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Social psychiatry is grounded in the recognition that we are fundamentally cultural beings. To advance the field, we need integrative theory and practical tools to better understand, assess, and intervene in the social-ecological cultural systems that constitute our selves and personhood. Cognitive science supports the view that mental processes are intrinsically social, embodied, and enacted through metaphor, narrative, and discursive practices. The circuits of the mind, therefore, extend beyond the brain to include our interactions with others through bodily and verbal communication. This ecosocial view of mind, brain, and culture calls for a shift in perspective from a psychiatry centered on brain circuitry and disorders toward one that recognizes social predicaments as the central focus of clinical concern and social systems or networks as a crucial site for explanation and intervention. The ecosocial perspective insists that we consider the powerful effects of structural violence and social inequality as key determinants of health. Social systems also have their own dynamics which can amplify inequities or provide sources of resilience. These social processes are framed, mediated, and maintained by cultural narratives, models, and metaphors. Hence, cultural analysis and critique must be foundational to social psychiatry. This opens the door to a creative engagement with human diversity in all its forms.

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Mental disorder is responsible for at least 20% of global disease burden which COVID-19 is likely to increase. Effective public mental health (PMH) interventions exist to treat mental disorder, prevent associated impacts, prevent mental disorder from arising and promote mental wellbeing. However, implementation is poor with only a minority with mental disorder receiving treatment even in high-income countries, far fewer receiving interventions to prevent associated impacts, and negligible coverage of interventions to prevent mental disorder or promote mental wellbeing. There is an urgent need to address this implementation failure which contravenes the right to health, results in broad population scale impacts and preventable suffering, and is further amplified by COVID-19. PMH practice including during COVID-19 can prepare for and address the implementation gap in the following ways: assessment of size, impact, and cost of the current and future PMH intervention implementation gap taking into account COVID-19; estimation of impact and associated economic returns from improved coverage of PMH interventions; use of this information to inform national policy and transparent decisions about acceptable levels of national coverage of different PMH interventions which then informs level of provision, required resource and commissioning; operationalization of intervention implementation nationally and locally; evaluation of coverage and outcomes; and communication to the population and different professional groups. Coverage of PMH interventions can be increased including during quarantine/lockdown through appropriate professional training, improving population knowledge, digital technology, settings and integrated approaches, maximizing existing resources and application of relevant legislation. PMH practice should be an integral part of the response to COVID-19.

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With the emergence of the COVID-19 pandemic, humanity experienced, at the same time, social confinement as a way to protect itself and the vulnerability of human life and institutions. In the past, overcoming calamities was done by being together, and now, with this pandemic, the form of protection is the opposite, social isolation. Over the past 27 years in Brazil, we have developed integrative community therapy (ICT) as a psychosocial intervention within the Brazilian Public Health System that is implemented in various contexts marked by the rupture of social bonds. The techniques of ICT, which have always had an essentially experiential character in face-to-face encounters, now need to be reinvented. To deal with the pandemic, ICT was offered to the general public virtually, with the following objectives: To strengthen bonds and build support networks; to minimize stigma and prejudices toward affected persons, encouraging empathy; and to offer a listening space by professionals involved in the fight against COVID-19. In March and April 2020, we conducted 100 sessions online with 3579 participants from 15 countries. The most frequent concerns expressed were fear and anxiety (53%), helplessness (30%), problems in dealing with family relationships (10%), and loneliness (7%). The techniques of virtual ICT became a support network for instilling hope for those in social confinement and moreover for discovering unknown potentials to transform life's adversities. Conducted in 15 countries and in four languages, emotional reactions were similar everywhere, demonstrating that pain and suffering have no frontiers and unite us in our humanity.

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Background: Socially disaffiliated elderly Nigerians are at higher risk for major depressive disorder (MDD). It is unclear whether subjective experience of loneliness has independent association with MDD. Methods: A household multistage probability sample of persons who were 65 years or older was drawn from a geographical area with approximately 25 million population. We measured loneliness using the three-item University of California at Los Angeles scale. Poor social engagement, social isolation, and MDD were assessed using the World Health Organization (WHO) Disability Assessment Schedule II and Composite International Diagnostic Interview (WHO), respectively. Results: Of 1704 respondents, 179 (16.7%) were classified as lonely. Lonely respondents were more likely to have poor social engagement (P < 0.001) and social isolation (P < 0.001). While loneliness (adjusted odds ratio [OR] = 2.3, 95% confidence interval [CI] = 1.3–4.0) and poor social engagement (adjusted OR = 3.1, 95% CI = 1.6–6.1) were independent correlates of MDD, the association of loneliness with MDD was substantially, but not totally, mediated by poor social engagement. Conclusion: The association of loneliness with late-life depression in this African sample is partly explained by poor social engagement. Interventions for loneliness based on social activity schedules and networking programs can be adapted to reduce loneliness and lower the burden of late-life depression in Africans.

