The pandemic has shown that mental health must be an essential part of the response to outbreaks.

Critical funding gaps are halting and disrupting crucial mental health services in Africa, as demand for these services rise amid the Covid-19 pandemic, a new World Health Organisation (WHO) survey shows.

Of 28 African countries surveyed in July and August, 37% reported that their Covid-19 mental health response plans are partially funded and a further 37% reported having no funds at all.

This comes as the pandemic increases demand for mental health services.

“Isolation, loss of income, the deaths of loved ones and a barrage of information on the dangers of this new virus can stir up stress levels and trigger mental health conditions or exacerbate existing ones,” said Dr Matshidiso Moeti, WHO regional director for Africa.

“The Covid-19 pandemic has shown, more than ever, how mental health is integral to health and well-being and must be an essential part of health services during outbreaks and emergencies.”

Twenty-seven of the 28 African nations surveyed have included mental health in their Covid-19 response plans, underscoring the growing recognition of the importance of this once-neglected area of health.

Even before the pandemic, the region had one of the lowest mental health public expenditure rates, at less than US$0.10 per capita.

With increasing pressure on health systems and rising demand, stretched and chronically underfunded mental health services are under increasing strain.

“Covid-19 is adding to a long-simmering mental health care crisis in Africa. Leaders must urgently invest in life-saving mental health care services,” said Dr Moeti.

Doctors Without Borders (MSF) in October warned of a growing mental health crisis in the Dadaab refugee complex in Kenya, where hundreds of thousands of Somalis have been stuck for decades.

MSF is seeing a “groundswell of desperation” in Kenya’s Dadaab refugee camp. Source: Pete Lewis/DFID 2011

In Dadaab’s Dagahaley camp, where MSF runs a mental health clinic, the number of attempted suicides is rising. Psychosocial consultations have jumped by more than 50% compared to 2019, over the same time period until September, from 505 to 766.

Many refugees in Dadaab were already frustrated with the lack of progress in finding durable solutions MSF says. Now they are faced with the new Covid-19 situation, where the meagre humanitarian assistance they depend on has been further reduced amid donor concerns of widening funding gaps.

The World Food Programme (WFP) has been forced to cut food rations by 40% and many other agencies have drastically reduced their presence, severely disrupting access to basic services.

These cuts, along with a lack of gainful employment and an ever-present uncertainty about the future, have created a new mental health crisis.

“Covid-19 has ended what little chance refugees had of escaping their degrading lives in the camps, compounding the mental distress for many who had nothing left but hope to cling to,” says MSF project coordinator for Dadaab, Jeroen Matthys. “We are seeing a groundswell of desperation in the camp.”

The after-effects of Covid-19 will likely deal a severe blow across societies, and refugees remain extremely vulnerable, with the slightest shock carrying the risk of upending their lives completely.

“As the Kenyan government draws up Covid-19 recovery plans, integrating refugees would represent a resounding acknowledgement of its commitment to seek a permanent solution for the forgotten refugees of Dadaab,” says Dana Krause, MSF Head of Mission.

“For donors, there has never been a more apt moment to demonstrate international solidarity with refugees, and they must fully share responsibility with the Kenyan government, not only through financial commitments, but also through restoring resettlement and complementary pathways for refugees.”

Find out more in the Africa Research Bulletin:

South Sudan: Mental Health Crisis
Political, Social and Cultural series
Vol. 53, Issue 7

International Monetary Fund: Emergency Response Funding
Economic, Financial and Technical series
Vol. 57, Issue 7

African Development Bank: Food Security Roadmap
Economic, Financial and Technical series
Vol. 57, Issue 5

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