Each year for thirty years October 10th has been recognized as World Mental Health Day, an international day for global mental health education, awareness and advocacy against social stigma. It was first designated in 1992 at the initiative of the World Federation for Mental Health (WFMH), a global mental health organization with members and contacts in more than 150 countries
At Ellipsis Health, we want to honor the 30th anniversary of this important day and acknowledge the ongoing international efforts to mobilize in support of mental health. In a year when the WFMH theme for the day is “Make mental health for all a global priority,” we thought it fitting to step back and ask, “what does mental health around the world look like in 2022?”
According to the World Health Organization (WHO)’s “Mental health report, Transforming mental health for all”, about 1 in 8 people worldwide—nearly 1 billion—live with a mental health disorder. Suicide accounts for 1 in every 100 deaths and is a leading cause of adolescent death. Yet on average, governments spend just 2% of their health budgets on mental health care. Low- and middle-income countries spend just 1%. As a result, mental illness remains a leading cause of disability worldwide, exacting an enormous financial toll. The World Economic Forum (WEF) estimates that mental health conditions (and related consequences) cost $2.5 trillion in 2010 and predicted that cost will rise to $6 trillion by 2030. The World Bank considers mental health disorders “the greatest thief of productive economic life.”
In this 30th year of recognizing the global impact of mental health, the team at Ellipsis wanted to look at the issue from an international point of view. Below are 30 mental health insights grouped by continent. What becomes immediately apparent are the opportunities in every corner of our shared globe to enhance peoples’ lives by improving mental health for all.
AFRICA
There is a scarcity of research into mental health problems in Africa which mirrors the weakness of mental health services on the continent and the blind eye turned to the problem by many Africans and their governments. Worldwide, 24% of countries that reported to the WHO's 2014 Mental Health Atlas survey did not have or had not implemented standalone mental health policies; in Africa, this proportion rose to 46%.
Most African governments devote less than 1% of their budgets to mental health services.
Currently, an estimated 100 million people in Africa suffer from clinical depression, including 66 million women, and demand for mental health services is increasing in Africa, particularly among vulnerable populations like women.
Mental health is not a popular subject in Africa; therefore, there are few higher education facilities teaching about it. The stigma around it prevents graduates from enrolling in mental health-related programs. As a result of this shortage, the Mental Health Innovation Network states that “90% of people with mental illnesses have no access to treatment, especially in poor and rural areas.”
A study done by BioMed Central in Northern Nigeria found that at least 34.3% of respondents believed that drug and alcohol abuse was “a major cause of mental illness.” Commonwealth Health reports that the widespread stigma makes families hide their members who are suffering from mental illness because of the discrimination they have to endure.
ASIA
Over 450 million persons are reported to suffer from mental or neurological disorders on the continent.
Mental health treatment is made widely available in Japan, and for the most part, is covered by national health insurance. This could be why only 3% of the population has diagnosable lifetime depression as compared to a 20.6% prevalence of lifetime depressive disorder in the United States, where national health care is unavailable.
Many elements of mental health care are not available in vast areas of Asia so often substitution comes from a remarkably resilient, but not always highly successful, family care alternative and a strong heritage of traditional medical care for the mentally ill. Traditional belief systems encourage care of the disabled and mentally ill in many cultures in Asia.
The ratio of mental health personnel to population is nowhere near the WHO recommended levels in the less-developed countries of the continent. In China there are about 15,000 psychiatrists for 1.2 billion people (about 1:80,000). In India, with 1 billion people, there are only 3,000 psychiatrists (about 1:330,000), Indonesia has about 450 psychiatrists for 210 million people spread over 13,000 islands. But the number of psychiatrists alone does not tell the whole story, as the distribution of the psychiatrists is heavily weighted in favor of the large and prosperous cities.
