Rose Nikolas, Manning Nick, Bentall Richard, Bhui Kamaldeep, Burgess Rochelle, Carr Sarah, Cornish Flora, Devakumar Delan, Dowd Jennifer B, Ecks Stefan, Faulkner Alison, Ruck Keene Alex, Kirkbride James, Knapp Martin, Lovell Anne M, Martin Paul, Moncrieff Joanna, Parr Hester, Pickersgill Martyn, Richardson Genevra, Sheard Sally
Centre for Society and Mental Health, King's College London, London, WC2B 4BG, UK.
Department of Psychology,, University of Sheffield, Sheffield, S1 2LT, UK.
Wellcome Open Res. 2020 Jul 13;5:166. doi: 10.12688/wellcomeopenres.16123.1. eCollection 2020.
We argue that predictions of a 'tsunami' of mental health problems as a consequence of the pandemic of coronavirus disease 2019 (COVID-19) and the lockdown are overstated; feelings of anxiety and sadness are entirely normal reactions to difficult circumstances, not symptoms of poor mental health. Some people will need specialised mental health support, especially those already leading tough lives; we need immediate reversal of years of underfunding of community mental health services. However, the disproportionate effects of COVID-19 on the most disadvantaged, especially BAME people placed at risk by their social and economic conditions, were entirely predictable. Mental health is best ensured by urgently rebuilding the social and economic supports stripped away over the last decade. Governments must pump funds into local authorities to rebuild community services, peer support, mutual aid and local community and voluntary sector organisations. Health care organisations must tackle racism and discrimination to ensure genuine equal access to universal health care. Government must replace highly conditional benefit systems by something like a universal basic income. All economic and social policies must be subjected to a legally binding mental health audit. This may sound unfeasibly expensive, but the social and economic costs, not to mention the costs in personal and community suffering, though often invisible, are far greater.
我们认为，将2019年冠状病毒病（COVID-19）大流行及封锁导致心理健康问题“海啸”的预测夸大了；焦虑和悲伤情绪是对艰难处境的完全正常反应，而非心理健康不佳的症状。有些人将需要专门的心理健康支持，尤其是那些已经过着艰难生活的人；我们需要立即扭转社区心理健康服务多年资金不足的状况。然而，COVID-19对最弱势群体，尤其是因社会和经济状况而面临风险的黑人和少数族裔人群产生的不成比例影响，是完全可以预见的。通过紧急重建过去十年被剥夺的社会和经济支持，才能最好地确保心理健康。政府必须向地方当局注入资金，以重建社区服务、同伴支持、互助以及地方社区和志愿部门组织。医疗保健机构必须解决种族主义和歧视问题，以确保真正平等地获得全民医疗保健。政府必须用类似普遍基本收入的东西取代高度有条件的福利制度。所有经济和社会政策都必须接受具有法律约束力的心理健康审查。这听起来可能成本高得令人难以承受，但社会和经济成本，更不用说个人和社区遭受的痛苦成本，尽管往往无形，却要大得多。
