Mental health is an aspect of life common to us all, which impacts all areas of our lives. Indeed, good mental health is fundamental for human wellbeing and healthy and sustainable societal growth. It enables people to realize their potential, develop and maintain proactive relationships, cope with life challenges and stresses, work productively and make a positive contribution to their communities. However, mental health is often seen as secondary to physical health, and is not given enough priority. And, despite the fact that one in four people develop a mental health condition during their lifetime, many do not receive the help and support they need to cope with and overcome their mental health challenges.
Before the COVID-19 pandemic, it was estimated that around 1 billion people live with a mental health or substance use disorder globally. This comes with a cost both to the people affected, our societies and the world economy. According to the WHO, the lost productivity resulting from depression and anxiety alone costs the global economy US$ 1 trillion each year. And, people’s mental health challenges have been further exacerbated by the pandemic and its related lockdowns and regulations, especially in vulnerable populations — including young people, elderly and people living with pre-existing mental health conditions. The mental health challenges and psychosocial stressors associated with the COVID-19 pandemic, as well as the many current global challenges the world is facing with armed conflicts, energy and economic crisis, rising household expenses, climate change and other threats and interruptions to our health and safety, adds significantly to the global health burden. This has both short-term and long-term consequences that require immediate actions and interventions on global, national and local level.
Despite the rising prevalence of mental health challenges worldwide, less than 2% of governmental health budgets are spent on mental health globally. It would appear that world leaders and politicians regard mental health as an issue unworthy of particular focus or action. Indeed, such attitudes prevail in parts of the general public worldwide. This may be due to a lack of awareness and understanding as to the intrinsic nature, value and impact that mental health has on all aspects of our lives; and the key it holds to resolving many of the current challenges the world is facing.
Increasing inequalities need to be addressed worldwide
The COVID-19 pandemic has also highlighted and increased inequalities between different parts of the population across countries, leaving vulnerable groups further behind. As a result, our world is becoming increasingly polarized between those with access to health related services and support, and those who are marginalized and lack access due to their location, socioeconomic status or other personal circumstances. This inequality in access is probably even clearer for mental health services, given the lack or limitations of such services and the low number of psychologists and other mental health professionals in many countries. In low- and middle- income countries, more than 75% of people with mental disorders receive no treatment at all for their condition. Worldwide, over two-thirds of those who meet the criteria for a mental health disorder do not receive the treatment or help that they need and deserve.
The gap between those who get their mental health needs met and those with unmet care needs is widest in countries where there is conflict, and in countries with higher rates of unemployment, unequal wealth distribution and budget cuts. Across low-, middle- and high-income countries there are significant treatment gaps between the most privileged people and those who are most marginalized, such as indigenous populations around the globe. Furthermore, those who live with mental health challenges—as well as their families and carers—are still faced with stigma, discrimination and human rights violations in many countries across the world. This not only affects their physical and mental health, it also affects their sense of dignity, social relationships, educational opportunities, current and future income and job opportunities, as well as their families and loved ones. This needs to change.
Awareness needs to be followed by action
People’s awareness and understanding about the importance of mental health and psychosocial well-being has increased as a result of the pandemic. During the last couple of years, we have also seen increased calls to action on mental health from several UN organizations and world leaders, including from the UN Secretary-General António Guterres and the WHO Director-General Tedros Adhanom Ghebreyesus. Furthermore, the WHO has recently launched a special initiative, action plan, coalition and report on mental health. These are important and valuable initiatives and resources to help shape the mental health agenda in member states and to integrate mental health into universal health coverage plans. However, more awareness, advocacy, guidelines and plans around mental health is not enough, if not followed by investment in and implementation of evidence-based and scalable mental health interventions promoting a rights-based approach across countries. Increased integration of mental health in public health services, accessible digital mental health platforms and programs, alongside community-based approaches and interventions can play a key role here. Such services and interventions should have a person-centered and integrative approach whenever possible, and should include disease prevention and health promotion.
Further, we need to increase our efforts towards protecting and promoting human rights and minimize stigma and coercion in mental healthcare, and address the needs of neglected populations. We must. without delays or excuses, recognize every person’s inherent dignity, worth and equal and non-negotiable human rights and increase our efforts towards meeting the mental health needs of people across population groups—including people living with disabilities and other vulnerable populations. Such efforts need to include lived experience expertise, monitoring and improvements of the service user experience and treatment outcomes, as well as ongoing mental health support for overburdened health workers. This will help to ensure high quality services which cultivate the human aspects of care.
Given the extent of the current challenges, solutions to mental health issues should not be limited to the healthcare sector. Schools, workplaces and local communities around the world can, and should, be places where mental health is placed at the forefront of the agenda. Indeed, leaders, policy makers and care deliverers across all societal sectors should accept their joint responsibility to help flatten the curve of the rising mental health challenges; while reducing the stigma associated with such conditions.
To conclude, each country, organization, institution, and individual has a role to play in increasing awareness around the importance of prioritizing and investing in mental health and wellbeing for all on a global and local level. But no country, entity or individual can act successfully alone. We need to unite and collaborate effectively across nations, sectors and disciplines towards these goals and commitments. Only then can we achieve a more healthy, equitable, mentally sound and sustainable world for all.
