The most systematic study to date of the COVID-19 pandemic’s effects on mental health suggests that it has caused an additional 53 million cases of major depressive disorder, 76 million cases of anxiety across 204 countries in 2020 alone, according to a new Lancet study. 

The study, published just ahead of World Mental Health Day, which was observed Sunday, found that countries most affected by COVID-19 had the largest increases in the 2 disorders studied, and women and younger people were the most affected. 

The Lancet study was one of several published last week that shed new light on mental health issues around the commemoration of World Mental Health Day, on Sunday. 

It included UNICEF’s State of the World’s Children report, showing that one in seven adolescents aged 10-19  lives with an undiagnosed mental disorder. 

A new WHO Atlas on Mental Health, meanwhile, pointed to the low levels of investments by countries in mental health prevention and treatment  – averaging only 2.1% of national health expenditures, worldwide, and amounting to only US$1 on average, per capita, in least developed countries.

Breaking the silence 

The UNICEF report, the first ever to focus on mental health, called for “breaking the silence around mental health.” 

“[Mental health] is an iceberg we have been ignoring for far too long, and unless we act, it will continue to have disastrous results for children and societies long after the pandemic is over,” UNICEF Executive Director Henrietta H. Fore said, in the report’s Foreword. 

The report underlines the need for a more comprehensive approach to promoting and protecting good mental health for children, including more regular and systematic assessment of mental health indicators as well as the performance of existing mental health services.   

Investment in children’s mental health negligible 

Investment in protection and care for children’s mental health remains negligible, despite widespread demand for action, the UNICEF report stated.

In terms of the broader public, just 52% of countries delivered the targeted mental health promotion and prevention programs—far short of the 80% goal for 2020, according to the new WHO Atlas.

This lack of investments means that health workforces, including community-based workers, are not equipped to properly address mental health across multiple sectors. 

Additional analysis from the UNICEF report indicates that the annual loss in human capital arising from mental health conditions in children aged 0-19 is US $387.2 billion.

The Lancet, UNICEF call for increased mental health investment

The Lancet, in an editorial, echoed UNICEF’s calls for increased government and worldwide investment.

“We urge governments and international organisations to increase their commitment, investments, and actions to prioritise child and adolescent mental health,” the statement read. 

“In addition to expanding the capacity of mental health and psychosocial services to respond to the rise in demand, more investment is needed to promote mental health, especially through parenting programmes and schools.”

Investing in school-based interventions that address anxiety, depression, and suicide provide a return on investment of US $21.50 for every US $1 invested over 80 years. 

“Mental health is a part of physical health – we cannot afford to continue to view it as otherwise,” said Fore. “For far too long, in rich and poor countries alike, we have seen too little understanding and too little investment in a critical element of maximizing every child’s potential. This needs to change.”

Suicide, the fourth leading cause of death for 15 – 19 year olds

The cost of how mental disorders impacts human lives is incalculable, with families, schools, and communities deeply affected by suicide – the fourth leading cause of death among 15 – 19 year olds. 

Every year almost 46,000 children and adolescents between the ages of 10 and 19 end their own lives – about 1 every 11 minutes. 

‘Increased Urgency’ in the aftershocks of pandemic 

The synergism of the The Lancet study, UNICEF report, and WHO Atlas has shown how the COVID-19 pandemic has created an increased urgency to strengthen mental health care in most countries.

“The risk is that the aftershocks of this pandemic will chip away at the happiness and well-being of children, adolescents and caregivers for years to come – that they will pose a risk to the foundations of mental health,” the UNICEF report reads. 

Image Credits: WHO/NOOR/Sebastian Liste, UNICEF, AMSA/Flickr.