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Asia Pacific: Building Mental Health Capability and Resilience on the Front Line

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In over half the countries in the world including Indonesia, Vietnam and the Philippines, there is only one psychiatrist per 100,000 people. In Asia Pacific, mental illness is the second largest contributor to years lost due to disability. Additionally, less than half of those affected receive any medical treatment, and in China and India, it is less than a tenth. Even when treatment is accessible, it is often insufficient.

Shortage of mental health professionals, coupled with the increasing need for mental health interventions exacerbated by COVID-19, is placing a high burden on frontline health workers and preventing vulnerable communities from accessing treatment. The Johnson & Johnson Center for Health Worker Innovation, with support from the Johnson & Johnson Foundation, is tackling this problem with a two-pronged approach: promoting frontline health worker resilience and strengthening mental health community-based care.

Promoting frontline health worker resilience to prevent burnout

Health workers on the front lines battling COVID-19 face overwhelming workload, medical supply shortages, depletion of personal protective equipment, and the reality of losing patients and colleagues. They are also burdened with the fear of infecting their family, friends and colleagues. The Center is working with partners in the Philippines and India to provide mental health services and psychosocial support to frontline health workers experiencing these stressors.

The Philippines Mental Health Association (PMHA) was one of the first organizations to provide virtual mental health support during the enhanced community quarantine in March 2020. We have partnered with PMHA to disseminate information on how frontline health workers can take care of their mental health, manage stress and fight stigma, as well as develop positive coping mechanisms during the pandemic. Health workers also have the option to join group therapy or seek individual counseling sessions or more specialized psychiatric services as needed.

In India, healthcare workers in COVID-19 dedicated facilities are stretched beyond their normal capacity, putting themselves at high risk of infection and experiencing high levels of physical and mental exhaustion. We are working with UNICEF India to improve healthcare workforce resilience by ensuring that frontline health workers have regular access to wellness content as well as enabling online self-assessment and care-seeking with full privacy.

Strengthening community-based care for mental health

In times of high-stress exacerbated by COVID-19, the severe shortage of adequately trained health workers who can help identify and care for people with mental health conditions is an emerging concern. Our programs aim to strengthen community-based care for mental health in Asia Pacific by placing the community health worker at the center.

We launched a 5-year program in China this year with the International Health Exchange and Cooperation Center of the National Health Commission to strengthen the country’s community mental health service capacity. The program aims to establish mental health peer support services and peer supporters as a vocation in China and will add 20,000 community health workers into the health system. While 60,000 patients will receive direct services under this program, the resulting national policy has the potential to benefit millions of patients across China.

In New Zealand, we are supporting an innovative new approach led by Te Rau Ora to develop a new community-based mental health workforce—health champions or mauri ora—for indigenous Maori people living with schizophrenia who have high and complex needs. By equipping these community health workers with health and social navigation skills, dedicated resources, and budget, the program seeks to achieve improved social and health outcomes for schizophrenia patients.

In South East Asia, our partnerships with BasicNeeds in Vietnam and Lembaga Kesehatan Nahdlatul Ulama in Indonesia focus on equipping community health workers with skills and capabilities to deliver essential community-based care. The program aims to train more than 100 health workers in Thai Nguyen province in Vietnam and provide depression care services to over 2,000 people in the community in one year. In Indonesia, the program is training 1,200 community health workers in 71 villages in East Java to screen people at risk and provide care for schizophrenia patients.

Accelerating evidence-based solutions for frontline health workers

At the Johnson & Johnson Center for Health Worker Innovation, we believe solving the challenges facing frontline health workers will improve healthcare for everyone. The Center is actively building a global community of practice including health workers, governments, professional associations, training institutions and NGOs to accelerate learning and evidence-based solutions aimed at empowering frontline health workers—specifically nurses, midwives, and community health workers—to be their most resilient selves and building cultures of resilience in public and private health systems.