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The impacts of COVID-19, both through its direct infectious sequelae, and through massive changes to our societal and health system functioning, are being felt differentially by different populations. In many ways, the disproportionate negative impacts are highlighting preexisting fault lines in our social fabric. Lessons learned during this epidemic can hopefully help guide long-term improvements to models of health-care delivery, and also draw attention to needed social changes for addressing vulnerable marginalized populations and inequities, and improving social resilience.

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The number of confirmed cases and fatalities in the Middle East countries has been relatively low in comparison to some countries in Europe and the United States, in spite of the economic, political, cultural, and medical differences. One explanation may be the closed borders and lack of migration in the Middle East, with the exception of Iran, largely to its close economic ties with China and mismanagement. The distribution of the infected cases in Israel reveals two distinct populations with disproportionately high infection rate: the elderly people leaving in nursery homes (like in the rest of the world) and ultra-orthodox Jews. Ultra-orthodox Jews comprise about 12% of Israel's population, but they accounted for more than one-third of the confirmed cases of COVID-19 and as much as 60%–70% of Israel's COVID-19 cases in major hospitals. Ultra-orthodox communities initially resisted physical-distancing measures regarding the closure of synagogues, religious schools, and prayer services, due to their shared belief that practicing the religious services and rituals as usual will protect them from harm. This seemed to be helpful in alleviating feelings of stress and anxiety from the pandemic on one hand but placed people in harm on the second hand. Thus, social factors such as sense of belonging, social support and religious beliefs, known to increase resilience, and coping with adversity in uncontrolled disasters turned to have a harmful effect on coping with the COVID-19 pandemic, a disaster that its consequences can be partially controlled. This is an interesting social phenomenon worth further study.

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The COVID-19 pandemic creates a cascade of social and mental health consequences for children, adolescents, and their families. After reviewing the known pediatric and epidemiological data on children, we discuss key features of children's mental health in response to this crisis, their specific needs, and the impacts of social distancing, confinement, and adverse childhood events. While acknowledging potential long-term consequences in this psychosocially vulnerable population, we also caution health and social care workers against pathologizing normal reactions to an abnormal global crisis.

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COVID-19 is creating a mental health crisis among children and youth around the globe. At the time of this writing, more than 1.5 billion, i.e., 91% of the world's students are out of school. The pandemic is raising fears, and causing clinginess, distraction, irritability, anxiety, depression, lethargy, impaired social interaction, and reduced appetite. Adolescents are at higher risk for depression, anxiety, distress, low self-esteem, substance use disorder, and suicide. Mental health consequences of the pandemic can be categorized as adjustment disorders, reactions to social isolation, reactions to family and family events, violence against women and children, and intensification of preexisting mental health conditions. Major challenges are being experienced by those struggling with attention-deficit hyperactivity disorder, autistic spectrum disorders, medical complications, posttraumatic stress disorder, and other conditions. After a short description of each category, we provide case examples, which, though fictitious, bear sufficient resemblance to real-life situations encountered in our daily practice to serve as useful vignettes. The mental health community, social psychiatrists and pediatricians, and other health-care providers should take an active role to address these serious issues.

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The psychosocial impact of the Covid-19 pandemic has been related to not only the viral epidemic but also by the sudden and extended lockdown. The prominent psychosocial issues are related to the stigma, changed lifestyle, impact on persons with mental health problems and mental illnesses including alcoholism and substance use, chronic medical illnesses, and this being one or more major life event. Social issues due to this stigma manifest as avoidance, discrimination, isolation, and seclusion of persons suspected to be anyway related to Covid-19. There are also self-stigma and fear of spreading it to the family members. However, the stigma associated with Covid-19 reduced stigma toward mental health and focused on the need of mental health support. This pandemic and its consequent lockdown to contain the spread of the viral infection will form a new health-related life event. During this period, there is a growing concern about the rise in domestic abuse and violence being reported by the media. Lockdown brought about reports in media about emotional disturbances and maladjustments within families including families of persons with mental illness. Finally, there has been a revival of cultural defenses in the form of traditional practices; people are reverting back to a folded hand “namaste” instead of a handshake, washing hands frequently, and use of a mask.

