An important new report (three years in the making) has finally been released by the Lancet Commission on Global Mental Health, showing the progress made in recognizing mental health and mental illness as global issues. It was not a celebratory event. It found that, around the globe, levels of financial support from governments and assistance groups for research and patient care in the area of mental health remain “pitifully small.”
The 28 mental health researchers, clinicians and advocates from across five continents who authored the report predict the consequences of such neglect will lead to far-reaching economic as well as psychological consequences unless there is a course correction. While the report points out that only 1 in 27 people who have depression and live in developing countries receive adequate treatment, the report goes on to state that “all countries can be thought of as developing countries in the context of mental health.”
The first Lancet Global study on mental health came out in the mid-1990s. At the time, of the top-10 causes of disability worldwide, five were mental illnesses. Mental health researchers had little to offer folks in terms of proven, available and inexpensive treatments. More recently, it has been shown that disorders such as depression and substance abuse can often be treated affordably by community health workers, minimizing the involvement of a costly specialist.
The report calls for more reliance on this community health worker approach, a broader definition of mental illness, as well as the use of technology tools like cell phones for diagnosis and therapy, and greater attention to the stigma associated with this illness.
It seems clear that fighting the stigma associated with a mental condition remains one of the biggest hurdles we face in addressing this issue of global proportions. As just one example, for a while now, the first week in October has been designated as Mental Illness Awareness week. Who knew?
According to a recent editorial by Dr. David B. Feldman, a professor of counseling psychology at Santa Clara University, about half of people in the United States – more than 160 million people – are estimated to have a diagnosable mental illness at some point in their lives. Despite the fact that excellent medications and therapies exist, only about half of people with mental health difficulties receive treatment. This includes even those with serious mental illnesses. The sorry fact remains that people with mental health difficulties continue to be among the most stigmatized groups in the world today, says Feldman.
In an estimated half of the states in the union, a history of mental illness can lead to the loss of one’s driver’s license and the inability to serve on a jury or run for public office. It may even lead to the loss of a job or custody of a child. Despite all efforts to dispel this myth, approximately 60 percent of people continue to believe that individuals with mental illness are inherently violent. Despite beliefs to the contrary, statistics show that mass shootings by people with serious mental illnesses account for less than one percent of all yearly gun-related homicides. People with serious mental illnesses are more likely to fall prey to violence than to commit it.
While it is tempting to think that the stigma attached to mental illness has improved, the Lancet Commission on Global Mental Health report paints a different picture when it comes to resources committed to addressing the problem. Compared to funding for care and treatment of other health issues, mental health’s funding availability is “alarmingly low.” The report concludes that at least part of the reason for this is a slow acceptance of the high incidence of mental illness and of people affected by it. As a result, the Lancet predicts that between 2010 and 2030, mental illnesses will cost the global economy trillions of dollars in health care spending, as well as in lost wages and productivity.
According to a 2017 survey conducted by One Medical, 69 percent of Americans claim at least one mental health issue affects their well-being. Of these individuals, 29 percent say they feel embarrassed to talk about their mental health, even with professionals.
As recently reported in the Guardian, mental health can now be seen as a worsening crisis for young people as demands for services are up, while at the same time those services are diminishing. In 2018, “The State of Mental Health in America” report revealed that the number of young people with severe depression increased from 5.9 percent in 2012 to 8.2 percent in 2015. Even in cases of severe depression, 76 percent of people were left with insufficient treatment – or no treatment at all.
According to the National College Health Assessment, 40 percent of college students in 2018 reported feeling “overwhelmingly anxious,” while 20 percent said they felt “so depressed it was difficult to function.” Thirteen percent said they had considered suicide in the last year. At the same time, other studies show that suicide is the second-largest cause of death for 10- to 24-year-olds in the U.S. and that 90 percent of those who commit suicide had a mental health condition.
Mental health disorders can affect all people – regardless of age, gender, socioeconomic status or nationality. Says the Center For Discovery, our society continues to paint mental illness as they would a prison sentence: a permanent situation that brands an individual.
The cultural sensitivity and denial that is holding back investment in confronting this epidemic has to stop.
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