Mental illness: is there really a global epidemic?

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Mental illness is not sadness, insanity or rage (though it can involve these in some of its forms); it is not binary or exclusive, but complex and universal, says a report in The Guardian.

Another way to think of it is as a spectrum, a continuum that we all sit on. At one end is mental health, where we are thriving, fulfilled and at ease. In the middle reaches, people can be described as coping, surviving or struggling. At the far end sit the range of mental illnesses. Most us move back and forth along this line our entire lives.

First, to bust some myths: there is no global epidemic. It is not growing exponentially. It is not a disease of western capitalism. Second, a warning. Data is remarkably patchy. It relies on people self-reporting their feelings, never the best foundation for accurate information.

But insofar as data exists, the most reliable time series curated by the Institute for Health Metrics Evaluation (IHME) appears to show that in 2017, just under 300 million people worldwide suffered from anxiety, about 160 million from major depressive disorder, another 100 million from the milder form of depression known as dysthymia.

According to data from the IHME’s Global Burden of Disease, about 13% of the global population – some 971 million people – suffer from some kind of mental disorder. Dementia is the fastest-growing mental illness. The British charity Mind refers to a statistic that one in four people will experience some form of mental illness in any given year.

Is it getting worse?

The short answer is not really. The increases in the above graphic are only slightly higher than the rise in global population since 1990.

“All the modeling we’ve done in high-income countries where there is survey data which has tracked over time shows that the prevalence hasn’t changed – it’s flatlined,” says Harvey Whiteford, professor of population mental health at the University of Queensland.

But there have been two big changes in the past 20 years. The first is that recognition and destigmatisation has resulted in a huge surge of people seeking help. The second is that surveys repeatedly show that more young people are reporting mental distress.

“There is much more talk about it and more people being treated,” Whiteford adds. “The treatment rates have gone up. In Australia, they have gone up from about one third of the diagnose population getting treatment to about a half.”

Who is best at treating mental illness?

Mental illnesses services are inadequate pretty much everywhere. But some countries are more inadequate than others.

According to WHO data, Turkey and Belgium are the only countries that have more than 100 mental health nurses for every 100,000 people. Ninety countries have fewer than 10.

Japan tops the list for mental health beds in mental health facilities (196 per 100,000), and is third behind Hungary and Germany for mental health beds in general hospitals. Britain is 50th for mental health beds per capita, behind China, Uzbekistan and Lebanon.

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