Mental Health and Substance Abuse
27 March 2020- The Mental Health and Substance Use Unit hosted a virtual seminar for PAHO and Ministry of Health mental health focal points in Latin America on mental health and psychosocial support (MHPSS) for health professionals involved in the COVID-19 response. The webinar was coordinated by Drs. Carmen Martinez and Andrea Bruni, the mental health advisors for Central America and South America, respectively. Presenters included Dr. Bruni; Miguel Ángel Castejón Bellmunt of Fundación Manantial, a mental health foundation based in Spain; and Dr. Luz María Salazar, consultant at PAHO/WHO Colombia.
Health professionals, including doctors, nurses, technicians, social workers, among others are at the front line of the COVID-19 outbreak response, exposing them to numerous hazards and stressors that can tax their mental health and wellbeing. Such hazards include pathogen exposure, long working hours, psychological distress, fatigue, occupational burnout, stigma, and physical and psychological violence.
Dr. Bruni provided recommendations for health teams responding to the COVID-19 outbreaks. He highlighted the importance of self-care, such as the need to rest, exercise, maintain a healthy diet, and avoid the use of tobacco, alcohol, and drugs for stress relief. Other key strategies include maintaining communication with loved ones, seeking out support from colleagues, and trying to recall and put into practice strategies that have worked on other occasions to manage stress. Dr. Bruni then presented the main principles of action of Psychological First Aid (PFA), a resource used to provide support to people in distress.
In his presentation, Dr. Castejón Bellmunt emphasized that health professionals require priority care in the context of the COVID-19 outbreak and response. This care can come from three different areas: the work organization; the professionals themselves; and the method of working. Organizations can ensure the necessary protection measures by the authorities (masks, gloves, etc.), allow and facilitate teleworking, make support and health services available for persons with disabilities, and make functions and tasks more flexible and to enhance versatility and exchange. Health professionals themselves can recognize themselves as vulnerable in this context, give themselves permission to rest, and focus on the present while avoiding negative anticipation. As a whole, it is recommended that health professionals face the COVID-19 situation collectively by trying to feel part of the community they are supporting and connecting with the mission that they are developing.
Dr. Luz María Salazar shared a presentation on Colombia’s mental health response to the COVID-19 pandemic, with a focus on health professionals. Key actions that have been taken include webinars and training workshops for health personnel on topics such as managing stress and preventing burnout, and a psychological support line available through virtual media.
A recording of the webinar can be found at (available only in Spanish): https://paho.webex.com/paho/lsr.php?RCID=2d232b5f5438092f130ebbfa845c6653
On 23 March, the WHO launched the document Considerations During the COVID 19 Outbreak. The document has been subsequently translated into Spanish, Portuguese and French. On 26 March PAHO hosted 2 webinars – in English and in Spanish – to explain the key concepts and actions contained within the document. People with disabilities may be at greater risk of contracting COVID 19 due to inaccessible public health messaging, barriers to preventative measures and difficulties in enacting physical distancing. Further, people with disabilities may be at risk of worse health outcomes if they contract COVID-19 depending on underlying health conditions and due to barriers and exclusion within health services.
It is vital that people with disabilities are fully included within the planning and implementation of COVID-19 initiatives. PAHO has begun to collaborate with organizations of persons with disabilities including The Latin American Network of Non-Governmental Organizations of Persons with Disabilities and their Families (RIADIS) to ensure that the voice of the disability community is heard and included. RIADIS has supported PAHO to develop some of the PAHO’s Spanish public health videos in international sign language.
5 practical approaches for ensuring people with disabilities are being included in the COVID response are:
- Coordinate actions with Disabled People’s Organisations and disability leaders.
- Engage sign language interpreters, closed captioning providers and other disability expert providers for inclusive public health messaging.
- Ensure facilities are accessible, staff are trained and policies do not discriminate against people with disability.
- Ensure COVID-19 testing and protective equipment for people with disability, household members and caregivers.
- Where possible, collect data on people with disability within surveillance
Dublin, Ireland, 9-12 March, 2020 The global alcohol policy conference is the largest gathering of research and advocates working on alcohol policy. The conference was sponsored by WHO, the Global Alcohol Policy Alliance (GAPA), Institute on Alcohol Studies, Forut and Movendi International. Due to the COVID-19 pandemic, of the 412 registered participants, about 340 participated from 47 countries. A few speakers sent videos or connected online. The conference was opened by the Minister of Health of Ireland, announcing sweeping changes in their alcohol national policy, based on the "best buys" recommended by WHO. A central topic of the conference was the interference of the alcohol industry in all aspects of alcohol policy, at local, national, regional and global levels.
Dr Maristela Monteiro, senior advisor on alcohol, presented in several sessions, on the activities carried out by PAHO since the launching of WHO SAFER technical package, as well as on regional barriers and opportunities to achieve a reduction in harmful use of alcohol. Dr Beatriz Champagne, from the Healthy Latin American Coalition on NCDs (CLAS), presented in several sessions, providing a perspective on what NGOs are doing in Latin America, as well as the gaps and challenges to advance civil society participation. As a result of her participation, CLAS is now a member organization of GAPA.
