Mental health including substance use disorders has been hidden behind a curtain of stigma and discrimination for too long. It’s time to bring it out into the open. The magnitude, suffering and burden in terms of disability and costs for individuals, families and societies are staggering. In the last few years, the world has become more aware of this enormous burden and the potential for mental health gains. We can make a difference using existing knowledge ready to be applied. We need to enhance our investment in mental health substantially and we need to do it now.
For all individuals, mental, physical and social health are vital and interwoven strands of life. No group is immune to mental disorders, but the risk is higher among the LGBTQ+ community, migrants and refugees, indigenous populations, children and adolescents, abused women and the neglected elderly. As our understanding of this relationship grows, it becomes ever more apparent that mental health is crucial to the overall well-being of individuals, societies, and countries. Indeed, mental health can be defined as a state of well-being enabling individuals to realize their abilities, cope with the normal stresses of life, work productively and fruitfully, and contribute to their communities. Unfortunately, mental health and mental disorders are not accorded anywhere near the same degree of importance as physical health. Rather, they have been largely ignored or neglected.
According to the World Health Organization:
• As many as 450 million people worldwide suffer from a mental or behavioral or substance use disorder.
• Nearly 1 million people die by suicide every year.
• Four of the six leading causes of years lived with disability are due to neuropsychiatric disorders (depression, alcohol-use disorders, schizophrenia and bipolar disorder).
• One in four families has at least one member with a mental disorder. Family members are often the primary caregivers of people with mental disorders. The extent of the burden of mental disorders on family members is difficult to assess and quantify and is consequently often ignored. However, it does have a significant impact on the family’s quality of life.
• In addition to the health and social costs, those suffering from mental illnesses are also victims of human rights violations, stigma and discrimination, both inside and outside psychiatric institutions and correctional facilities.
Yet, there is an enormous gap between the need for treatment of mental disorders and the resources available. In developed countries with well-organized health care systems like our own, between 44% and 70% of patients with mental disorders do not receive treatment. In developing countries, the figures are even more startling, with the treatment gap being close to 90%. Sadly, the failure to provide comprehensive treatment leads to fractured homes, destabilized communities, suicide, incarceration or death.