The effects on our collective mental wellbeing are just beginning to be truly appreciated. Not only could COVID-19 have a devastating effect on already vulnerable sectors of society, but also we anticipate a second, and potentially large cohort of newly at-risk people as a result of the economic downturn, both globally and nationally, and expected ongoing rise in unemployment.
A prolonged period of chronic stress means New Zealand’s recovery period will also be long term, and considerable socioeconomic and psychosocial support will be required. In the context of an essential ‘reset’ of many services and functions, the mental health sector has an opportunity to reinvent itself, moving from an outdated lexicon in favour of adaptive and innovative approaches.
A strong consensus exists among mental health professionals that the time is right for a paradigm shift away from mental illness towards mental wellbeing. There needs to be a broader focus on preventive actions and measures designed to keep individuals, families and communities well. First, there is an urgent need for central government to address critical upstream structural drivers of socioeconomic determinants of mental health and wellbeing. This should be complemented by grassroots research, action and empowerment to better understand and meet communities’ needs and aspirations. For individuals needing a greater level of professional care for their mental wellbeing, services need to be culturally responsive and evidence-based.
As we enter the recovery period, it will be important to recognise the distinctive needs of those who already had mental wellbeing difficulties pre-COVID-19 (about 20% of the population every year), as well as a ‘new’ cohort who find themselves unexpectedly at risk as the pandemic’s broader psycho-social-economic impacts begin to bite. Those formerly at risk are predicted to become even more so, putting further strain on a system that was already under pressure.
Those newly at risk (currently an unknown number, but potentially doubling the overall level of need) may require standard as well as bespoke forms of support and/or intervention. Children and youth, who are experiencing multiple transitions, will have stress compounded by disruption to schooling and future prospects. Adults will be facing loss of jobs and businesses (women may be at particularly high risk of unemployment because of the sectors they are employed in), and possible role changes within families or couples. As such, it will be important to consider the effects of these dynamics on families and relationships more generally. Rebuilding a sense of individual and collective agency will be key at every level of society for promoting mental wellbeing.
Encouraging self-determination in mental health care will be essential for delivering effective and acceptable services guided by best practice.