Bharat Dogra
It is a paradox—and a very worrying one too- that in the middle of overall high levels of prosperity the burden of mental health problems is very high in several rich countries and appears to be increasing in some important contexts.
In the USA 1 in 4 adults suffers from a diagnosable mental disorder in a given year, according to the National Institute of Mental Health Disorders. 15% of youths suffered a major depressive episode in the previous year. 11% suffered severe major depression ( that could affect normal functioning) in the previous year.
The situation is worrying in a normal year but worsened further during the pandemic. During the pandemic 4 in 10 adults recorded symptoms of anxiety and depressive disorder, up from 1 in 10 adults who reported similar symptoms in the first half of 2019. According to KFF Tracker 36% experienced difficulty in sleeping.
Among adults mental health problems were found to be the highest among young adults, affecting 56% in the 18-24 group. 26% of them had suicide thoughts, compared to 11% average for all adult age-groups.
In 2019, a typical year, according to official data, 12 million Americans thought about suicide and 1.4 million attempted suicide. Suicide ideation affects 4.6% of population in a year and has seen steady increase during the last decade.
Another aspect of mental health relates to sudden nervous breakdown. James Veroff conducted surveys on this at 20 year intervals in USA—in 1957, 1976 and 1996– regarding the likelihood of a nervous breakdown. These surveys reveal an increase after the first 20 years, and a much bigger increase in the next 20 years, regarding the percentage of people who admitted to the likelihood of a nervous breakdown.
In recent years mental health problems among adolescents and children have increased more rapidly, particularly during the last decade. According to recent research published by the American Psychological Association (APA) in 2019, analysis of responses by about 600,000 adolescents and young adults, as received under a national survey for drug use, revealed that psychological distress, major depression, suicidal thoughts and even suicide attempts increased at an exceptionally fast rate during 2005-2018. The increase was more pronounced in more recent times, 2012-2018.
The results of this study were published in a paper published in the Journal of Abnormal Psychology in a paper authored by Dr. Jean Twenge and co-authors. This paper mentions increases in the range of 47 to 71 per cent in these various mental health problems during a few years of this period. Serious sleep related problems were also noted.
Only about half of those suffering from mental health disorders are able to get treatment. Those suffering from mental health are involved in nearly two million visits to prison in a year. 66% of women prisoners have a history of mental health disorders.
The USA is by no means the only high income country to suffer from high levels of mental health problems. According to WHO data for Europe for 2020, nearly 25% population suffers from depression or anxiety. 50% of chronic sick leave is taken for these problems. Treatment is available only for about 50% of those suffering from mental health disorders. As in the USA, the high and increasing rates of mental health problems among children and adolescents are a cause of special concern.
In Australia studies for the year 1997 and 2001 reveal a huge two-thirds increase in percentage of people affected by major psychological distress. The increase was even higher among women. This increase within a very short period has been linked to various policy changes made during this period, one of those rare cases where such linkages could be established due to the availability of comparable data from surveys in both years.
The survey in the case of APA study quoted above had placed much more emphasis on cultural factors and big spurt of digital media during 2012-18 as the main explanatory factor. While this is useful , it is important also to look at a much broader range of issues including family and community relationships, work environment and job related pressures, debts, economic pressures, uncertainty regarding fulfilment of basic needs, inequalities, consumerist trends and pressures to keep up with the Joneses.
Clearly there are several short-term and longer-term factors which lead to high levels of mental distress. There is an urgent need not just for short-term specific responses but also wider policy reform, with a more comprehensive approach, which can significantly reduce various causes of increasing mental stress.
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