staff members at her organization through the challenges brought about by the pandemic.
“Staff were stressed for various reasons,” she said. “My audience was in-home therapists for younger children with developmental disabilities and their challenge was the stress the pandemic put on already stressed family systems.”
Lundeen Bonnette created the presentation to focus on self-care for the staff members who were going into the homes, but they expanded the program in an effort to help the caregivers in the family—many of whom had become full-time caregivers juggling care of family members with full-time jobs—deal with anxiety, stress and depression.
As part of her presentation, Lundeen Bonnette spends time talking about burnout, which she described as “a state of physical, emotional and mental exhaustion caused by excessive and prolonged stress. It may be accompanied by a change in attitude, from positive and caring to negative and unconcerned. It can occur when you feel overwhelmed, emotionally drained and unable to meet constant demands and comes over time.” (For many employees around the globe, burnout has contributed to the “Great Resignation” phenomena, in which 50 percent or more of workers surveyed said they were looking for a new job.)
For the staff presentation, Lundeen Bonnette offered guidance about meeting fatigue. Not unlike most of us, members of her organization were forced to work remotely and that created issues. Zoom fatigue is real, she said.
“Video calls require more mental processing than face-to-face interactions. In real life, do we stand 3 feet away from a colleague and stare at their face? Do we typically engage in a “constant gaze?” she asked. “No; we use our peripheral vision to glance around. But on a Zoom call, we worry if we glance elsewhere it may appear we are not paying attention.” She added that in Zoom and Teams calls, we all are faced with a small window of ourselves. This makes us hyperaware of every expression and how it might be interpreted.
Lundeen Bonnette added that during video calls and meetings:
- Our brains have to work harder to attend to the tasks at hand and stay focused. In a conference room we can connect with colleagues if we miss something or quickly ask a question.
- Our brains are also taking in the backgrounds of each person’s background AND our own!
- Video calls make it easier to lose focus: listen, text, check email, etc. Let the multi-tasking begin! If working from home, we also have to tune out our housemates and find new polite ways to ask them not to disturb us.
Tips to combat Zoom fatigue include:
Check your position: Try to correctly position your screen to avoid glare. Try to distance yourself about 25 inches from the screen and angle it so that you are looking slightly down Adjust your view: Reduce on-screen stimuli. Instead of “gallery view,” choose speaker view for less visual stimulation. Hide your self view or turn your video off. Agree as a group to use plain backgrounds or to have everyone who is not talking turn off their video
Look away from the screen during a Zoom break: Don’t use your 15 minutes to check your email, text someone, etc. Prevent eye strain by using the 20-20-20 rule. Every 20 minutes look away from your screen and focus on an object 20 feet away for 20 seconds.
Don’t schedule back-to-back meetings: Your brain needs a break.
Focus on listening: When tuning into a meeting, turn off your video so focusing on listening and taking paper-and-pencil notes rather than doing “double screen duty.” This will increase retention
Take stretch breaks.
“The Zoom fatigue information was well received [by staff] as we were all just adjusting to the new way of service delivery,” said Lundeen Bonnette, who added that programming around burnout, trauma-informed care and compassion fatigue also was well-received.
She encouraged everyone to run through a 5-minute mental health checklist. It’s important to remind ourselves to get outside in the fresh air, to get enough sleep, to eat regular meals, to stay connected to friends and family members and to take it easy on ourselves. None of us has lived through a situation like this before, one which truly impacts not only the entire world, but almost every aspect of our lives, both at work and at home.
When anxiety strikes, her stress-reducing calming techniques include:
- Take breaks throughout shift when possible.
- Communicate with your colleagues. Seek and accept support from those around you. Step back and allow another staff member to assist when needed.
- Take a drink of cool water.
- Take slow, deep breaths.
- Progressive muscle relaxation/body scanning (focusing briefly on various areas of your body). Brief guided meditations.
- Put on relaxing music if possible.
- Avoid drinking caffeine during or prior to your shift.
- Take opportunities for physical outlets/acknowledge personal sensory needs (e.g., take a quick walk, chair yoga, bouncing on an exercise ball, etc.).
“I am a big proponent of recharging and practicing self-care. I think when working in helping professions the emphasis is on others and often those who are in those professions consider it their calling in life to help but help themselves last,” said Lundeen Bonnette. As a supervisor, she encourages her reports to take time for themselves and find out what works best for them in terms of handling stress, whether it’s taking some time off, exercising, changing eating habits, etc. “I would hope my staff know that I value them above the job and want them to be mentally well.”
As far as the pandemic goes in terms of creating new challenges for workers all around the globe. Lundeen Bonnette points out that people suddenly found themselves working in spaces they typically would relax in. “Typically, people had the commute home to separate from work; now they had just a few steps from their workspace to home life. I encouraged them to find little ways to make the break (between work and home life). Only use their workspace for work, nothing else; pack up all their work and put it in their travel bag for the visual of being done with it until the next day; take a walk at lunch time or immediately after work to again separate themselves from work.”
Intelex Resources
When the COVID-19 pandemic disrupted the world in 2020, organizations struggled to support workers experiencing unprecedented levels of anxiety and overwork. ISO has responded to this challenge with two new standards to supplement ISO 45001:2018. The new Insight Report, Expanding the Reach of ISO 45001: How to Build Organizational Resiliency with ISO 45003 and ISO/PAS 45005:2020, examines these new standards and how you can apply them to your organization.
Mental Health Toolkit: Supporting Employee Success
With mental health issues affecting many workers today, it’s critical for organizations to develop effective workplace plans for their employees. Designed to identify physical, mental and environmental stressors and create a safe, collaborative and productive work environment, these plans are a win-win for both employees and employers. Jumpstart the process by downloading Mental Health Toolkit: Supporting Employee Success.
Employee Mental Health Checklists: Action Steps Employers and Employees Can Take to Help Reduce the Impact of Mental Health Concerns in the Workplace
With anxiety and depression rates being alarmingly high during the current COVID-19 crisis, it’s become a key concern and top priority for most employers. Affecting work performance, relationships and communication levels, these mental health issues can often have negative impacts on daily functioning and can lead to increased substance abuse. To help you address these types of issues, we’ve put together a series of mental health checklists.
