We Are Living in A Global Mental Health Pandemic

Prior to the COVID pandemic, poor mental health was considered the leading cause of disability worldwide. And, research suggests, one in four of us will experience a mental-health condition in our lifetime.  The reality is we are living amidst a spiraling global mental health pandemic.  What can we do?

Mental Health Pandemic

Then, in the first year of the COVID-19 pandemic, the global prevalence of anxiety and depression increased by 25%, according to a scientific brief released by the World Health Organization (WHO) in 2022. Statistics show that there is also no recovery towards pre-pandemic levels, with mental well-being, on average, remaining at the same levels as during the pandemic, according to Sapien Labs’ Mental State of the World in 2022 report.

Unfortunately, the situation underscores a chronic global shortage of mental-health resources. WHO’s most recent Mental Health Atlas shows that, in 2020, governments worldwide spent, on average, just over 2% of their health budgets on mental health. Many low-income countries reported having fewer than one mental-health worker per 100,000 people, with 90% of those living with poor mental health in low/middle-income countries receiving no support at all. It’s reported that there are only around 12 psychiatrists in the whole of Zimbabwe. 

This is more than a global issue. It’s a global health crisis.

Mental-health literacy

At the 2019 World Economic Forum, the UK’s Prince William spoke about Heads Together, a campaign he and his brother launched in 2016 to combat the stigma of mental health and to promote seeking help. Such was the stigma that it took a year of public advocacy, including sharing their own struggles with mental health publicly, to encourage celebrities to join the campaign.

“Mental health was the great taboo. If you are anxious, it’s because you are weak. If you can’t cope with whatever life throws at you, it’s because you are failing. Successful, strong people don’t suffer like that, do they? But of course – we all do. It’s just that a few of us speak about it,” Prince William said.

The lack of mental-health literacy is a major contributor to the stigma of mental health worldwide. A 2015 study in the UK revealed that 61% of participants had a poor understanding of mental-health conditions, symptoms, and treatments. 

In the case of “self-stigma”, individuals who don’t fully understand the concepts of poor mental health may blame themselves for their conditions, which can exacerbate the conditions. 

The mental state of the world

The stigmatization around mental illness is more severe in developing countries. South Africa is a good example. According to the Mental State of the World in 2022 report, released in March 2023 – for which data was collected from 500,000 people across 64 countries, making it the largest database of mental wellbeing in the world – South Africa ranks as one of the worst countries in the world for mental healthcare.

Contributing factors include poor quality and availability of mental-healthcare services, high levels of poverty, unemployment, and violence, and a prevailing stigma around mental illness due to a lack of mental-health literacy.

In South Africa, one in three people will experience a mental-health disorder in their lifetime, and 75% go untreated. With only 975 psychiatrists serving a population of more than 60 million, most of whom practice in the private sector, 80% of the population is relying on the public health sector, with very limited services. And unequal access to mental healthcare has deteriorated since the pandemic.

The report revealed a concerning trend: teenagers and young adults in internet-enabled countries worldwide are experiencing a significant decline in mental wellness, compared to older generations. This translates to a notable increase in the percentage of younger individuals requiring professional help due to mental distress or struggles.

Social self

One of the major areas in which this is evident is in the decline of the “social self”, a dimensional score encompassing the way we see ourselves and our ability to relate to others. The biggest decline in this area is in countries where culture has changed, showing a greater push towards individualism and personal material achievement. 

According to the report, “This paints a picture of changing parenting priorities in younger generations from providing a stable and loving childhood home to one focused on material comfort and accomplishment that fosters greater conflict and abuse.” More than the lack of positive relationships, at a national level, it aligns with increased rates of suicide, physical assault, and sexual abuse.

Social media is compounding mental health problems

And in the digital age, where children are exposed to social media at an alarmingly young age, they’re increasingly exposed to cyberbullying and the pressure to live up to an unrealistic standard of perfection, at the cost of real, honest social interactions and friendships. This was exacerbated by the social isolation caused by the pandemic lockdowns. 

A lack of trustworthy, honest friendships results in youths being unable to relate to one another authentically and openly discuss their emotions, leading to feelings of loneliness, worthlessness, and isolation.

Aside from governments increasing funding and resources for mental healthcare, what other actions can we take? 

“We need to transform our attitudes, actions and approaches to promoting and protecting mental wellness, and providing care and support for those who suffer. We can and should do this by transforming the environments that influence our mental health,” stated Tedros Adhanom Ghebreyesus, director of the WHO.

Support is crucial

At home

Infancy, childhood, and adolescence are ages of both vulnerability and opportunity in mental health. Nurturing, caregiving, and supportive learning environments can be extremely protective of future mental health. Parents need to be encouraged to spend more quality time with their children, and focus on teaching them to recognize and manage their own frustrations and anger, limiting the amount of time they spend online. 

At school

Schools need to focus on educating the youth about mental health and wellness, and provide safe spaces where children can open up about their struggles. They should introduce social and emotional learning programs while countering bullying. 

At work

Attitudes towards mental illness in the workplace also need to be transformed. Companies should foster an environment of inclusion and openness, where workers feel comfortable being themselves and opening up about mental-health issues, without fear of judgment or discrimination.

Communities making a difference 

Considering that psychiatric care and medication are expensive, not always the answer to mental-health issues, and often not accessible, innovative community-based solutions are the frontline of defense, especially for common mental-health conditions such as anxiety and depression.

Against the odds of limited support, communities around the world are finding ways to support those in need. One such community-based initiative is The Friendship Bench, started in Zimbabwe by psychiatrist Dr Dixon Chibanda. 

The concept was developed over 20 years of community-based research to bridge the mental-health treatment gap. Psychological therapy delivered predominantly by community grandmothers who are trained in the very basics of cognitive behavioral “talk” therapy, the Friendship Bench takes place on a bench that is placed in a safe space within the community. Such is the success of the Friendship Bench initiative that it has expanded within the country and has been replicated around the world.

The role of a healthy lifestyle

Research emphasizes the crucial role of gut health and nutrition in mental well-being. Through a balance of gut microbiota and the microbiota-gut-brain connection, there can be positive impacts for conditions such as anxiety and depression. 

In addition, nutrition affects neurotransmitter balance, neuro-signaling, and neuro-inflammation. Highly processed and sugary foods can cause inflammation in the brain, affecting concentration, memory, and mood. A balanced diet rich in whole grains, lean proteins, fats, carbohydrates, vitamins, and minerals from fruits and vegetables is vital for brain function and mood regulation. 

Furthermore, adequate exercise and sleep are essential for regulating mood and concentration levels, underscoring the importance of a holistic, balanced lifestyle for maintaining mental wellness.

The role of health technology

Digital technologies in various contexts offer promising tools for enhancing mental health. 

Since COVID, a host of digital mental-health apps have come onto the market, empowering users to take a more active role in managing their mental health. Initially, these apps were simple tools for stress management and relaxation. Now they’ve evolved into sophisticated platforms offering personalized mental-healthcare plans, AI-driven therapy sessions, data-driven insights into one’s mental-health status, and online access to licensed therapists and psychologists.

Some apps also provide platforms where users can connect with others who are experiencing similar mental-health challenges. (When choosing an online therapy provider, it’s important to check the site’s privacy guidelines and the qualifications of the therapist before you sign up.)

COVID has also given rise to an increase in support groups, particularly online. The advantage is that anyone, anywhere in the world, can access a support group and feel less alone, more understood, and part of a network of people who have gone through a similar situation.

This article first appeared in Longevity magazine edition, Living Beyond 100.

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