It is common to find yourself in a scenario where a friend or family member suffers a physical injury, like a broken leg. The socially acceptable course of action would be to offer assistance in the form of rides to work or or offering to cook them dinner. We would send texts offering words of encouragement and recognition of their pain. We would never suggest someone with a broken leg to “get over it” or just “move on.” Yet many suffer an invisible pain associated with deep despair, hopelessness, or crippling anxiety, and we fail to recognize this suffering in the same way.
There is a clear global impact of mental health issues. The WHO created a calculation to quantify the global burden of disease called the DALYs (disability adjusted life years) and YLD (years lived with disability) (1). It is quantified as the sum of the years of life lost due to premature death, and the years lost due to disability for those living with the consequences and effects of the disease. The global burden of mental illness accounts for 32.4% of years lived with disability and 13% of disability adjusted life years. In other words, a third of all years lived with disability are due to mental health issues. This large percentage highlights the tremendous disparity between how extensive the consequences of mental health issues are as compared to the lack of attention the issues receive.
This negligence of mental health issues is even reflected by the United Nations. Although one in four people are affected by mental health issues, international efforts to combat these issues are minimal. For instance, the Millennium Goals List published every fifteen years by the United Nations neglected to specifically acknowledge the global burden of mental illness. In 2000, eight specific international development goals were announced which include the eradication of extreme poverty, increasing access to primary education, combating specific infectious diseases such as HIV and malaria, and promoting gender equality (2). These goals are undoubtedly priorities for the upcoming fifteen years. However, it is interesting to consider that mental health issues are completely left out of this list.
In addition, another international list fails to acknowledge the severity of the situation regarding mental health burdens. The United Nations sustainable development goals published in 2015 included 17 goals, again including “health and well being” as one distinct goal, which fails to acknowledge the issues within the broader topic at hand. Even with the clear quantifying statistics that show the widespread effect of mental illness, the global burden is underestimated due to the sheer lack of mental health surveillance. Only approximately 80,000 epidemiological studies were conducted on the issue of mental health, which were nearly all conducted in high income countries. We are unaware of the true sweeping reality of mental health disability in our world.
The neglect to acknowledge mental health as a global public health epidemic creates an environment where people refrain from asking for help, or primary care physicians fail to attempt to give help. Tara M. Bishop et al., explicitly highlights this issue in their study. They compared use of care management processes by primary care physicians across chronic conditions. They focused on the use of care management processes for diabetes, asthma, congestive heart failure, and depression. They found that depression had the lowest rate of care management process use between all four conditions (3). This serves to underscore the critical situation regarding healthcare for mental illness. There is clearly a need to pay attention to how our healthcare system implements their care management processes for chronic depression, and especially that the use of such care management processes are imperative to patient care just as treating physical illness is.
Mental health issues inherently come with a stigma. The intangible nature of their diagnoses make them easy to cast off as insignificant. This reality informs the inconsistency between the widespread disability associated with mental health disorders and the lack of serious attention we give to these conditions. It is crucial that we adjust healthcare attitudes and systems to accurately engage with all healthcare issues that contribute to suffering.
Edited by: Amaan Qazi
Illustrated by: Eugenia Yoh