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June 19, 2021

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Calling the cavalry: coronavirus and the global mental health crisis

THE crisis we’re facing has affected billions of people across every nation of the world. It’s touched every community, impacted countless families and inflicted unquantifiable damage on the global economy. We’re yet to know what the future holds, but in 2021 an estimated 970 million people are suffering.

And we’re not talking COVID-19.

Mental illness takes many forms. Unlike the identifiable symptoms of a virus, psychological disorders are harder to spot. Despite misconception, they are complex, widespread afflictions along a line we all travel.

That’s not the only reason mental health is hard to measure. Many live with multiple conditions at once. What’s more, figures rely on people speaking up. But shame acts as a stuff gag; one shoved so far down the throat of the bound, they choke on their pain and are left suffering in silence. The World Health Organization (WHO) reports an estimated 800,000 deaths by suicide per year. That’s one every 40 seconds. Indications show that for every suicide, 20 others were attempted.

So, where’s the cavalry?

Cooperation, commitment and unprecedented spending have all been critical factors in the battle against COVID-19. Triumph has been the priority of every administration and privy to the front page of every newspaper. But while the WHO praises the response to coronavirus, it reports under-investment in mental health, sighting the global average of government spending at less than 2 percent. Perversely, many psychological conditions can be treated at relatively low cost, but the gap between people needing support and those with access to it remains unbridged.

In China, some 100 million people live with a mental health disorder. As acknowledged by the WHO, the country has made efforts to overcome barriers that prevent people from accessing diagnosis and care, including mental health laws that call for more facilities and better awareness. But like other parts of the world, people with mental health conditions experience discrimination and stigma. Still, there aren’t enough specialists to meet the country’s needs, with only two registered psychiatrists per 100,000 citizens. And in a global city like Shanghai, there’s something else to consider.

We might assume that expatriates leave their troubles at home. But, as international psychologist Debi Yohn writes, “the stresses of living in a challenging new environment exacerbate issues faster and stronger with fewer familiar resources at hand.” There are around 174,000 foreign nationals in Shanghai. If one in four people have a mental health disorder, we risk 43,500 members of our community living with a pain they can’t manage.

In an interview for CNN, Michael Phillips, director of the Suicide Research and Prevention Center at Shanghai Jiao Tong University School of Medicine, said: “It’s impossible to characterize the mental health of a nation, particularly the size and diversity of China.” His study of over 60,000 subjects found rates of mental illness in China “similar to that in Europe and North America.”

So let’s look at that.

Among the wealthiest countries in Europe, poor mental health costs the UK over 100 billion pounds (US$122 billion) a year in social and economic fallout. Yet, the Mental Health Foundation reports mental health research in the UK as chronically underfunded. And while the UK government boasted a 12-billion-pound spend on mental health services in England (2017-18), these same services are buckling at the knees. The effect? Approximately 5,821 deaths by suicide per year in England alone, that’s an average of 16 suicides a day. Death by suicide is now the country’s single biggest killer of men under 45.

We’ve systematically changed our way of life to stop the spread of COVID-19. But you can’t catch a mental health disorder, right? Arguable.

Mental illness is linked to three causes — biological, psychological and social; the latter are dangerously overlooked. Meanwhile, the WHO cites poor mental health as a social indicator that requires social solutions, and the United Nations, when referring to the treatment of depression — the most common mental health disorder — advises we shift our focus from chemical imbalances to imbalances of power. Serotonin isn’t the problem; society is.

Biology plays a part in mental illness, but when it’s not the root cause, we mustn’t make it a scapegoat for change. Rightly, the response to coronavirus has been nothing short of radical. The world has responded in unison, political parties have put differences aside, and governments have prioritized both time and budget to overcome the pandemic.

In one of only five such addresses throughout her reign, Queen Elizabeth II gave a four-minute speech designed to rally national resolve against COVID-19.

“Together we are tackling this disease, and I want to reassure you that if we remain united and resolute, then we will overcome it. I hope in the years to come, everyone will be able to take pride in how we responded to this challenge.”

In that same four minutes, six people will have died by suicide.

Let’s hope a similar address is one day made by world leaders in response to mental health; and that we might take pride in our global response to the silent killer that has spread too far, for too long.


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