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Every health care system requires an adequate health care workforce, service delivery, financial support, and information technology. During the COVID-19 pandemic, global health systems were ill prepared to address the rising prevalence of mental health problems, especially in low- and middle-income countries (LMICs), thereby increasing treatment gaps. To close these gaps globally, task shifting and telepsychiatry should be made available and maximized, particularly in LMICs. Task shifting to nonspecialist health workers to improve essential mental health coverage and encourage efficient use of the available resources and technology has become the most viable strategy.

Objectives: The global crisis of COVID-19 and its consequential strict public health measures placed around the world have impacted mental health. New scales and tools have been developed to measure these mental health effects. This narrative review assesses the psychometric properties of these scales and tools and methodological aspects of their development. Methods: PubMed, PubMed Central, and Google Scholar were searched for articles published from 15 May 2020 to 15 August 2020. This search used three groups of terms (“tool” OR “scale” AND “mental” OR “psychological”; AND “COVID-19” OR “coronavirus”). The identified scales were further evaluated for their psychometric properties and methodological aspects of their development. Results: Though the studies developing these scales ( n = 12) have demonstrated their robust psychometric properties, some methodological concerns are noteworthy. Most of the scales were validated using internet-based surveys, and detailed descriptions of the mode of administration, sampling process, response rates, and augmentation strategies were missing. Conclusions: The heterogeneous and inadequate reporting of methods adopted to evaluate the psychometric properties of the identified scales can limit their utility in clinical and research settings. We suggest developing guidelines and checklists to improve the design and testing, and result in reporting of online-administered scales to assess the mental health effects of the COVID-19 pandemic.

Healthcare workers have faced an unprecedented workload in overstretched health facilities during the COVID-19 pandemic, and we describe various initiatives to support them. Psychological, financial and peer support, accommodation and meal services, proper personal protective equipment, applause and gratitude in the community, spiritual and religious life, child care and volunteering were identified. The potential effects of the COVID-19 pandemic – permanent stress, burnout and other mental health problems among healthcare professionals – can be expected to grow. Continued monitoring is essential to bolster resilience among healthcare workers and prevent the possible consequences for their mental health.

Background With the uncertainties of COVID-19, people infected by coronavirus present with diverse psychiatric presentations. Some centers have had to manage their patients with existing protocols, others have had to come up with innovations. We aim to report the challenges and good practices recorded in the management of psychiatric conditions and delirium coexisting with COVID-19 and during the COVID-19 era across continents. Material and Methods Early Career Psychiatrists (ECPs) from across five continents were approached to provide their perspective on the management of psychiatric conditions in patients with COVID-19 and during the current pandemic. Results We collected information about the experiences from ten countries. Commonalities were similar psychiatric presentations and poor preparedness across countries. Differences were varying innovations and adjustments made in the management of psychiatric conditions coexisting with COVID-19. Good practices which can be adopted by other countries are novel approaches such as telepsychiatry, proactive consultation-liaison units and enhanced community services targeted at circumventing challenges faced yet providing mental health services. Conclusions This publication highlights the need for global preparedness in the mental health sector during outbreaks of infectious diseases. With our results we can conclude that there is the need for concerted efforts targeted at global and locally sensitive adaptation of existing protocols and the development of new guidelines for the management of psychiatric conditions for the present pandemic and subsequent occurrences., Highlights • Twenty-one Early Career Psychiatrists (ECPs) from thirteen countries across five continents, provided their perspective on the management of psychiatric conditions in patients with COVID-19. • We found commonalities such as similar psychiatric presentations, poor preparedness and alterations in the management of psychiatric conditions coexisting with COVID-19. • There are shared similarities and differences, likewise modifications in pre-existing protocols in the management of delirium and other psychiatric conditions in patients with COVID-19 and during the current era across continents. • A common factor is the need for preparedness in the mental health sector; the need for concerted efforts targeted at globally and locally sensitive adaptation of guidelines and protocols for the management of psychiatric conditions for the present pandemic and subsequent occurrences.

The collaborative effort of an international research team from the Early Career Psychiatrists section of the World Psychiatry Association has brought about an easy-to-use, quick and stepwise mental health care toolkit for the identification and appropriate referral of those in need of mental health care during the pandemic. This simple guide can be applied in the general outpatient setting and is catered for all healthcare professionals, regardless of their expertise within the mental health field with minimal training. It is our hope that by incorporating this toolkit into our daily clinical care during the pandemic for high-risk patients and patients with non-specific complaints, we will be able to bridge the mental health gap present in our society.

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The COVID-19 pandemic has posed a serious threat to global mental health. Multiple lines of evidence suggest that there is a varying yet considerable increase in mental health issues among the general population and vulnerable groups.1 2 The aftermath is obscure and speculative from a social, economic, individual and public mental health perspective. Recently published studies support the existence of an emotional epidemic curve, describing a high probability of an increase in the burden of mental health issues in the postpandemic era.3 4 Furthermore, previous major public health emergencies showed that more than half of the population developed mental health problems and required mental health intervention.4 5 There is, therefore, an urgent need to reorganise existing mental health services to address the current unmet needs for mental health and to prepare for future challenges in the postpandemic era in terms of prevention and management. The current evidence and published literature related to previous epidemics suggest that mental health issues may arise after the peak of the pandemic, with increased prevalence among the vulnerable population and people with risk factors (box 1).4 The surge in mental health issues may remain untreated or undiagnosed due to interrupted mental health services and other challenges for mental health services in the post-COVID-19 pandemic era. Box 1 ### Mental health issues, vulnerable population and risk factors 1. Mental health issues : including grief reactions, substance use disorders, anxiety, sleep disorders, depression, suicides, post-traumatic stress disorders, panic disorders.4,25,26

Highlights • Mental health (MH) problems are difficult to address in pandemic and may have devastating consequence if remains untreated. • An appropriate conceptual framework can provide better opportunity to address the MH problems during epidemic. • Sixteen early career psychiatrists across the world attempted to develop a conceptual framework (CF). • CF can guide for development, implementation, and evaluation of MH interventions during the ongoing pandemic., The emergence of mental health (MH) problems during a pandemic is extremely common, though difficult to address due to the complexities of pandemics and the little evidence about the epidemiology of pandemic-related MH problems and the potential interventions to tackle them. Little attention has been devoted so far to this topic from policymakers, stakeholders and researchers, what could be due to a lack of replicable, scalable and applicable frameworks to plan, develop and deliver MH care during pandemics. As a response, we have attempted to develop a conceptual framework (CF) that could guide the development, implementation, and evaluation of MH interventions during the ongoing COVID-19 pandemic. This CF was developed by early career psychiatrists, from 16 countries that cover all the WHO regions. Their opinions were elicited via semi-structured questionnaire. They were asked to provide their views about the current MH situation of their countries, existing myths and misinformation, and the possible resources available. They were also asked to propose solutions and approaches to provide accessible and affordable care. The CF’s were prepared based on the extant literature and the views expressed; they illustrate the epidemiology of MH issues, preparedness plans, stage-specific plans/innovative solutions, opportunities to integrate those plans and probable outcomes at policy level. This CF can serve as a technical guide for future research in pandemic. It can be used to monitor trends and to optimize efforts and to develop evidence based MH interventions. However further research focusing on the individual components of this framework is needed.