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Any epidemic of infectious disease such as the present one that we are witnessing puts a strain on both the individual and the community. The very basis of physical and emotional health, dependent as it is on the body and social networks, is threatened. Existing inequalities in society get accentuated, and systemic responses that provide succor to all sections of society, especially the marginalized, are critical. Scientific and technological insights will, ultimately, provide solutions (or at least a better understanding), but the broader engagement of the “social body” in this endeavor is very important. Humans are social beings, and the isolation, stigma and the labeling of those infected; indeed, the very “othering” of the virus, makes us concerned about the long-term consequences of this pandemic. From health-care workers and those seeking help who are concerned about imminent infection and morbidity, to those displaced and dispossessed, who now face months of poverty and hardship, the spectrum of mental health needs is very large. Pandemics like this underline the urgent need to work beyond real and imagined boundaries. As a group of mental health professionals and social scientists, we hope that the social and psychological responses will help us emerge from this with a greater sense of harmony and cohesiveness.

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Interest in seeking to understand psychopathology in social and cultural contexts has gone through phases. There was a time when the traditional social context in which Africans lived was mystified and exoticized by the West as simple and unsophisticated. While a more liberalized understanding of the diversity of social organizations is now common, a more complex social configuration is nevertheless emerging on the continent. The countries in sub-Saharan Africa are undergoing rapid transitions characterized by epidemiological shifts, urbanization, and a reorganization of family structure. Each of these transitions is, in turn, affected by the pervasive influence of globalization and the prominent impact of information technology, including social media. In this context, the traditional defining features of “social” networks and sociocultural norms and rituals are changing. These changes bring tensions which have consequences for the mental health of populations and how the people who experience mental illness are related to and cared for. Changes that produce lonely elderly in the villages and disaffiliated youths in urban slums challenge us to re-think how we conceptualize the emerging social networks and social interactions and grasp the nexus of syndemics that often develop in those contexts.

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Coronavirus disease 2019 (COVID-19) is wreaking havoc across the world, upending every known facet of the human activity. Although a viral disease, it has nevertheless brought home to the world the huge importance of social factors as determinants of health and, of course, of ill health. These social determinants, though universal, are generally more inequitably skewed in low- and middle-income countries (LMICs). Since social factors are important in the acquisition and dissemination of the infection, it is no surprise that a number of the containment and mitigation activities are also essentially social. Yet, those mitigation efforts such as a stringent lockdown and social distancing create their own problems, more so in LMIC. The situation is precarious for LMIC in both ways. The consequences of both the disease and the mitigation strategies on mental health of the population are multifactorial and likely to be huge. Further, it is plausible to expect the effects of COVID-19 to include a widening of the treatment gap for mental disorders in LMIC. Social psychiatry provides an important platform to grasp the contextual demands of community response to COVID-19. A good understanding of the social contexts in which the mental health consequence of COVID-19 is being experienced will be vital to provide appropriate care to persons affected. These are not strategies and approaches to be seen as only for short-term use. Clinicians will require the necessary skills of social psychiatry as approaches to care for the long-term, as the mental health consequences of COVID-19, including associated stigma of those infected by the virus, may linger much longer in the LMIC.

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Coronavirus disease 2019 (COVID-19) pandemic is associated with mental health consequences in patients diagnosed as having the disease, their contacts, healthcare workers, and also in the general community because of fear of getting the infection. Organizing mental health services in a big general hospital, especially in the background of diversion of many services including the workforce for pandemic-related services is a big challenge. The paper discusses the personal experience of the author in organizing mental health and psychosocial support services at a tertiary care teaching medical institution in India in the background of the COVID-19 pandemic. The services were targeted at the population visiting the hospital, healthcare workers, persons being quarantined, caregivers of patients with COVID-19 and the community in general. Some guidance notes were also developed for the physicians dealing with persons with COVID-19-related concerns and for psychiatrists in dealing with their patients. The strategy employed has a scope of being used at other similar institutions and also in similar situations arising in the future.

