World mental health day blog

Challenges and Silver Linings 

It is 2021-And the world’s mental health has changed. It is important to reflect on how the last 2 years have reshaped, the field of mental health. None of us have seen a pandemic affecting all nations and people. The many deaths, disruptions and incessant political battle lines have never been starker. But there have been advances, rethinking of mental health care and indeed reimagining of mental well-being itself. We summarized some of the key findings in the evolving picture of mental health, as new data keeps accumulating.

 

The pandemic and the mental health of the population

A systematic review of 71 studies showed that anxiety and insomnia are possibly the biggest problems followed by depression and PTSD during the pandemic. Interestingly repeated analyses show that the prevalence of mental health problems is higher outside of China and higher outside of Asia. Suicidal thinking and attempts have increased across the board but it is unclear if the actual rates of suicide have increased.In the general population, mental health problems were highest in those who had COVD-19, followed by health care professionals, and then the rest of the population.Across the world, the risk factors for mental health issues are previous mental health history, youth, low or middle social economic status. 

 

Children and Youth

This group is affected by the pandemic restrictions, but the effect is greater in adolescence. This is also the time when peer relationships are important. Social isolation affects young people’s mental health. The duration of the isolation has a bigger effect than the intensity . Parental stress also increased. Changes in schooling have led to increased stress in teachers, with those from Asia reporting higher anxiety.

 

Women’s mental health

There are increased demands on women, particularly in their home management roles. Intimate partner violence has also risen across the world. Depression and anxiety have increased in the perinatal period compared to the time before Covid-19.

 

Loneliness matters

Loneliness has long been held to be a risk factor for mental health and the pandemic has given us further insights that this applies across age groups. These cuts across all age groups, and are prompting more research in the area. Reduction in social connection affects both mental and physical health. 

 

Addictive behaviours during the pandemic

The use of alcohol and addictive substances is on the rise across the world. Social isolation, economic hardships, impact on mental health are important factors as also the decreased availability of services for people with addictions. 

 

Internet Use and Mental Health

Excessive use of social media was associated with an increased risk of mental health problems. Internet addiction with behaviours such as social media use, online gaming and pornography have also increased during the pandemic period.

 

The inequity of mental health care

 Living in an area with lower income and having poor access to the internet does reduce the chances of receiving mental health care in the Asia-Pacific region. Canada has one of the highest cell phone and internet costs, which surprisingly, has not been a talking point during the pandemic either in the popular press or scientific publications. Such costs would clearly disadvantage many with mental health adversity in both metropolitan and remote areas from access to appropriate treatments. 

 

Work & mental health 

 Workplaces have changed forever and so should human resource management. The work environments would change and many people would either work remotely or do a hybrid of remote and in-person work. These changes were stressful but now we have to come to agreements on the new normal. This would require redefining work, personal life, functioning as a team, organizational citizenship and new human resource thinking. 

 

The spectre of post-Covid-19 syndromes

 After recovery from Covid-19, sufferers may continue to have physical health and mental health problems. 

The rate is particularly higher if they have received inpatient hospital care, indicating that the severity of the infection matters. Depression and anxiety are noted, but even the physical health symptoms such as fatigue and loss of smell or taste made an impact on the mental health. Our own study of fatigue shows persistence up to 12 months after recovery from COVID-19. The treatment of all these conditions is improved by adding a psychological approach. 

 

And now the silver linings 

Delivery of mental health interventions, changed overnight despite the long-standing concerns of the practitioners to use existing technology. Randomized controlled trials of Internet-based psychological treatments (predominantly CBT) for mental health conditions are reasonably effective.  We now have good studies on managing and alleviating loneliness. Several approaches work, but the majority of the studies used cognitive behavioural therapy. Both group and personalized individual treatments work. Positive communication and parenting make a difference in the lives of children and adolescents who are trying to make sense of the unexpected changes in the sensitive years of their lives. The most common technologies for mental health care were video, zoom and WhatsApp. The possibility of access to mental health care has improved dramatically, cutting the cost of inconveniences such as travel, arrangement for child care and the costs around these.  We have several effective vaccines for COVID-19 developed in record time. Studies show that having COVID-19 vaccination is linked with a reduction in mental distress.  And finally, we do have an answer if governments actions matter with regards to mental health. Those countries which implemented strict public health rules based on science have less anxiety and depression compared to countries that followed less rigour. 

