What are the consequences of the COVID-19 pandemic on mental health for patients, families, and practitioners in the world’s three largest countries–China, India and the United States? Panelists shared experience and current research addressing these questions while also reflecting on the challenges of their countries’ mental health care systems in providing care for mental health patients.
- Moderator: Arthur Kleinman, Professor of Medical Anthropology, Department of Global Health and Social Medicine, Harvard Medical School
- Shuiyuan Xiao, Professor, Central South University, Xianya School of Public Health
- Yifeng Xu, President, Shanghai Mental Health Center; Head & Professor, Department of Psychiatry, Shanghai Jiao Tong University School of Medicine; Director, WHO/Shanghai Collaborating Center for Research and Training in Mental Health
- Vikram Patel, The Pershing Square Professor of Global Health and Wellcome Trust Principal Research Fellow, Department of Global Health and Social Medicine, Harvard Medical School; Professor, Department of Global Health and Population, Harvard T.H. Chan School of Public Health; Co-Founder and Member of Managing Committee, Sangath
- Cindy Liu, Assistant Professor of Pediatrics, Harvard Medical School
- Host and Commentator: Winnie Yip, Professor of Global Health Policy and Economics, Harvard T.H. Chan School of Public Health; Director, Harvard China Health Partnership; Interim Director, Fairbank Center for Chinese Studies
Presented by the Harvard China Health Partnership as part of the ongoing series, China and Global Experience with COVID-19, and co-sponsored by the Fairbank Center for Chinese Studies.
The discussion covered a few themes. First, strikingly high rates of mental illness, particularly among adolescents and young adults, even predating the pandemic were identified in China, India, and the United States, and all panelists agreed that incidence of mental illness has only risen in response to the pandemic. They also noted that the rise in incidence has hit frontline healthcare workers especially hard and expressed that far more support is needed for this group.
Second, the discussants noted that the impact of the pandemic on the provision of mental health treatment has been very heterogeneous. In China, where government policy has strongly promoted telemedicine for a number of years, disruptions to the provision of treatment were minimal, though questions were raised about the feasibility of ensuring that mental healthcare delivered via video call meets basic quality standards. In India, where essentially only those with severe, chronic cases of mental illness were receiving treatment pre-pandemic, only those individuals experienced disruptions in their care. For those with milder conditions, the pandemic led to an explosion in the provision and popularity of tele-counseling and likely reduced some of the stigma on receiving treatment for mild mental illness (at least among younger generations), leading to a net expansion in the number of people who feel that mental healthcare is an accessible option for them. In the United States, the mass transition to (and deregulation of) telemedicine during the pandemic also likely increased the number of people who felt receiving mental health treatment was a realistic possibility for them; however, access and quality issues certainly remain.
Third, discussants highlighted the neglected state of epidemiological research and surveillance addressing mental illness, noting that it is often difficult for research concerning non-communicable diseases to attract adequate funding, even when there isn’t an ongoing pandemic. They opined that this has left us with a far poorer understanding of the state of mental health in countries around the world than we should tolerate. Finally, they expressed concern for the future, noting that the United States and India remain in the “acute phase” of the pandemic, and there remains much uncertainty about how the incidence of mental illness and mental healthcare will continue to develop over the coming year. They expressed hope that burgeoning interest in infectious disease will not siphon away the funding necessary for us to understand those developments, but they voiced fear that this may be likely.
- Presented as a Zoom webinar.
- A recording of the event is available here.