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org

IMUN Online Conference 58.0

Study Guide

Committee: World Health Organization

Topic: Mental health action plan: Promoting
care and treatment

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Table of Contents
Introduction to the Committee: ......................................................................... 3
Introduction of the Topic: .................................................................................. 5
Possible Reasons .................................................................................................. 6
Pre-existing risk factors: ................................................................................. 6
Social factors: ................................................................................................... 6
Environmental factors: ................................................................................... 6
Effect of COVID-19 Pandemic .......................................................................... 7
Current Situation: ............................................................................................... 9
Possible Solutions: .............................................................................................10
Questions A Resolution Must Answer: ...........................................................11
References ..........................................................................................................12

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Introduction to the Committee:

The World Health Organization (WHO) is a specialized agency of the United
Nations responsible for international public health. It is part of the U.N.
Sustainable Development Group. The WHO Constitution, which establishes the
agency's governing structure and principles, states its main objective as ensuring
"the attainment by all peoples of the highest possible level of health." It is
headquartered in Geneva, Switzerland, with six semi-autonomous regional
offices and 150 field offices worldwide.

The WHO was established in 7 April 1948, which is commemorated as World

Health Day. The first meeting of the World Health Assembly (WHA), the
agency's governing body, took place on 24 July 1948. The WHO incorporated the
assets, personnel, and duties of the League of Nations' Health Organization and
the Office International d'Hygiène Publique, including the International
Classification of Diseases. Its work began in earnest in 1951 following a
significant infusion of financial and technical resources.

For universal health coverage, WHO:

• focuses on primary health care to improve access to quality essential
services
• works toward sustainable financing and financial protection
• improves access to essential medicines and health products
• trains the health workforce and advise on labour policies
• supports people's participation in national health policies
• Improves monitoring, data and information.

For health emergencies, WHO:

• prepares for emergencies by identifying, mitigating and managing risks
• prevents emergencies and support development of tools necessary during
outbreaks
• detects and respond to acute health emergencies
• Supports delivery of essential health services in fragile settings.

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For health and well-being WHO:

• addresses social determinants
• promotes inter-sectorial approaches for health
• Prioritizes health in all policies and healthy settings.

Through their work, WHO addresses:

• human capital across the life-course
• non-communicable diseases prevention
• mental health promotion
• climate change in small island developing states
• antimicrobial resistance
• elimination and eradication of high-impact communicable diseases.

The WHO's broad mandate includes advocating for universal healthcare,

monitoring public health risks, coordinating responses to health emergencies, and
promoting human health and wellbeing. It provides technical assistance to
countries, sets international health standards and guidelines, and collects data on
global health issues through the World Health Survey. Its flagship publication,
the World Health Report, provides expert assessments of global health topics and
health statistics on all nations. The WHO also serves as a forum for summits and
discussions on health issues.

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The WHO has played a leading role in several public health achievements, most
notably the eradication of smallpox, the near-eradication of polio, and the
development of an Ebola vaccine. Its current priorities include communicable
diseases, particularly HIV/AIDS, Ebola, malaria and tuberculosis; non
communicable diseases such as heart disease and cancer; healthy diet, nutrition,
and food security; occupational health; and substance abuse.

The WHA, composed of representatives from all 194 member states, serves as
the agency's supreme decision-making body. It also elects and advises an
Executive Board made up of 34 health specialists. The WHO relies on assessed
and voluntary contributions from member states and private donors for funding.
As of 2018, it has a budget of over $4.2 billion, most of which comes from
voluntary contributions from member states.

Introduction of the Topic:

Urbanization, defined as the increase in the number of cities and urban

population, is not only a demographic movement but also includes, social,
economic and psychological changes that constitute the demographic movement.
It is a process that leads to the growth of cities due to industrialization and
economic development. The rapid increase in urban population worldwide is one
among the important global health issues of the 21stcentury. According to the
projections of the United Nations Population Division, by 2030, more people in
the developing world will live in urban than rural areas; by 2050, two-thirds of
its population is likely to be urban. The scenario in India is also affected by this
trend.

Urbanization brings with it a unique set of advantages and disadvantages. This

demographic transition is accompanied by economic growth and
industrialization, and by profound changes in social organization and in the
pattern of family life. Urbanization affects mental health through the influence of
increased stressors and factors such as overcrowded and polluted environment,
high levels of violence, and reduced social support.

The physical and social environments of urban life can contribute both positively
and negatively to mental health and wellbeing. Cities are associated with higher
rates of most mental health problems compared to rural areas: an almost 40%
higher risk of depression, over 20% more anxiety, and double the risk of
schizophrenia, in addition to more loneliness, isolation and stress.

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Possible Reasons

Pre-existing risk factors:

Many people move to the city in search of better services, economic and social
opportunities, and distance from past negative experiences. Some of the reasons
that some people may seek these things happen to be risk factors for mental health
problems: for example, poverty, unemployment, homelessness, physical and
mental health problems, previous trauma, personal crises, family break up,
addiction, and immigration. This social drift engenders a population who are
particularly predisposed to mental disorders.