 

Opportunities and challenges to better training in evidence-based psychological treatments

Psychological interventions are now recognized as a key force to improve health care across the world. This has created an increased demand for training, supervision and consultation to deliver the therapies with expertise and consistent with the recommendations for evidence-based treatments. The dramatic improvement in digital technology has made it possible to have such training available right at students’ and therapists’ homes through video conferencing, webinars, webcasts and app-based approaches. In all this, we must remember that it is not just hours before the screen which shapes the therapist but ongoing practice, supervision, mentorship, coaching and delivery of measurement-based care which eventually makes the difference for them and the people who reach out to them for help. 

 

About the Author:

Dr Sanjay Rao is an experienced teacher and Associate Professor of Psychiatry at the University of Ottawa. In 2018, he was awarded a Fellowship of the Canadian Association of Cognitive Behavioural Therapy for his contribution to CBT in Canada. He has received an award from the Department of Health, UK for CBT development. He is the Director of Unified CBT Academy and the Medical Director at the Center for Mental & Psychological Health.

Learn more about our programs
Enter your email address and we'll reach out to you with more information!

Learn more
close-link

Unified CBT for Social Anxiety
17/10/2019 | 12:00 pm - 6:00 pm EDT

Get an insightful understanding of experiential cognitive and exposure-based exposure treatment of social anxiety. Enhance your confidence in providing therapy by following a step by step specific protocol rather than all too common generic ‘thought mood’ stereotypes of CBT formulation. 


Bookings are closed for this event.


close-link

Unified Experiential CBT for Generalised Anxiety Disorder
03/10/2019 | 12:00 pm - 6:00 pm EDT

Get an insightful understanding of experiential cognitive and exposure-based exposure treatment of social anxiety. Enhance your confidence in providing therapy by following a step by step specific protocol rather than all too common generic ‘thought mood’ stereotypes of CBT formulation. 


Bookings are closed for this event.


close-link

Behavioural Activation Treatment For Depression
10/10/2019 | All Day EDT

The course covers the theory and model for diagnosing and treating depression. Approach BAT through the functional analysis of avoidance and loss of rewards in depression. By understanding the skilled use of the activity diary, you will learn to identify ‘stuck’ points and effective treatment strategies to get clients unstuck. 


Bookings are closed for this event.


close-link

Post-Traumatic Stress Disorder: Unified CBT Approach
23/11/2019 - 24/11/2019 | 9:00 am EDT

TBD


Bookings are closed for this event.


close-link

Unified Experiential CBT for Obsessive Compulsive Disorder
07/11/2019 | 12:00 pm EDT

Cognitive Behavioural Therapy (CBT) is a first line evidence-based treatment for Obsessive Compulsive Disorder (OCD). 


Bookings are closed for this event.


close-link

Rumination Focused Cognitive Behavioural Therapy
14/11/2019 | 9:00 am EDT

Rumination is a common phenomenon across a range of conditions like posttraumatic stress disorder and social anxiety disorder. It can be a challenge for therapists as it is associated with poor clinical outcomes. Rumination may go undetected and derail therapy.


Bookings are closed for this event.


close-link

STAR Centre’s Structured Psychotherapies Conference
15/11/2019 | 8:00 am EDT

This 1-day event is packed with learning opportunities for practicing clinicians with a diverse array of topics on structured psychotherapies delivered by recognized experts. The conference consists of state of the art presentations and workshops, focused on key skills for practice.


Bookings are closed for this event.


close-link

Unified Experiential CBT Skin Picking & Hair pulling
21/11/2019 | 12:00 pm EDT

Trichotillomania (hair pulling disorder) and Excoriation Disorders (Skin Picking Disorder) are included in the obsessive-compulsive related disorder section of the DSM-5 and are present in about 1-2% of the population. They are more common in females, often co-morbid with other conditions.


Bookings are closed for this event.


close-link

Unified Experiential CBT for ADHD
28/11/2019 | 12:00 pm EDT

Attention Deficit Hyperactivity Disorder is a common presentation in adult mental health. It is often co-morbid mood and anxiety disorders. Adult ADHD (AADHD) is frequently missed in presentations. There is also the danger of overdiagnosis in presence of other conditions which disrupt attention and concentration. 


Bookings are closed for this event.


close-link