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World Mental Health Day: Pandemic blues worsen global mental health

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Mental health has been one of the casualties both of the pandemic and the resulting lockdowns

World Mental Health Day: Pandemic blues worsen global mental health
Sumant (name changed) wakes up late, rushes straight to his laptop and starts preparing for his meeting. He works past midnight and feels tired the whole day. Since the pandemic, he has been working from home but can feel how the stress level has taken a detrimental toll on his physical health.
Ravi (name changed) has lost all interest in life. He has started isolating himself from friends and spends most of the time either sleeping or browsing social media. He has put on 5 kgs weight in the last four months.
Although the COVID-19 crisis has essentially been a physical health problem, it has germinated the seeds of a mental health problem. The pandemic has brought to the forefront that a good mental health structure is critical for the overall well being of a society.
The objective of World Mental Health Day that falls on October 10 is to raise awareness of mental health issues around the world and to mobilize efforts in support of mental health. This year’s theme is “Mental Health in an Unequal World,” aiming to address the deepening inequalities in our society.
“This theme cannot be more apt in the face of the ongoing COVID pandemic. The last two years have taught us that each one of us are equal before an illness (be it physical or psychological), irrespective of our socio-economic, racial, ethnic, political and religious status,” says Dr Debanjan Banerjee, Consultant Psychiatrist, Kolkata and member International Psychogeriatric Association.
Mental wellbeing, he says is just not the absence of a psychiatric disorder, but much more. “It is the ability to leave peacefully with dignity, understand one’s limitations and be included in a society.”
According to the World Federation for Mental Health (WFMH), between 75-95 per cent of people with mental disorders in low and middle-income countries are unable to access mental health services at all. Mental disorders among children and adolescents are far more prevalent than previously thought. Diagnosable mental health conditions affect about one in seven (14 percent) of children and adolescents aged 6–18. A fifth of adolescents aged 12–18 have a mental health condition. Suicide is tragically claiming the lives of up to 700,000 people every year (1 person every 40 seconds) and it is the fourth leading cause of death among young people aged 15–19. Most of the mental health conditions start by 14 years of age, but most cases, while treatable, go undetected and unmanaged.
“The devastating social determinants for mental health has been further exacerbated by the socio-economic impact of the COVID-19 pandemic. Growing inequalities against people with mental health conditions have created visible societal divide and injustices. Such inequalities have had a direct impact on peoples’ mental health in every country,” says Dr Ingrid Daniels, President of the World Federation for Mental Health.
Defeating Depression
According to the World Health Organisation, depression is a common mental disorder with an estimated 3.8  percent of the population affected, including 5.0 percent among adults and 5.7 percent among adults older than 60 years.
Approximately 280 million people in the world have depression. Depression is different from usual mood fluctuations and can become a serious health condition.
According to the National Mental Health Survey 2015-16, one in every 20 persons in India suffers from depression. The weighted prevalence of depression for both current and lifetime was 2.7 percent and 5.2 percent, respectively, indicating that nearly 1 in 40 and 1 in 20 suffer from past and current depression, respectively. Depression was reported to be higher in females, in the age group of 40-49 years and among those residing in urban metros. Equally high rates were reported among the elderly (3.5 percent).
Nearly 1 percent of the population reported high suicidal risk. The prevalence of high suicidal risk was more in the 40-49 age group (1.19 percent), among females (1.14 percent) and in those residing in urban metros (1.71 percent). While half of this group reporting suicidal risk had a co-occurring mental illness, the other half did not report any co-morbid mental disorder. This warrants the need for multi-sectoral actions.
The survey that carried out the research in 12 states across six regions found that nearly 9.8 million young Indians aged between 13-17 years are in need of active interventions. The prevalence of mental disorders was nearly twice (13.5 percent) as much in urban metros as compared to rural (6.9 percent) areas. The most common prevalent problems were Depressive Episode & Recurrent Depressive Disorder (2.6 percent), Agoraphobia (2.3 percent), Intellectual Disability (1.7 percent), Autism Spectrum Disorder (1.6 percent), Phobic anxiety disorder (1.3 percent) and Psychotic disorder (1.3 percent).
The rates of depression and anxiety climbed globally by more than 25 percent in 2020, a devastating ripple effect of the COVID-19 pandemic that has particularly affected women and young people, according to a new study. Published in Lancet on October 8, 2021.
“This study is the first to quantify the prevalence and burden of depressive and anxiety disorders by age, sex, and location globally,” the researchers said.
“We knew COVID would have an impact on these mental disorders, we just didn’t know how big the impact was going to be,” said Alize Ferrari, a lead researcher at the Queensland Center for Mental Health Research in Australia and co-author of the study.
The researchers compiled available evidence of the change in the prevalence of major depressive disorder and anxiety disorders during the COVID-19 pandemic. They developed a model to estimate the prevalence of major depressive disorder and anxiety disorders and then used prevalence to estimate the burden of major depressive disorder and anxiety disorders due to the COVID-19 pandemic in 2020.
The study titled -Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic- found that depressive and anxiety disorders increased during 2020 due to the COVID-19 pandemic. Even before the COVID-19 pandemic, depressive and anxiety disorders featured as leading causes of burden globally, despite the existence of intervention strategies that can reduce their effects.
COVID & Mental Health
Mental health has been one of the casualties both of the pandemic and the resulting lockdowns. According to the World Happiness Report 2021, it is hard to speculate precisely on the magnitude of the mental health consequences of the pandemic since the economic shocks have been of a nature and size that we have not seen in modern times.
Focusing on the different stressors caused by the pandemic and the various mechanisms by which these stressors have their mental health effects, as well as the continual measurement and monitoring of all population subgroups, will help researchers derive long-run estimates effects in as timely a manner This will be particularly crucial for younger generations, who will be most heavily affected by the long-run economic consequences and who are already a group with poor mental health and high mental health inequalities, the Report maintains.
Estimates on the affect of mental health due to the pandemic vary depending on the measure used and the country in question, but the findings are remarkably similar. The early decline in mental health was higher in groups that already had more mental health problems -- women, young people, and poorer people. It thus increased the existing inequalities in mental well-being.
The report feels that emotions changed more than did life satisfaction during the first year of COVID-19, worsening more during lockdown and recovering faster. For the world as a whole, based on the annual data from the Gallup World Poll, there was no overall change in positive affect, but there was a roughly 10 percent increase in the number of people who said they were worried or sad the previous day.
The Way Ahead
Experts maintain that there is an urgent need to make available high-quality mental health care besides providing assistance to psychiatrists and health workers. There is an urgent need to reposition the role of psychiatry and promote public mental health.
Besides sprucing the infrastructure for mental health, specific importance should be given to NGOs for mental health services. Multi-sectoral mental health approaches should be tailored for addressing the various loopholes in the delivery of mental health structures.
The author, Dr Vanita Srivastava is an independent science and health writer
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