Social factors:

People with pre-existing risk factors, particularly poverty, minority status, or

existing mental health problems often encounter negative disparities in the city.
For example, this can involve physical and psychological segregation into
neighbourhoods that may be characterised by poverty and social challenges,
engendering feelings of injustice and hopelessness, and experiences of prejudice
and discrimination that may affect mental health. Low social cohesion and crime
victimisation have been found to increase the risk of psychosis in childhood.

Environmental factors:

The urban setting can affect people in two key ways: increasing stimuli, and
stripping away of protective factors.

• Overload: People who live in the city experience an increased stimulus

level: density, crowding, noise, smells, sights, disarray, pollution and
intensity of other inputs. Every part of the urban environment is
deliberately designed to assert meanings and messages. These stimuli
trigger action and thought on a latent level of awareness, and become more
potent as an inability to ‘cope’ sets in. This can have the effect of overload:
increasing the body's baseline levels of arousal, stress, and preparedness,
but also driving people to seek relief: quiet, private spaces; over time this
urge may evolve into social isolation associated with depression and
anxiety, and also forms the basis of the ecological hypothesis of
schizophrenia.

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• Erosion of protective factors: People who live in the city may find that they
have less access to the factors that are protective for good mental health
than those in rural areas. For example, they may have diminished access to
nature, fewer opportunities to integrate exercise as part of their daily
routines, and reduced leisure time as increased time is spent at work and
commuting around the city. People may find themselves feeling unsafe,
having less privacy, and even less sleep, due to factors like crowding, light,
noise and stress. Rural to urban migration often sees people leaving behind
their strong social networks of friends and family, and it takes time to
develop similarly supportive social capital in the city. This may
particularly be the case as urban dwellers may be reluctant to engage in
social interactions, to avoid overstimulation, due to safety concerns, or
because of the reduced likelihood of future relationships with each
individual they encounter. As these protective factors erode, people
become more vulnerable to developing mental health problems.

Effect of COVID-19 Pandemic

The novel coronavirus disease 2019 (COVID-19) has become a pandemic
affecting health and wellbeing globally. In addition to the physical health,
economic, and social implications, the psychological impacts of this pandemic
are increasingly being reported in the scientific literature.
Research suggests that people affected by COVID-19 may have a high burden of
mental health problems, including depression, anxiety disorders, stress, panic
attack, irrational anger, impulsivity, somatization disorder, sleep disorders,
emotional disturbance, posttraumatic stress symptoms, and suicidal behavior.
Moreover, several factors associated with mental health problems in COVID-19
are found, which include age, gender, marital status, education, occupation,
income, place of living, close contact with people with COVID-19, comorbid
physical and mental health problems, exposure to COVID-19 related news and
social media, coping styles, stigma, psychosocial support, health communication,
confidence in health services, personal protective measures, risk of contracting
COVID-19, and perceived likelihood of survival. Furthermore, the
epidemiological distribution of mental health problems and associated factors
were heterogeneous among the general public, COVID-19 patients, and
healthcare providers.

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The current evidence suggests that a psychiatric epidemic is cooccurring with the
COVID-19 pandemic, which necessitates the attention of the global health
community. Future epidemiological studies should emphasize on
psychopathological variations and temporality of mental health problems in
different populations. Nonetheless, multipronged interventions should be
developed and adopted to address the existing psychosocial challenges and
promote mental health amid the COVID-19 pandemic.
According to WHO, a pandemic is defined as “an epidemic occurring worldwide,
or over a very wide area, crossing international boundaries and usually affecting
a large number of people.”
Pandemics can be said to occur annually in each of the temperate southern and
northern hemispheres, given that seasonal epidemics cross international
boundaries and affect a large number of people. However, seasonal epidemics are
not considered pandemics.
As cases of COVID-19 rapidly soars throughout the world, so does the pressure
and anxiety being built up by the masses. The biggest pandemic in recent years
for this generation and the enforced isolation of lockdowns by Member States
heavily affected not only presents a physical toll on people but also affecting their
mental health. It is manifested through an increase of fear, worry, and concern in
the population at large and certain groups, such as the middle-aged and elderly,
health care providers and people with underlying health conditions.

Within the scope of public health, the main psychological impact of the current
pandemic to date is elevated rates of stress. Retroactively, as new measures and
impacts are introduced to mitigate the spread of the virus-especially quarantine
and its effects on people’s usual activities, routines, or livelihoods- stages of
loneliness, depression, and alcohol and drug abuse are expected to rise.

Furthermore, the worsening mental health of people under isolation has been less
immediately obvious by many national governments as a whole. As an agency
that is vested with responsibilities to set new standards for health, the World
Health Organization (WHO) has worked with multiple regional and national
partners to develop a set of new materials on mental health and psychosocial
support aspects of COVID-19.

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Current Situation:

The increase of anxiety is apparent in areas with large populations. In the case of
the Italian city of Lombardy, issues of service access and continuity for people
with developing or existing mental health has evolved into to a major concern for
not only civilians but also health workers.