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There is evidence from earlier studies that the probability to be traumatized by pictures of disasters is associated with a high level of exposure, the traumatic significance of the pictured event, prior exposure to similar real-life events, and personality variables. Preexisting symptoms of posttraumatic stress disorder, depression, and anxiety are predictors of the higher impact of mass media (MM) and social media (SM) contributing to a vicious cycle. We aimed to discuss mechanisms through which MM and SM may cause massive indirect traumatization of populations and that may be relevant for the psychosocial conditions that emerged during COVID-19 pandemic news bombardment. The current pandemic is an example of a serious and deadly disease with extremely enhanced representation in the MM and SM and high rates of unverified, false, and sometimes apocalyptic information. Both mass as well as social medial tendencies to select their news according to their controversial and often negatively affective load contribute to this. This phenomenon is characterized as “infodemic” – a situation that may have profound consequences for mental health due to undermining feelings of personal safety, corroding social cohesion, and inducing conflicts and bitterness. Pandemic-infodemic situation has shown that complicated but inevitable turn to higher transparency including ethically motivated restrictions of anonymity and the contents of the web– measures that, however, have to be sensitively balanced with the demands guaranteeing the freedom of opinion, the freedom of speech and the avoidance of censorship. In general, there is a need for complex solutions, difficult decisions, and intricate balances.

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The pervasive spread of the novel coronavirus known as COVID-19 has resulted in a global pandemic. The virus arrived in Malaysia in January 2020 but only started to significantly spread in March after the country hosted a large international religious gathering. The government response to the outbreak was effective, resulting in a high recovery rate of the afflicted. This response included the enactment of a “Movement Control Order” (MCO), which saw gradually increasing restrictions on public movement, leading ultimately to a lockdown. The MCO has been a cause of psychological unrest in the population due to social isolation, financial stress, and the limitations placed on cultural practices. This increase in psychological unrest has manifested quantifiably, specifically in the observed 57% spike of domestic violence following the enforcement of the MCO. The initiatives that were implemented to curb the public decline in mental health included a hotline offering psychological first aid, which saw reasonable success. However, it is suspected that a large proportion of those suffering from mental health issues is not coming forward to use the available services due to the prevalent mental health stigma in the country. On May 1, the MCO was drastically relaxed, and public movement was again allowed despite a considerable number of new infections being reported daily. This, in turn, inspired more psychological anxiety in the population, and it is speculated that the feelings of unease and uncertainty due to the coronavirus outbreak and resulting MCO will carry forward into the following months.

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The COVID-19 pandemic has challenged mental health globally. Feelings of fear, isolation, restrictions, and quarantine, all are impacting on population's well-being, above all for those vulnerable individuals with preexisting health and mental health problems. In Italy, as in the rest of the world, data on socioeconomic consequences as well as regarding the impact of COVID-19 on population lifestyle and public opinion are emerging. This commentary reports on the Italian perspective of the current emergency.

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On 11 March 2020, the World Health Organization declared the coronavirus disease-19 (COVID-19) outbreak a global pandemic. The coronavirus has affected different aspects of people's lives in different ways from physical isolation, job losses, schools, offices shutting down, etc., These changes have had an impact on people's emotional, psychological, spiritual, and physical well-being. The country has seen 2021 infections, 482 recoveries, and 69 people succumbing due to coronavirus as of May 31, 2020. The Kenyan government has taken measures to stop the spread of the disease, but this has come with its challenges as a large number of Kenyans rely on day-to-day income, live in shared accommodation, thus making social distancing a nearly impossible task to achieve. These factors among others have raised the fears of the expected impact on psychosocial needs and response during the COVID-19 period. It is likely that governments have focused on how to stop the spread of coronavirus and finding a cure, that attention on the psychosocial impact of the coronavirus has not been given the needed attention. This review has been done to examine the psychosocial responses undertaken by the Kenyan government and its stakeholders during the COVID-19 pandemic. The gaps likely to be felt by vulnerable populations have also been examined. There is a need to develop measures that will address the psychosocial stressors faced by the vulnerable populations. There will be a need for mental health services long after COVID-19 is managed and a working vaccine is developed; thus, the development and implementation of integrative treatment and services is imperative.

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A critical issue for our field is how to define contemporary social psychiatry for our times. In this article, I address this definitional task by breaking it down into three major questions for social psychiatry and conclude with a call for action, a manifesto for the 21^st century social psychiatry: (1) What is social about psychiatry? I address definitional problems that arise, such as binary thinking, and the need for a common language. (2) What are the theory and practice of social psychiatry? Issues include social psychiatry's core principles, values, and operational criteria; the social determinants of health and the Global Mental Health (GMH) Movement; and the need for translational research. This part of the review establishes the minimal criteria for a coherent theory of social psychiatry and the view of persons that emerges from such a theory, the social self. (3) Why the time has come for a manifesto for social psychiatry. I outline the parameters for a theory of social psychiatry, based on both the social self and the social determinants of health, to offer an inclusive social definition of health, concluding with a call for action, a manifesto for the 21^st century social psychiatry.

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