Mental Health Often Overlooked

Article excerpt

In 2001, the World Health Organization (WHO) estimated that 450 million people worldwide had a mental or neurological disorder. Twenty-five percent of the population can expect to experience one or more disorders within their lifetime. Mental illness is universal, affecting people in all nations and from every background, but poor people in developing countries lack access to many of the most basic resources for effective treatment.

WHO's definition of mental health disorders is broad, encompassing a wide range of problems of both the mind and brain. It includes autism, Alzheimer's disease, schizophrenia, depression, sleep disorders, addiction and substance abuse, bipolar affective disorder, panic and anxiety disorders, mental retardation, and epilepsy. (Although epilepsy occurs because of an electrical mix-up in the brain, and retardation and autism are developmental problems, people with these conditions are often discriminated against and prevented from fully participating in normal social activities.)

Overall, mental disorders account for almost a third of global disability (the number of healthy life years lost to a disability) from all diseases. Depression is by far the most debilitating--more than 120 million people are affected worldwide. Currently, depression represents 12 percent of the global disability burden, and by 2020 its share is expected to rise to 15 percent, second only to heart disease.

Although the incidence of depression is highest during middle age, experts recognize that the elderly and children aren't immune to mental health problems. The prevalence of some disorders--dementia and Alzheimer's--rises with age. In the United States, one in ten young people suffers from impairment of psychological development or from behavioral, emotional, and depressive disorders. Roughly 18 percent of children and adolescents in Ethiopia have a mental disorder, while in India the figure is 13 percent. More than 20 percent of young people in Germany, Spain, and Switzerland are afflicted with depression, anxiety, or other mental problems.

Rural isolation and poverty can make things worse. In remote regions, mental and general health care facilities and counselors are nonexistent or too expensive. Rural women--who also suffer from economic hardship--are more than twice as likely to suffer from depression than the general population. Often the mentally ill, who carry the extra burden of being poor, wind up incarcerated. In the United States, there are five times as many prisoners with mental illness as there are patients in state mental hospitals.

Changing societal norms can also bring out psychological problems as people are separated from their traditional social safety nets of family and community. For instance, eating disorders--an increasingly common problem among girls (and more and more boys) in affluent nations--have spread to developing countries as cultural definitions of female beauty change. Dependence on a cash economy, overcrowding, pollution, and increased violence in cities can also exacerbate mental disorders.

Mental illness strikes men and women differently. Almost 10 percent of women have a depressive episode every year, compared with fewer than 6 percent of men. Men, however, are more likely to have substance abuse problems and antisocial personality disorders. Severe mental disorders, such as schizophrenia, show no clear gender preference.

Mental illness often exacerbates and in some cases leads to other health problems. Patients with untreated mental disorders who also suffer from other chronic conditions--such as cancer, HIV/AIDS, heart disease, or diabetes--are less likely to experience an improvement in their overall health. And addictions to drugs, tobacco, or alcohol--which WHO also classifies as mental health disorders--can increase the severity and duration of mental illness. …