5 things to know about mental health across the world

Good mental health is fundamental to the world’s overall health and well-being.

That’s the view of Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. The WHO is talking about the issues surrounding mental health as it marks World Mental Health Day, which this year comes at a crucial time.

Despite growing awareness of the impact of mental health problems, the budget for treating them remains small – less than 2% of global health spending. And COVID-19 has put tremendous pressure on care for people with these conditions, with 93% of services disrupted or halted by the pandemic.

As the WHO calls for global action to help close these gaps, here are five things to know about mental health worldwide.

1. Who is at risk from mental health conditions?

Mental health disorders can affect anyone at any time in their lives. But some people are more at risk than others. People in conflict zones and those who suffer physical or emotional abuse are particularly vulnerable, the WHO says.

More than 264 million people of all ages suffer from depression, which is a major cause of disability and a leading contributor to the overall burden of disease. More women than men suffer from depression which, at its worst, can lead to suicide.

Attributes such as the ability to manage our thoughts, emotions, behaviours and interactions with others influence the risk of developing mental health disorders. But social, cultural, economic and environmental factors play an equally important role, while stress, genetics and nutrition can also contribute.

2. How are they diagnosed?

The symptoms of mental health conditions vary widely. But they are often characterized by a combination of abnormal thoughts, perceptions, emotions, behaviour and damaged relationships with others, the WHO says.

As many as 85% of people with depression in low- and middle-income countries receive no treatment. And a lack of trained healthcare professionals means people either go undiagnosed or are misdiagnosed and prescribed antidepressants they don’t need.

The UK’s Royal College of Psychiatrists warns of the dangers of self diagnosis. “There are plenty of online tests which will give you a number for how depressed you allegedly are,” the college’s Dr Bernadka Dubicka writes in Mental Health Today. “[But] there is nothing to replace clinical judgement when making a diagnosis.”

There are effective treatments for most conditions, but as the WHO points out: “Access to healthcare and social services capable of providing treatment and social support is key.”

3. What’s the situation with treatment and prevention?

Mental health conditions are increasing worldwide. Many of these conditions can be effectively treated at relatively low cost, according to the WHO. But there is a significant gap between those needing care and those that have access to it.

Supporting children is especially important to prevention. Half of all mental health disorders begin before the age of 14, WHO data shows, and around a fifth of all children and adolescents suffer from a mental health condition.

Overall, increased investment is required in everything from mental health awareness to increasing access to quality care and effective treatments, the organization says.

4. What impact is this having?

Mental health conditions have impacts on all aspects of people’s lives, from disrupting education to impairing work performance. They can put pressure on relationships and cut people off from their communities.

At its most extreme, depression can lead to suicide. Almost 800,000 people take their own lives every year and suicide is the second biggest cause of death in 15- to 29-year-olds worldwide.

Every $1 spent treating common mental health disorders repays $5 in improved health and productivity, the WHO says. In the US alone, 200 million working days are lost every year to depression. And in the UK, stress, depression or anxiety account for 44% of all work-related ill health cases and 54% of all working days lost due to ill health.

Research for the World Economic Forum estimates that between 2011 and 2030 mental ill-health will cost $16 trillion in lost economic output worldwide.

5. What needs to be done?

Raising awareness of the scale and nature of the problem is an essential first step. In many communities, discussing mental health is still taboo and those who suffer are stigmatised. Changing attitudes and encouraging people to seek help is vital.

Progress on the WHO’s Mental Health Action Plan 2013-20, which called for comprehensive, integrated mental health and social care services to be provided to communities has been uneven, and the organization recently extended the deadline to 2030.

But the World Economic Forum’s report A Global Framework for Youth Mental Health says: “Green shoots of progress are sprouting in mental health,” especially in developed nations where new models of care are being pioneered.