Disasters and emergencies take an immense toll not only on people’s physical health, but on their mental health and wellbeing too. Addressing global mental health and psychosocial needs is a vital part of the IFRC’s work supporting healthy communities.

The verdict is in: COVID-19 worsens mental health. So there can be no excuse and no delay in stepping up now to prevent a worsening and chronic catastrophe. There is no health without mental health, therefore recovery from the pandemic needs to factor in mental health and psychosocial interventions. Let’s step back and view the evidence. No group is immune from COVID-19’s insidious effects on mental health: from school children, to those of us working remotely, to the elderly. Studies have documented the extreme negative impact of the isolation caused by school closures which, at one point, saw 90 per cent of the world’s children locked out of school. A study of children in China found elevated rates of depression and anxiety. Similarly, another study found 86 per cent of Italian and Spanish parents noticed changes in their children’s emotional states and behavior during home confinement. Sadly, children at home can be more at risk of abuse and neglect, as stressors on families increase, and the structure of the school day is taken away. There is also evidence of increased risk of suicide and self-harm among young people during the pandemic. Other studies have pointed to negative consequences of increased screen time . For the wider population, the suicide risk has also climbed . And new research co-led by the International Federation of Red Cross and Red Crescent Societies (IFRC) has found older people become sicker and poorer and feel more alone as a result of living through the pandemic. To bridge the gap between ballooning mental health care needs and services, traditional mental health care systems will not be the only answer. The IFRC and its network of 192 Red Cross and Red Crescent National Societies is already part of this solution. Mental health and psychosocial support is a core part of our work. Following commitments we made to the state parties of the Geneva Conventions at the International Conference of the Red Cross and Red Crescent in 2019, we are making mental health and psychosocial support an even bigger part of our work. Globally we have provided mental health and psychological support to 7.16 million people affected by COVID-19 since the pandemic started. Volunteers and staff have taken to telephone hotlines, new digital forms of support such as webinars, videos and SMS chats. Our support comes alongside a wider expansion in new ways of reaching out to people suffering depression, anxiety, and PTSD, such as videoconferencing, online forums, smartphone apps, text-messaging, and e-mails, which evidence shows have been found to be effective ways of delivering treatment. In Armenia, Red Cross psychologists provide psychosocial support services to people and assign volunteers to those identified as struggling to provide extra help with household chores. Danish Red Cross set up a phone service for volunteers to chat with people who are home alone. A new form of support was seen in a project run by Serbian Red Cross, which published a collection ofcreative writingabout peoples’ experiences of living through the pandemic. The French Red Cross has set up Croix-Rouge Chez Vous (Red Cross at Home), combining a national call centre and the dispatch of aid to all parts of France, both mainland and overseas territories. It targets any socially-isolated person who has no connections or support from family, friends or neighbours, who are able to call in and receive a listening ear, and receive a follow-up delivery of goods if needed. Bulgarian Red Cross operates a telephone-based psychology service, where people can book free sessions online with qualified psychologists. And Italian Red Cross psychologists are on board quarantine ships for migrants, to support the mental health and protection of the most vulnerable migrants, including minors, trafficked women, pregnant women and victims of discrimination. They also support the wellbeing of Red Cross personnel. In a partnership with the IFRC, British Red Cross psychologist Dr Sarah Davidson has featured in a successful social media video series to reach new audiences. Global action With the pandemic’s effects expected to extend well beyond the current year, it’s clear more action needs to take place now if we are to be serious about preventing the deteriorating mental health of millions of people. We are recommending three key steps: A serious scaling up of mental health and psychosocial services. High attention to widening national societies’ access to new digital and other innovative means is needed. The IFRC network is well placed to facilitate sharing new practices and learning, and to work towards narrowing the digital divide. Governments and major donors should step up investment in addressing mental health problems to enable individuals, families and communities to meet the challenges brought by the pandemic. Early and effective access to mental health and psychosocial support is key to creating sustainable and healthy local communities. More care for the carers. Red Cross and Red Crescent people, who have worked through the pandemic, often when responding to other disasters, are immensely tired. We have become a more flexible workplace with increased support systems and monitoring of staff and volunteers’ wellbeing, and encourage wider formal supports for these often invisible responders. Sadly, the full effects of this pandemic will only emerge much later, robbing many people of their future dreams. Now is the time to invest more in mental health care and psychological support that works. Even a small investment can have big results. Our movement is uniquely placed to scale up engagement through the variety of new platforms and services with our networks of trained volunteers in every community. Together with our partners, we can meet increased demand with expanded and integrated services and supports.

