Mental health and well-being (in times of Covid-19) – why it matters

Eight months into the Covid-19 pandemic, most current media attention on global health is focused on vaccine trials, and who will get vaccines first (and who last, if at all). Most global health organisations are focused on protecting essential services (that fall under their mandates).

Mental health and well-being, which were promoted strongly as important issues especially by the World Health Organization when countries started going into shutdown, have slipped off the agenda, perhaps with the exception of domestic abuse and violence (albeit also here with a primary focus on physical risks and health).

Who cares?

Mental health and well-being have never been front and centre of health responses, they are often deemed as nice-to-haves – especially in low- and middle-income countries. The MDGs did not include them, and very few global health organisations are mandated to work on them (the most prominent exceptions are WHO and the Wellcome Trust). The SDGs mention well-being in their health goal title, but in the actual targets mental health and well-being are mentioned in a byline.

“By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.”

Sustainable Development Goal 3.4

Save lives first

With Covid-19 infections and deaths continuing to increase exponentially, and most countries in the Northern hemisphere worrying about second waves as the summer comes to an end, the entire global health architecture seems to be primarily focused on “saving lives”. The fact that large proportions of the population struggle with shutdown and existential threats (hunger, housing, jobs), and that one person died of suicide every 40 seconds even before Covid-19 hit, do not seem to factor in much.

I fully agree that saving lives is important. For most of my career in global health, this has been a focus of my work. But equally important for me has been to prevent unnecessary suffering. Mental health and well-being are a key component of this. What I have learned about the impacts that conflicts, crises and separation can have, for example on children, will never leave me.

Well-being

Having engaged on and written about issues such as work-life-balance and well-being in the global health and development sector, I’ve also come to realise that well-being is even further down the priority list, far behind behind mental health that already lies somewhere at rock bottom. Everyone cares about their well-being at an individual level, but heaven forbid you claim it’s important when we face “real problems” – the list of which is never ending in our sector.

I would be the first person to agree that it’s important to call out our own privileges, and I am more than aware that in my own personal case these really are abundant. But does that mean that we are not allowed to discuss or advocate for self-care, warn people to watch out for burnout, or tackle issues such as institutionally-accepted bullying? Is caring about ourselves, our friends and our colleagues – and future generations joining our workforce and sector – only something that is acceptable to do in private?

What you can do

As this pieces and my blogs over the past months show, I disagree. I disagree that it is ok to keep working and treating people the way we often do in our sector, just because we have an important mission. I disagree that the the health and well-being of each individual doesn’t count in the face of millions of lives to be saved. And I disagree that these issues should not be raised and discussed – also publicly.

Especially during Covid-19, take care of yourselves and each other. Saving lives is important. But mental health and well-being also matter.

I’m sharing some WHO guidance on what to watch out for, and what you can do if you agree.

World Health Organization, Mental Health and Covid-19

“You can start by promoting and protecting your own health and the health of those around you, by making well-informed choices, practicing safe sex and vaccinating your children. You can raise awareness in your community about the importance of good health, healthy lifestyles as well as people’s right to quality health care services, especially for the most vulnerable such as women and children. You can also hold your government, local leaders and other decisionmakers accountable to their commitments to improve people’s access to health and health care.”

Health and Covid19 Factsheet, What you can do, United Nations