Dr Monteiro also had three posters: one with key findings from the upcoming regional report on alcohol and health; the SAFER initiative in the Americas, and on indicators for trials on screening and brief interventions from a Latin American perspective (results from a regional study sponsored by PAHO and the National Institute of Psychiatry, first author was Dr Marcela Tiburcio Sainz, who could not attend the conference).
COVID-19: addressing mental health needs and providing psychosocial support during the pandemic in the Region of the Americas: Plan of action 2020-
The mental health and psychosocial wellbeing of populations are profoundly affected by the COVID-19 pandemic. Fear, anxiety/worry, and uncertainty are common reactions in all of the affected countries. However, for some people, these reactions can be more prolonged, severe and disabling, leading to increases in mental disorders in the Region. Additionally, extreme stressors may induce, worsen or exacerbate pre-existing mental health conditions.
In response to this growing threat, PAHO’s Mental Health and Substance Use Unit has developed a Plan of Action to guide mental health and psychosocial support (MHPSS) actions in the context of the COVID-19 outbreak in the Americas, entitled “COVID-19: addressing mental health needs and providing psychosocial support during the pandemic in the Region of the Americas: Plan of action 2020.” The goal of the Regional plan, aligned with the WHO MHPSS plan, is to reduce suffering and improve the mental health and psychosocial wellbeing of people in the Region of the Americas affected by the global COVID-19 pandemic.
The structure of the plan follows the five pillars of the PAHO/WHO Regional COVID-19 Incident Management Strategic Plan, and below are the areas covered in each pillar:
- Communications (developing, adapting and disseminating communications materials related to MHPSS during COVID-19);
- Strengthening Health Systems (building MHPSS response capacity, supporting the mental health of healthcare workers, and protecting persons in institutions);
- Epidemic Intelligence (generating evidence on MHPSS and COVID-19 and supporting countries in rapid appraisal and monitoring);
- Public Health Measures (enabling digital/virtual MHPSS and strengthening cross-disciplinary coordination and integration); and
- Enabling Functions (staff wellbeing and information).
The Plan is a living document, intended to inform PAHO COVID-19 MHPSS technical activities as well as countries’ response to the developing mental health and psychosocial needs of their populations. The Plan incorporates key evidence-based recommendations for action. The COVID-19 MHPSS response plan encompasses short-, medium-, and longer-term actions, with the long-term aim of building back stronger mental health systems. Country contexts within the Region differ widely, and countries may choose to prioritize actions that are most relevant to their context, or use the Plan as guidance in developing more specific national action plans.
Miami, Estados Unidos, 3-5 March 2020.- The Pan American Health Organization held a subregional workshop on the use of the law to address NCDs and Risk Factors in the Caribbean, in collaboration with the PAHO’s Noncommunicable Diseases and Mental Health (NMH) Department, PAHO’s Office of the Legal Counsel, and the International Legal Consortium (ILC) of the Campaign for Tobacco-Free Kids (CTFK). The meeting was jointly funded by CTFK and PAHO as part of the EU/ACP for Health System Strengthening with a focus on NCDs.
The purpose of this 3-day subregional workshop was to build capacity to advance the use of laws and regulations to address NCD RFs in the Caribbean, with special attention to tobacco control, reduction of the harmful use of alcohol, and nutrition. The meeting was attended by 44 participants, including representatives of the Ministries of Health and Legal Affairs from 10 Caribbean countries (Antigua and Barbuda, Dominica, Grenada, Guyana, Jamaica, Saint Lucia, Saint Vincent and the Grenadines Saint Kitts and Nevis, Suriname Trinidad and Tobago), as well as representatives from the Caribbean Community (CARICOM0 Institutions (CARICOM Secretariat Human & Social Development, CARICOM Office of the General, The Caribbean Public Health Agency (CARPHA), the CARICOM Region Organisation for Standards & Quality (CROSQ), CARICOM Single Market and Economy Unit, Caribbean Court of Justice Court Administration), the Organisation of Eastern Caribbean States (OECS) Commission (Head of Health and Legal Officer), Academia, Civil Society, partner organizations (The Union, CTFK), and country/subregional/HQ PAHO Advisors (Patrice Lawrence-Williams, Francisco Armada, Audrey Morris, Maristela Monteiro, Ignacio Ibarra, Alejandro Morlachetti, and Elisa Prieto). Additionally, Benn McGrady (WHO) and a representative of the Ministry of Health of Trinidad and Tobago (Michelle Ash), participated virtually.
Dr Monteiro, senior advisor on alcohol at NMH presented on the global and regional mandates related to alcohol, the new WHO SAFER initiative, on the cost-effectiveness of each alcohol policy and the current status of their implementation in the Caribbean countries. as well as on how alcohol marketing can be regulated, with examples of what other countries are doing. Suriname and Jamaica were interested in strengthening the technical cooperation on alcohol policy. In general, there was uncertainty about the feasibility of effectively manage conflicts of interest given the strong influence of the alcohol industry in the subregion. At the end of the workshop, it was agreed to create a network of lawyers interested in advancing public health related laws, using NCDs and risk factors as entry points and expand to other areas in the future. The network can benefit from capacity building activities, sharing of documents, materials and experiences on health-related laws.