By Dr Eliza Cheung, Technical Advisor International Federation of Red Cross and Red Crescent Societies Reference Centre for Psychosocial Support. In ‘ordinary’ times, good mental health is fundamental for overall wellbeing. But when we are all stalked by fear and uncertainty caused by COVID-19, access to good mental health support is more important than ever. It is life-saving. There is mounting evidence that this Coronavirus is taking a heavy toll on the mental health of people in Asia and across the globe. At the global level, a major review of 36 studies across the world has found that around one in three people are suffering from stress, anxiety or depression during this pandemic, while recent modelling suggests that unemployment caused by COVID-19 may lead to almost 10,000 additional suicides a year. An analysis of 160 studies of eight South Asian countries also shows that nearly one in three people experienced anxiety or depressive symptoms. In the midst of this global pandemic, it is understandable that people are worried about their health, their loved ones and how they will cope if they get sick. Ongoing restrictions are limiting social interaction, leading to increased loneliness and isolation. COVID-19 is causing enormous stress for people who were already worried about how they will support their families. A new survey by the International Committee of the Red Cross in seven countries, including the Philippines, shows that one in two adults believe their mental health has been negatively affected by COVID-19. It is also alarming that latest World Health Organisation (WHO) figures reveal the pandemic has interrupted or suspended mental health support services in 93% of countries. Across most countries in Asia, investment in mental health support is woefully inadequate, even before this pandemic and in some countries there are only 0.3 psychiatrists and psychiatric nurses to serve 100,000 people. By contrast, WHO data shows that the rate of psychiatrists is 120 times higher in countries such as France, Canada and Sweden. The stresses we are experiencing affect us physically, psychologically and emotionally, as well as changing our behaviour. The stress undermines our ability to stay healthy, look after our families, and process new information. It can endanger nurses, doctors, police, leaders and disaster responders, jeopardising life-saving decisions to contain the virus and reduce longer-term impacts. People already living with mental health challenges are experiencing the loss of critical support networks and clinical management. Yet they need this care more than ever. We simply cannot afford to wait until the epidemic is under control before dealing with the massive, and increasing, psychological toll. To have any hope of stopping and recovering from this pandemic in a way that leaves no one behind, we need to treat the psychological and physical distress at the same time. So how can we do it? Early intervention prevents distress from developing into more severe mental health conditions. We need to bridge the gap between those who need psychological and emotional support and those who seek it. We also need to better harness and strengthen existing community and clinical resources. Preventing psychological issues and mental health support need to be integrated at all levels, in local communities, workplaces, schools, in hospitals and health systems. People in communities are our first line of defence, making teachers, parents and colleagues in our workplaces critical for bridging the current resource gap. We urgently need to invest in supporting, engaging and equipping them to know what questions to ask, what signs to look for and what to do if someone may be struggling. Asia-Pacific is the world’s most disaster-prone region and many people have developed an incredible ability to cope with adversity. Across our region, millions of Red Cross and Red Crescent volunteers are first to respond, experiencing the stress in crises, from monsoon floods to typhoons, and COVID-19. The trauma is real. People have lost loved ones, jobs or livelihoods. They have been separated by borders or quarantine, stranded and jobless in another country or living in crowded camps. All too many are overcome by anxiety, depression and distress. It’s vital that we all support each other at this time. Get in touch. Be kind to friends, family, neighbours and colleagues, as well as ourselves. Taking good care of oneself enables us to take care of others. We are at a crossroads. The response to COVID-19 and associated socio-economic impacts will be more effective and we will save countless more lives and livelihoods if we invest wisely in accessible and sustainable mental health and psychosocial support.

