The following piece was written by Dr David Nabarro for TIME and highlights a fundamental problem with the way we understand and talk about mental illness in this country, and collectively across the globe.
We must do more to unravel the cultural stigma and feed the growing awareness online with healthy information and access to real solutions.
"What comes to mind when you think of the big challenges to global health?
Catastrophic infectious outbreaks like Ebola in West Africa during 2014 and 2015? Or perhaps you focus on long-term threats, like the sickness caused by polluted air in mega-cities like Beijing and New Delhi, the growing worldwide epidemic of diabetes or the threats to health posed by climate change?
All valid and serious concerns that must be addressed, certainly. But often overlooked are the silent killers such as mental illness. As we deal with the physical side of wars and violence across the world, we must not forget the physiological burden which can follow weeks, months and even years after.
As with all health conditions, the best approach is to prevent the problem before it gets too severe and becomes a crisis. But sometimes it can be difficult to persuade hard pressed governments, especially in poorer countries, of this truth. However, this is the essence of good public health. To do this with mental health, it is imperative that we break the stigma and I want to see the World Health Organization (WHO) employ a relentless international focus, which is long overdue.
We are not spending enough money on mental illness. On average, just 3% of government health budgets are invested in mental health, varying from less than 1% in low-income countries to 5% in high-income countries. We need to let the world's governments know that investment in mental health makes economic sense: Every dollar invested in scaling up treatment for depression and anxiety leads to a return of $4 in better health and ability to work.
Mental illness can include anxiety, addictive behaviour, schizophrenia and dementia, but by far the most common malady is depression. More than 300 million people—5% of the world population—suffer from depression at any time. This is a truly staggering number, and it's on the rise; the number of sufferers has increased by one fifth since 2005 . When we are depressed we lose energy and are less able to concentrate. Our appetites and sleep patterns change. We may feel worthless or guilty, we might lose hope and start thinking about harming ourselves. Indeed, hundreds of thousands of lives are lost due to suicide each year. People who are depressed are more likely to abuse drugs and other substances, to eat the wrong foods and become diabetic, or to be at risk of heart disease.
How can depression be better understood and treated? First—we must recognize the problem. Second—we must talk about it. Third—we must ensure that depressed people are effectively treated
Let us begin by focusing on recognition. The number of people who experience depression and its consequences is often underestimated. Even in high-income countries, nearly 50% of people with depression do not get treatment. That is partly because they do not know that it works.
So talking is also key. We must speak freely about depression and its treatment, and fight the stigma that surrounds all mental illness. In many communities people do not share their anxieties or sadness with health workers because they are embarrassed, and fear being shunned or ridiculed. It leads them to suffer in silence."
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