A crisis is growing in mental health as the widespread impacts of the COVID-19 pandemic and the economic hardship it has brought bites deeper. In Japan, suicides rose by 16% during the second wave of the pandemic, from July to October 2020, compared with the rate in previous years1. In the United States, 25% of people aged 18–24 surveyed in June 2020 reported increased substance use to cope with pandemic-related stress2. This year, the flagship report of the United Nations children’s charity UNICEF, The State of the World’s Children, focused on child and adolescent mental health and well-being for the first time. If urgent and effective action is not taken, the protracted and global scale of the pandemic disruption will cast a long shadow on mental health, particularly that of young people.
Decades of research suggests that the response must be all-encompassing and long term. The fact that this is neither feasible nor affordable in many contexts gives rise to two types of response. Some governments or agencies allocate available resources over too broad a range of evidence-based programmes and services; without the scale and intensity needed, these cannot achieve real and sustained impact. An example is Australia’s struggle, over three decades, to shift the needle on many mental-health conditions. Other governments and agencies take a reactive and ad hoc approach — as exemplified by the US response to the synthetic-opioid overdose epidemic. Neither approach will be adequate to tackle today’s mental-health crisis.
Instead, policymakers must account for how the pandemic has fundamentally changed the state of mental health across society. It is time to examine preconceptions about what interventions are effective.
Lessons can be learned from infectious-disease research. Systems models allowed researchers to rapidly predict the spread of COVID-19 (see Nature 580, 316–318; 2020), integrating contact-tracing data based on commuting patterns and mobile-phone location trackers. Although imperfect, in some places these models provided a virtual testing ground for alternative assumptions and for the timing and scale of mitigation strategies, including lockdowns, mask wearing, school closures and vaccination. The models also accounted for the changing likelihood of people complying with such measures as the pandemic persisted. Where …….