**Question 4: how can the mental health consequences of the COVID-19 containment measures, socio-demographic forces, and other health conditions among vulnerable groups be mitigated in Africa?**

#### a.**Vulnerability to mental health impact of COVID-19:**

Vulnerability to the negative psychological impact of the current pandemic varies among different populations across the continent. In post-apartheid South Africa, for instance, even though mental health services have been decentralized and integrated into primary health care, there still remain service gaps within and between provinces, especially in the rural areas [47] According to Jaguga and Kwobah [48], even though preventive and medical actions are critical to the containment of the pandemic, emergency psychological crisis interventions (EPCI) are required for the mitigations of the mental health consequences of the pandemic among affected populations by and other vulnerable groups such as pediatric patients, pregnant women, mothers, older people, PLWDs, other marginalized groups with suspected or confirmed cases and frontline workers. The direct EPCI may be utilized for COVID-19 patients, while the indirect EPCI is employed for their relatives, caregivers, and health care professionals. Forms of Emergency Psychological Crisis Interventions (EPCI) could entail both digital and preventive virtual mental health services aimed at addressing scale and limiting the exposure of patients to COVID-19 at health facilities. Psychological counseling, digital mental health education, and communication materials may be delivered for those in need and shared through Facebook, Twitter, Whatsapp, and other commonly used social media platforms.

There is also the need to proactively identify high-risk groups early on and provide them with targeted interventions. This may be done through research and deployment of artificial intelligence to proactively identify posts on social media from people who are in crisis and likely to commit suicide. Such vulnerable persons may be reached through different types of virtual psychotherapeutic mechanisms, including video-conferencing, the conduct of cognitive-behavioral and mindfulnessbased smartphone therapies, and chess-edutainment [49, 50]. Most African nations, especially Nigeria, Ghana, South Africa, and Kenya, already have a telecommunications density exceeding 100%, which serves as a veritable tool for the implementation of mobile psycho-therapeutic care and services. Existing digital psycho-therapeutic clinical care across Africa include Wazi in Kenya, PsyndUp in Nigeria, MindIT in Ghana, and the MEGA project in South Africa and Zambia. There could also be the provision of several mental health hotlines and online therapy services for COVID-19 pandemic emotionally distressed people.

The following vulnerable groups within the larger population in all African nations are particularly needing EPCI and support:

