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Table 1 Mental health system specific recommendations relevant to policy maker by available resources during the pandemic

From: Roadmap to strengthen global mental health systems to tackle the impact of the COVID-19 pandemic

Recommendations relevant to policy makers Low resource settings with few mental health resources and infrastructure Medium resource settings with some mental health resources and infrastructure
(includes recommendations in addition to those in low resource settings)
High resource settings with good mental health resources and infrastructure
(includes recommendations in addition to those in low and medium resource settings)
Strengthen leadership and governance * Using an intersectoral approach, develop evidence-based policies to manage basic mental health needs, and strategies for implementation of those policies, especially involving teams managing COVID infection
*Inform and support politicians, and administrators to the need of mental health interventions in the light of this pandemic using existing evidence-based communication tools available on the internet
*Have clear standard operating procedures (SOPs) to operationalize implementation strategies which are well integrated within the larger framework to tackle COVID infection
*Develop and implement monitoring mechanisms using feasible indicators to capture prevalence of common mental disorders, number of mental health service providers and accessibility
Mental health care is integrated within the overall health and humanitarian policy; decentralize the administrative machinery but ensure that certain sound principles are adhered to by all
*Mental health needs of special vulnerable population groups addressed using appropriate policies and programmes and these should focus on the poor and marginalized communities
*Existing policies and programmes are tailor made to specific regional needs even within a country based on data about the burden of mental disorders in the community
*Special training of policy makers are undertaken to increase knowledge about mental health in the face of this pandemic by mental health professionals
*Key aspects of the policies are geared around inclusivity and equity and specifically target vulnerable populations of different types;
Teams and departments in charge of each component are outlined and accountability is addressed appropriately using suitable indicators; data collection is synchronized within the larger system that gathers data on the pandemic
Identify appropriate finance mechanism to support policies and programmes; develop schemes to cover longer term mental health care *There are earmark additional funds to cover evidence-based mental health activities under health budget at national, regional and district level; especially ring-fence budget to cover the mental health impact due to COVID pandemic
*Mental health expenditure is tracked and protected and mechanisms are created to do so if not in place, given increased proportion of health budget allocation for COVID
*Include mental health within the care packages of social and private insurances at least to cover expenses arising out of the pandemic; identify micro financing schemes to support mental health support for individuals who may need extensive mental health care
*Budget allocated for mental health care during this crisis can be spread across different intersectoral activities including poverty alleviation programmes, employment generation activities, where addressing mental health needs is prioritised in those programmes; funds should look at both short and long term outcomes
A large pool of private and public insurance schemes is in place to cover mental health care costs
*Mental health budget to address enhanced needs of mental health burden during the pandemic is increased significantly to cover current and future needs and those are tracked using robust systems
*Private or public insurance systems have mental health care integrated within their policies and is adequate to cover for long term care and included in packages to cover COVID
Promote programmes specifically targeting vulnerable groups *Identify specific components within other existing programmes such as those targeting homelessness, employment, migrant populations which focus on mental health needs of such populations, especially given the impact of the pandemic on these populations
*Develop mental health promotion communications focused on stigma related to the pandemic and its effect on mental health
If any mental health program exists, then strengthen those to specifically address needs during the crisis; specifically ensure that such programmes are accessible to those needing it
Programmes are culturally relevant and tested; but programmes tested in similar settings but in some other areas may be used in order to save time and money
*Develop new mental health programmes that are not only focused on addressing the immediate mental health needs due to the COVID pandemic but has long term benefits too; implement those programmes amongst populations in need- migrants, women, elderly, children
*Involve relevant stakeholders (government or non-government) in the programmes being developed and target programmes to cater to the specific needs of individuals, families, care givers, employers, different vulnerable groups
*Develop targeted programmes for local settings which specifically focus on issues such as domestic violence, child abuse, elderly care, alcohol and substance use, reducing suicide risk which are showing increased prevalence during this pandemic
*Enhance any existing programmes that already focus on vulnerable populations
Integrate mental health programmes within other social sector specific programmes such as those on housing, employment generation, elderly care, child care, school systems
  1. *Recommendations that are particularly relevant for managing mental health issues during COVID infection