Mental health risks worsening as national government impose closures of non-

essential businesses and schools, prohibiting large public gatherings, force
quarantine on travelers, and social distancing. From research from the WHO,
isolation is correlated to poor mental and physical health. People more naturally
outgoing and extroverted have to deal with the reality of being kept away from
people. Concurrently, those whose livelihood is tied to their business or
employment are left psychologically vulnerable if their means of income has been
taken away. It is cited that the more anxiety that builds up has a greater risk on
association of reduced lifespan and greater suicide. Subsequently, WHO has
advised government in collaboration with NGO’s to ensure the socio-economic
protection of people under quarantine, by ensuring there are health packages,
supply of basic amenities, and psychiatric help.

Currently, age groups are more easily identified on the degree their mental health
has been affected as many countries have implemented strict partial or total
lockdowns that have been ongoing for over a month. Children are at an increased

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risk to child protection incidents or make them witness to interpersonal violence

if their home is not a safe. Moreover, young children may find themselves in
difficult situations that they do not understand and may express irritability or
anger. In addition to the cases of children, elderly are in more risks due to many
having underlying diseases that increases their chances of death. Elderly being
informed that they are very vulnerable into contacting the disease can be
frightening and fear-inducing. Increase symptoms of anger and stress will be
particularly difficult for people with cognitive decline or dementia.

Not only is clinical progress have been conducted by the WHO, after the first
wave of cases in China, clinical institutions and universities have opened online
platforms to provides psychological counselling services for affected people.
Subsequently, research had underlined that the mental health of COVID-19
patients have been poorly considered and handled and that it’s more important
than ever to address the psychological impacts and symptoms.

Possible Solutions:

The WHO and public health authorities around the world are acting to contain
the pandemic. Retroactively, recommendations were developed by the WHO
Department of Mental Health and Substance Use to help certain vulnerable
groups support themselves during at a time of crisis which are the following..,

1. General Population-avoid constantly watching news and media on cases

on COVID-19 that induces a near constant stream of fear and anxiety as
some are products of misinformation. In addition, look into news of
positive stories of people recovering to increase self-esteem.

2. Healthcare Workers- ensure sufficient rest and respite during work or

between shifts, eat healthy food, and engage in physical activities while
staying in contact with loved ones. Deterrence from negative coping
strategies such as drugs and alcohol. Moreover, provide support to people
who are affected by COVID-19 and know how to link them with available
resources.

3. Health Facilities Management- Ensure that good quality communication

and accurate information updates are provided to all staff. Rotate workers
from higher-stress to lower-stress functions. Partner inexperienced
workers with their more experienced colleagues. The buddy system helps

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to provide support, monitor stress and reinforce safety procedures. In

addition, outreach personnel should enter the community in pairs. Initiate,
encourage and monitor work breaks. Lastly, implement flexible schedules
for workers who are directly impacted or have a family member affected
by a stressful event.

The WHO has been lobbying with national government to implement frameworks
on low-minimum cost social initiatives and guidelines for their populace that
compliments the extensive capacity-building activities to ensure health care
workers are able to give the proper treatment necessary for their patients mental
challenges.
.

Questions A Resolution Must Answer:

• What are the possible solutions to combat ongoing pandemic in terms of

mental health?
• Are the ongoing strategies effective so far? If no, what else need to be
done?
• What can be the strategies to normalize mental diseases in population of
least developed countries?
• Can WHO undertake an initiative to promote mental health awareness in
member countries in cooperation with government and other local or
regional NGOs
• How can the WHO strengthen effective leadership and governance for
mental health?

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References

1. https://www.who.int/emergencies/diseases/novel-coronavirus-
2019/technical-guidance/health-workers
2. https://www.who.int/emergencies/diseases/novel-coronavirus-
2019/technical-guidance/surveillance-and-case-definitions
3. http://www9.who.int/bulletin/volumes/89/7/11-088815/en/
4. https://www.washingtonpost.com/opinions/2020/03/31/pandemic-is-
about-devastate-developing-world/
5. https://www.ncbi.nlm.nih.gov/books/NBK54171/
6. https://www.who.int/docs/default-source/coronaviruse/mental-health-
considerations.pdf
7. https://www.theguardian.com/news/audio/2020/apr/24/what-is-the-covid-
19-crisis-doing-to-our-mental-health-podcast
8. https://mhanational.org/covid19
9. http://www.euro.who.int/en/health-topics/health-
emergencies/coronavirus-covid-19/novel-coronavirus-2019-ncov-
technical-guidance/coronavirus-disease-covid-19-outbreak-technical-
guidance-europe/mental-health-and-covid-19
10.http://www.euro.who.int/en/health-topics/health-
emergencies/coronavirus-covid-19/news/news/2020/3/mental-health-and-
psychological-resilience-during-the-covid-19-pandemic
11.https://www.kff.org/health-reform/issue-brief/the-implications-of-covid-
19-for-mental-health-and-substance-use/

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