We have become accustomed in the UK during the last decade to both talking about and understanding mental health issues in a far more open way. There is still much to do, still so many feel stigmatised and misunderstood. Post-COVID it is also clear that global mental health issues have increased and limited resources have become even more stretched. Waiting lists for support and help are extensive with some people waiting far too long for treatment. The Royal College of Psychiatrists reported in October 2020 that 38% of people waiting for mental health services had needed to resort to emergency or crisis services. [1]
No boundaries to mental health challenges
But as we approach World Mental Health Day this year lets recognise that the problem is by no means confined to the UK. As Health Poverty Action[2] cogently state mental health is no respecter of geographic boundaries and is linked inextricably to poverty, discrimination and overall poor health.
In the countries where Health Poverty Action are most active over 80% of those with mental health problems have a low or bare-subsistence income. They are highly unlikely to be able to access any treatment at all, barely 20% are referred or received any level of support. It is left to struggling families and communities to do whatever they can. Compare this to the US where there is a high prevalence of depression reported but where 65% have access to timely treatment. A clear example of the inequality that continues to pervade our world in so many ways today.
As the World Health Organization estimates in their recently published 2020 report, there are 264 million people suffering from depression each year in the world. It may be interesting to note that the Top Five countries suffering from depression are the Ukraine, the US, Estonia, Australia and Brazil. Whilst the five countries reporting the lowest levels of depression in the world are small – the Solomon Isles, Papua New Guinea, Timon, Vanuatu and Kiribati. [3]
The range of global mental health issues
Of course, mental health issues are not confined to depression although it is one of the most prevalent difficulties. In the Our World in Data report for 2017 the global prevalence of different mental health issues were anxiety (3.76%), depression (3.44%), alcohol use disorders (1.4%), drug use disorders (0.94%), bipolar disorder (0.6%), schizophrenia (0.25%) and eating disorders (0.21%). Such a range over all countries and again in so many cases such limited treatment facilities available.
Mental health in the UK
Turning to the UK, we know the prevalence of mental health issues nationally and some of the regional variations with particular high instances of significant issues, and significant lack of resources, in the areas of greatest economic and social deprivation. Many of us have become aware of the issues, for example, in areas such as Blackpool where there are high levels of alcohol and drug misuse, unemployment and poor networks of family support for so many relatively young who have gravitated to the area in search of inexpensive housing. The issues become compounded and intractable.
Mental health and employment
We know the devastating impact of mental health issues and employment. Those with mental health issues are twice as likely to lose their jobs and take three times as long to re-enter the workplace. The anxiety this creates, the lack of income and the stress clearly compound the issues.
The message from Mental Health Day
As we contemplate Mental Health Day on 10th October, there is no way we can deny the issues facing us in our own society and in the world in general. It is still a deeply disturbing situation and mental health charities whilst doing their best to meet immediate needs, are coming under increasing pressure as the NHS facilities become simply too stretched to respond quickly enough as our insight from the Royal College of Psychiatrists showed.
However, there is a message of hope to give – but it comes with a challenge because it faces us all with the reality that more can be done if each one of us makes a very tangible and specific contribution. Organisations like Health Poverty Action are now targeting mental health initiatives, for example their work in Zimbabwe, both to provide immediate support to people and to raise awareness. They are seeing relatively straightforward interventions having a strong and positive impact.
A case study – new ways to bring assistance
Finally, a case study from Uganda demonstrates how significant the problems in Africa are – but also the ingenuity, creativity and commitment being shown to tackle the issues. Uganda is one of the Top 6 counties in Africa in terms of mental health issues with 4.6% of the population suffering from depression and, 2.9% from anxiety. 5.1% of females are affected against 3.6% of males. Post-COVID the crisis has deepened. Sustained stress exposure causes people to turn to damaging behaviour like crime, reckless sexual acts, violence, domestic abuse, and substance abuse. Reports indicate that 80% of Ugandan youths are using alcohol (Ayebare et al., 2019). Without doubt, COVID-19 has imposed a significant mental health burden upon the people of Uganda.
As might be expected, resources are very limited with only 1% of GDP being provided for mental health care – roughly $24 per head per year according to the report of the American Psychological Association (APA)[4].
Yet post-pandemic, and with increasing numbers as we have seen reported globally, those in Uganda have sought new ways to try to bring assistance. They have not given up. Tele-calls, radio programmes providing support, tele-conferencing outreach into both the urban and rural communities have continued to try to provide at least some level of professional support. Whilst the problems are great the research report of Molodynski and colleagues back in 2017 put the situation in Uganda succinctly – “Desperate challenges but real opportunities”[5].
Practical steps we can all take
Some people and communities, both in the UK and further afield, are at greater risk of living with mental health problems. However, no-one is immune from developing problems and there are positive steps we call all take to understand, protect and sustain good mental wellbeing.
- Talk to someone/ask for help – a friend, colleague, call the Employee Assistance Programme (EAP) or Mental Health First Aider at work
- Keep active – regular physical activity has many benefits including improving mental health
- Eat well – our brain needs a good balance of nutrients to stay healthy and function well
- Accept who you are – we all are different. Be proud of who you are – feeling good about yourself boosts self-esteem
- Take a break – a change of place, slow down, take time to relax. Listen to your body – if you are tired, rest and sleep
How Cordell Health can help
We believe in empowering leaders and managers with training, tools and techniques to take care of their employees’ mental and physical wellbeing whilst at work. If you would like to discuss our wellbeing services or to explore what mental health training could be designed to support your line managers and employees please get in touch.
Sources
[1] https://www.rcpsych.ac.uk/news-and-features/latest-news/detail/2020/10/06/two-fifths-of-patients-waiting-for-mental-health-treatment-forced-to-resort-to-emergency-or-crisis-services
[2] https://www.healthpovertyaction.org/
[3] https://apps.who.int/iris/bitstream/handle/10665/332070/9789240005105-eng.pdf
[4] https://www.apa.org/international/global-insights/uganda-mental-health
[5] Molodynski, A., Cusack, C., and Nixon, J. (2017). Mental healthcare in Uganda: Desparate challenges but real opportunities. BJPsych International, 14(4).
