Mental health is an integral component of each life stage from childhood through adulthood. It is a state of mental wellbeing that enables people to thrive, cope with stress, connect with others and contribute meaningfully to the community. The interlinkages between mental health and other health components are well documented.
It is a complex continuum characterized by varying levels of experiences and difficulties. The social and clinical outcomes also differ from person to person. The position of a person on the mental health continuum is influenced by several factors which may alone or together interact to protect, undermine or shift along the continuum. The importance of mental wellbeing as a basic human right is reflected in the theme for the 2022 World Mental Health day; “Make Mental Health and Wellbeing for All a Global Priority”.
Mental health conditions are highly prevalent worldwide. The World Health Organization (WHO) estimates that 1 in 8 people, nearly 1 billion, currently live with a mental health disorder. According to the World Economic Forum, mental health conditions exert a huge economic and financial burden, costing $2.5 trillion in 2010, with a predicted rise to $6 trillion by 2030.
It is a leading cause of disability and the most common conditions are depressive and anxiety disorders. Suicide has been identified as a major cause of death among young people, accounting for more than 1 for every 100 deaths. Schizophrenia, considered one of the most impairing of all mental health conditions occurring approximately in 1 out of 200 adults, cuts life expectancies short by an average of 10-20 years. The picture is grimmer in Africa, with mental health problems affecting 116 million people, a rise from the 53 million reported in 1990. This is alarming.
Despite its prevalence and widespread impact, several people with mental health disorders still do not seek the help they need. Often, they choose to remain silent to avoid being subjected to stigmatization and discrimination. Some are denied basic human rights such as access to voting, employment, education, and housing while others are excluded from community and family activities. Several others become victims of physical or sexual abuse, sometimes by the same people responsible for their care.
Additionally, on average, governments spend less than 2% of budgetary allocation on mental healthcare. Unsurprisingly, this allocation is less than 1% in Low and Middle-Income Countries (LMICs). This leads to almost “non-existent” services and low mental health literacy levels among health providers. In cases where the services are available, they are low quality, and essential mental health drugs are either unavailable or unaffordable.
WHO, in its 2013 comprehensive mental health action plan advocated for a global shift towards community-based mental care approaches integrated with primary care. It promoted prevention, information-tracking systems and improved mental health research, however, progress in the implementation of the action plan has been slow. Almost every country in the world has failed to provide mental health care comparable to physical health care service provision. The ongoing Covid-19 pandemic has served as a catalyst, compounding the global mental health crisis.
There is an urgent need for renewed commitments, plans, and actions to make the population’s mental wellbeing a priority. One of the cost-effective keys to achieving this gallant goal is increased investment and multi-sectoral collaboration. Increased coverage and financial protection through the inclusion of mental health in health insurance coverage packages and incorporating mental and physical health services provision in primary health care will bridge the inequity and inaccessibility gaps and consolidate healthcare efforts and resources for better service uptake and health outcomes.
Government’s implementation of international laws, conventions, and national policies that protect people with mental health disabilities against stigmatization, discrimination, and abuse will encourage a positive attitude toward people living with mental health conditions. This can also be achieved by adopting “people-centered” care approaches that emphasize prevention, respect for human rights and values, and viable treatment options in places where it is needed. Furthermore, the various factors; physical, emotional, and social environment, that interplay to determine the position on the mental health continuum should be continually modified at all levels to prevent mental health conditions whilst protecting and supporting the vulnerable.
The realization that there are no shortcuts is clear. We all must take responsibility for “walking the talk” to create a new world where mental health and wellbeing for all is a global priority.