Mental health recovery and transformation: lessons for action

Abstract

The COVID-19 pandemic has reminded us that mental, physical and social wellbeing are closely interconnected and that the disciplines of health promotion, health protection and healthcare public health need to work in harmony. As the virus becomes more controlled and our physical health protected there is potential for a mental health crisis to unfold unless public health attention is given to it (The Lancet Public Health Editorial 2020). Distress is a normal response in any disaster. Whilst average population mental health dropped significantly in the first lockdown in England it then rose to near-normal levels as people adapted (Daly and Robinson 2021). However, recent research shows variation across six distinct population groups, with 77% of the population having consistently good or very good mental health throughout the pandemic and a significant minority of 7% having very poor or steadily worsening mental health throughout (Matthias et al. 2021). Mental health and its determinants were not equally distributed across the population before the pandemic and further changes in social determinants following the pandemic are unlikely to return life to normal for those most disadvantaged. Whilst many impacts on mental health are still unknown, there are lessons from the first year of the pandemic that could transform our future way of working. First, the pandemic has made us acknowledge the importance of maintaining our mental health and that it is central to societies health and functioning, especially in recovery from the pandemic and for resilience to future disasters and crises. The lockdowns have focussed our attention on many aspects of mental health – personal resilience to adversities, the importance of having meaning, purpose and routine, of cultural practices and identity, social connectedness and resilient relationships, a sense of coherence and control, adaptability and resourcefulness, and importance of the natural environment, physical activity and spending time doing things we enjoy. Mental health is an asset, individually and collectively, and as such should be protected, promoted and valued as a social goal, not least for children and young people and as an asset for future generations. There have been many studies taking place over the last year into population mental health and it would be beneficial to continue to track changes, based on the outcomes that matter to people and the determinants that affect it. Developing research can also help us understand better how mental health affects our immune system, through trauma, stress and other biopsychosocial pathways. Second, a whole-of-government approach is needed to address the wider social factors that impact our mental health. Studies have shown that financial loss from quarantine creates significant socioeconomic distress and is found to be a risk factor for developing symptoms of psychological disorders (Brooks et al. 2020). The financial support packages put in place during COVID-19 have provided immediate social protection to many and have arguable been the best protection of mental health in the short term. Financial INTERNATIONAL JOURNAL OF HEALTH PROMOTION AND EDUCATION 2021, VOL. 59, NO. 3, 131–134 https://doi.org/10.1080/14635240.2021.1905967