The world has not yet learned from the COVID crisis, experts warn

New research published in The Lancet Psychiatry finds governments have failed to embed mental health into pandemic preparedness.

Mental health must become a core component of global disaster planning, according to new research published in The Lancet Psychiatry. The study — led by the Lancet Standing Commission on the COVID-19 Pandemic and Mental Health, and supported by MQ Mental Health Research — warns that the world has not yet learned key lessons from the pandemic’s mental health impact.

The five-year study examined global policy responses and long-term data to assess which measures best protected mental wellbeing. Drawing on contributions from 43 international experts, including people with lived experience of mental illness and long COVID, the Commission’s findings are published in two linked papers.

The first paper, The implications of the COVID-19 pandemic for clinical mental health care, reviewed how services adapted during the crisis. It found that anxiety and depression rates rose sharply in early 2020 but later stabilised in many high-income countries. However, vulnerable groups — including socioeconomically disadvantaged communities, minoritised ethnic groups, children and young people, and people with pre-existing mental illness — suffered greater and more persistent harms.

While overall clinical mental illness rates shifted less dramatically, eating disorders increased, particularly among young women. In many regions, mental health services were disrupted as face-to-face care was suspended. Providers were forced to improvise, often without evidence-based guidance. Digital services offered continuity for some, but widened inequalities where access to technology was limited.

The second paper took a broader view, analysing the effects of public policy on population-level mental health. Policies that supported wellbeing included wage subsidies, furlough schemes, eviction bans, school-based mental health services, and domestic violence support programmes. Yet these interventions were unevenly implemented, and digital and economic divides often deepened existing inequalities.

Professor Peter B. Jones, Professor of Psychiatry at the University of Cambridge and Co-chair of the Commission, said: “It was a privilege to work with the Commission members who became so immersed in a rapidly accumulating and ultimately vast evidence base. To have extracted sense and meaningful recommendations is rewarding, but the biggest impact will come from their implementation.”

He added: “It is true that we were all in the same storm, but not in the same boat. Protecting health services should not be the aim if it is at the expense of the people who need them.”

The Commission urges policymakers to integrate mental health into social protection and recovery planning for future crises. It recommends investment in “blended” digital and community-based services that reduce, rather than reinforce, inequality.

Professor Etheldreda Nakimuli-Mpungu, Professor of Epidemiology at the London School of Hygiene and Tropical Medicine and Co-chair of the Commission, said: “In low-resource settings, COVID-19 showed that mental health suffers most when people lose income, food, safety, schooling, and trust — and improves when governments protect livelihoods and communities. Mental health must be built into social protection, community services, and crisis planning from the start.”

The authors also call for long-term, cross-national studies — particularly in low and middle-income countries — to assess the enduring mental health effects of the pandemic and the consequences of policy choices.