There are growing numbers of mental health non-governmental organizations (NGOs) in India, Thailand, Malaysia, Japan, Korea that have started dealing with numerous mental health problems in the community, mainly through public education, awareness raising and lobbying for better care. Some have set up their own training for volunteers, as in Korea, and day centers for rehabilitating mentally ill persons in the community, as in Malaysia and Philippines.
AUSTRALIA
More than 2 in 5 (43.7%) Australians aged 16–85 have experienced a mental disorder during their lifetime.
Those aged 15–24 years have the highest proportion of mental or behavioral conditions (27.5%).
Females report a higher proportion of mental or behavioral conditions (22.8%) than males (17.3%).
Anxiety disorders are the most common mental illnesses with 16.8% or 3.3 million Australians aged 16-85 experiencing anxiety disorders every year, more than twice the rate of depressive disorders.
In 2022, as part of the Nation's mental health reform agenda, the National Mental Health Commission has been tasked with developing a National Stigma and Discrimination Reduction Strategy.
EUROPE
84 million people (1 out of 6) are diagnosed with a mental health condition in the EU.
According to OECD, one in two people will experience a mental health problem in their lifetime, and many will not receive the care they need.
Mental health conditions are still largely stigmatized by society at large.
The youth population has been particularly hard hit, as the incidence of mental health problems among people aged between 15 -24 doubled in most countries during the pandemic. The severity is also underlined by the fact that suicide is the second leading cause of death among young people in Europe.
Over 84000 people died of mental health problems and suicides across EU countries in 2015.
NORTH AMERICA
An estimated 26% of Americans and Candians ages 18 and older – about 1 in 4 US adults / 1in 5 Candians – suffer from a diagnosable mental disorder in a given year.
Suicide is one of the leading causes of death in adolescents and adults ages 15-24. It is the 2nd leading cause of death among people aged 10-14. In Canada, only 1 in 5 children receive appropriate mental health services.
50% of all lifetime mental illness begin by age 14, and 75% by age 24.
More than 50% of people will be diagnosed with a mental illness or disorder at some point in their lifetime
46.2% of adults with mental illness received treatment in 2020. The average delay between onset of mental illness symptoms and treatment is 11 years.
CENTRAL / SOUTH AMERICA
The yearly prevalence in Central and South America for mental, neurological, and substance use disorders range from 18.7% to 24.2% of the population.
Depressive disorders and alcohol abuse show the highest lifetime prevalence in Latin America and the Caribbean: 14.5% and 12.4% respectively. Chronic presentations of these disorders have been identified as present in more than 90% of suicidal people in Latin American Countries.
Nearly 16 million adolescents aged 10–19 live with a mental disorder in Latin America and the Caribbean. Anxiety and depression account for almost 50% of mental disorders among these adolescents.
When men or women are no longer able to fulfill their respective duties due to mental health conditions, stigmatization becomes evident. Men may even try to hide their symptoms, deny symptoms, and avoid seeking treatment in order to keep their status in society.
Although the total health budget for psychiatric hospitals in Mexico, Central America and the Caribbean was only 0.9% and 2.1% for South America in 2019, during the last few decades, there have been strong efforts to increase mental health awareness and understand the influence of mental health in Latin American society.
Clearly, despite progress in some countries, access to mental health care remains elusive for much of the global population while discrimination and stigma remain ever-present around the world. Only by recognizing and acknowledging these facts, can we address these challenges with culturally relevant solutions.
There is hope. Many mental health conditions – when identified early – can be effectively treated at relatively low cost. Further proof that we need to continue advocating for, creating, and implementing innovative technologies to close the global gaps in care. Only with accessible, objective and scalable mental health screening tools, like the ones being developed by Ellipsis Health, will we be able to break through the barriers erected by stigma and geography to support people in need.
In the words of the Mental Health Europe Team at the WHO: Mental health should be seen as a valued source of human capital or well-being in society. It contributes to individual and population health, happiness and welfare, enables social interaction, cohesion and security, and feeds national output and labour force productivity. We need good mental health to succeed in all areas of life.