Depression the leading cause of ill health and disability worldwide, WHO finds

Call for greater investment in mental health as cost to global economy estimated at a trillion US dollars annually

Rachel Roberts
Friday 31 March 2017 13:35 BST
Researchers found that even in high income countries, nearly half of all those with depression do not receive treatment (file)
Researchers found that even in high income countries, nearly half of all those with depression do not receive treatment (file) (Time to Change)

Depression is now the leading cause of ill health and disability in the world, according to the World Health Organisation (WHO), following a huge spike in the number of people who report living with the condition.

The condition has overtaken lower respiratory disease as the biggest global health problem, with latest figures showing more than 300 million people worldwide have a diagnosis of depression, an increase of more than 18 per cent between 2006 and 2015.

The organisation said it hopes the figures will lead to improved availability of effective treatment for the condition which carries a huge human cost as well as costing the world economy billions.

WHO Director-General, Dr Margaret Chan, said: “These new figures are a wake-up call for all countries to re-think their approaches to mental health and to treat it with the urgency that it deserves.”

Dr Skekhar Saxena of the WHO said lack of understanding of the condition and prejudice towards those who suffer from it remain barriers to effective treatment.

“For someone living with depression, talking to a person they trust is often the first step towards treatment and recovery,” he said ahead of the launch of the WHO’s “let’s talk” campaign.

According to researchers, even in high income countries, nearly 50 per cent of people with depression do not receive treatment and drugs prescribed are often ineffective. On average, just three per cent of government health budgets is invested in mental health, varying from less than one per cent in low-income countries to around five per cent in high-income countries including the UK.

The WHO said investing in mental health makes economic sense and claims that for every US dollar invested in better treatment for depression and anxiety, there is a return of 4 dollars in better health and ability to work.

According to a separate WHO-led study, which calculated projected treatment costs and health outcomes in 36 low, middle and high-income countries for the 15 years from 2016-2030, low levels of recognition and access to care for depression and anxiety result in a global economic loss of a trillion US dollars every year.

Prime Minister Theresa May has pledged to create parity of esteem between mental and physical health in the UK, but critics have suggested the motivation is purely economic, with an aim of “fixing” people and finding them fit for work as quickly as possible.

But some mental health professionals and campaigners say the human cost of the condition is immeasurable and the focus should not be exclusively on the estimated cost to the economy and on getting people “back to work” because this is not always helpful and can lead to further problems.

The UK’s leading bodies representing psychologists, psychotherapists, psychoanalysts and counsellors recently wrote an open letter, published in The Independent, urging the Government to suspend benefit sanctions which are often imposed on people with mental health problems.

The letter suggested that far from being an automatic “cure” for depression, unhappiness at work can be a major cause of the condition, and that “bad jobs can be more damaging to mental health than unemployment.”

It said: “Suspending the sanctions system alone is not enough. We believe the Government also has to change its focus from making unemployment less attractive, to making employment more attractive – which means a wholesale review of the back to work system.

“We want to see a range of policy changes to promote mental health and wellbeing. These include increased mental health awareness training for job centre staff – and reform of the work capability assessment (WCA), which may be psychologically damaging, and lacks clear evidence of reliability or effectiveness.

“We urge the Government to rethink the Jobcentre’s role from not only increasing employment, but also ensuring the quality of that employment, given that bad jobs can be more damaging to mental health than unemployment.”

WHO identifies clear links between depression and other mental and physical health problems.

“Depression increases the risk of substance use disorders and diseases such as diabetes and heart disease; the opposite is also true, meaning that people with these other conditions have a higher risk of depression.”

According to mental health charities in the UK, mixed anxiety and depression is the most commonly diagnosed mental health problem in the country, with 7.8 per cent of the population meeting the criteria for the condition, which is believed to account for one fifth of all days taken of work.

There is a clear link between depression and suicide, which is the leading cause of death in men under 35. The number of unexpected patient deaths reported by mental health trusts in England has risen by 50 per cent in the last three years, according to figures obtained by the BBC under the freedom of information act.

The rise in “virtual” treatments, such as Apps approved by the NHS for depression and anxiety – has proved controversial, with critics claiming that while they may help some people, they are no substitute for proper talking therapies with mental health professionals for those who need it.

Demand for mental health services has reached an unprecedented level, while funding for mental health services fell by 8 per cent between 2010 and 2015, according to statistics from 43 trusts.

Theresa May delivered a much-publicised speech in January pledging to end the stigma around mental health, but did not promise significant extra funding to deal with the surge in demand for treatment.

The focus of her speech was on mental health problems among young people rather than adults, pledging that every secondary school will be offered mental health first aid training, while the Care Quality Commission is conducting a review into child and adolescent mental health services across the country.

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