By Olivia Acosta David Brito is studying to be a commercial engineer in Chile and in the meantime he is thinking about how to help most affected people by COVID-19 in his country. And he comes up with some good ideas. His mother was already a volunteer with the Chilean Red Cross for the extinction of forest fires, when her 23-year-old son joined the O'Higgins Regional Committee three years ago, where he works and develops his creativity in the fight against COVID-19. Since the declaration of the pandemic, David has been thinking about how the Red Cross could help people who were feeling lonely and isolated during the months of confinement. At the same time, many of the organization's senior volunteers were also very frustrated about having to stay home from volunteering. And so, in late March, the Speak to Me project was born. "It all started with the purchase of a SIM card that cost less than 2,000 Chilean pesos (2 euros). With that card and a phone, we were able to make ourselves available to people in confinement who were looking for an emotional distress... At first, we were surprised to find that not only elderly living alone called us, also parents or even young people who were looking to talk to someone who would listen to them and get truthful information about the virus, did it. This service is helping us a lot to fight false rumors that put people's health at risk”. First it was the phone, but such was the acceptance in the community that they quickly set up a WhatsApp line and a Facebook account so they could reach more people. Several senior volunteers in their 70s and 80s answer the calls, while younger ones take care of Facebook and WhatsApp line. According to David: "I thought the project was an excellent idea to offer a double service of psychosocial support: on one hand, senior volunteers who could not leave their homes due to the confinement restrictions, now can work from their homes without over-exposure themselves to the virus, and on the other hand, many people in need are receiving support during these difficult times." The team of 7 volunteers who answer the calls have psychosocial training, and to attend most difficult cases they receive counseling from a psychologist. "I must admit that it was not easy to start”, continues David, "because everyone thought it was very complicated to do it right, but now we have become so famous that we also get calls from other countries. I remember one day when the phone rang at four in the morning... it was an old lady from Spain, Doña Concepción, who was very lonely and needed support. We referred the case to the Spanish Red Cross so they could take care of her from there." They also receive calls from people who have detected that a neighbor is very lonely and needs company, or food, hygiene items, or even medicine. One of the saddest cases was a call that came in about 32 migrant families from different Latin American countries who were living in confinement, crowded together in a tiny space, in terrible conditions. "It was gratifying to be able to help them, especially the children, who were really in need… the best payment is a sincere smile from someone who says thank you.” According to David, "we adapt to any situation no matter how difficult it is, the will of the whole team made the project moving forward because we are not going to give up on our fight against coronavirus. Our motto is: we make the imposible, possible," he ends. The Chilean Red Cross in response to the pandemic has provided more than 49,000 services in polyclinic activities, support to vaccination campaigns, delivery of humanitarian aid to migrants and vulnerable communities, distribution of PPE, food distribution, psychosocial support, etc. In addition, it has disseminated information and prevention measures and has made home visits to people with mobility difficulties and the elderly.

Bethlehem - The Palestine Red Crescent Society's PRCS' campaign, “30 Minutes With My Child”, is still gaining momentum in the towns and villages of the Bethlehem Governate in Palestine since its launch at the onset of the COVID-19 crisis. The successful campaign has been achieved thanks to the helping hands of many of the PRCS 350, who enthusiastically engaged in delivering this initiative. To learn more about the campaign’s creation, Ms. Judith al Sayej, PRCS’ Bethlehem branch Administrative Director, described the campaign saying that “at the beginning of COVID-19 outbreak, we decided to set up a psychological support team to help mothers, and subsequently their children, as part of the service provided by PRCS to local communities during these difficult times. We asked mothers to film their children as they carried out various activities, such as drawing, telling stories, and reciting poetry”. Judith explained how “the videos aimed to showcase the children’s creativity and allow them to express their feelings and emotions”. Given the outstanding artistic skills displayed by the gifted children, who exhibited their talents in many videos, PRCS’ Bethlehem Branch decided to hold a contest and recognise the top 10 videos with an award. According to Judith al Sayej, the judges we select will be tasked with selecting the winning videos. The abilities of the boys and girls of Bethlehem in expressive art does not come as a surprise since the city boasts 10 museums and over 150 cultural centers and NGO’s. “30 Minutes With My Child” owes a crucial part of its positive outcome to thePRCS volunteers. Salwa al Zeer, PRCS’ Bethlehem Branch Community Action Coordinator, shed some light on the instrumental role they played in the campaign. Our “volunteers have played a major role in the implementation of this campaign. The local communities’ response has also been high, and the campaign gained interest rapidly with people eager to display their children’s creativity. We were heartened by this response rate, which proves that we can do great things even in the most difficult of times”. Speaking about this phenomenal campaign and as one of the volunteers, Ahmad Imteir, PRCS’ Bethlehem Branch’s Activities Officer, elaborated and added that “the current extraordinary context led us to focus on psychological support as part of our social mission”. He applauded the volunteers’ great job in the campaign and detailed the areas they participated in to keep the confined children on track. “They also assisted children in grade one through grade three with their schooling by resorting to distance learning solutions. This was done in a fun and accessible way, so children received gifts as an incentive to join this initiative”. He attributed the success of these activities to the imagination and originality of the children as well as the widespread participation among the local communities. In its response to COVID-19, PRCS provided the following humanitarian services: Emergency medical Services, Health and Relief, and Psycho-Social Support (PSS). PRCS distributed food parcels to 12480 families in the Occupied Palestinian Territory (oPT), delivered medical services in primary health care centers to 1189 persons and activated 50 members of its PSS team to respond to people’s needs via phone sessions. The elderly and the patients who are dealing with chronic diseases have been visited at home by volunteers as well. General Background: PRCS was established in December 1968 as a national humanitarian organization to look after the health, welfare and well-being of the Palestinian people in West Bank, including East Jerusalem, and Gaza Strip, Lebanon, Syria, Egypt and Iraq. PRCS, as a full member of the International Movement of the Red Cross and Red Crescent, goes the extra mile to provide humanitarian, health, cultural and social services with its 4,200 employees and a network of 20,000 volunteers.