World Mental Health Day: If you are struggling, do not despair, you are not alone and there are effective treatments – Dr Sheila O'Neill
Tomorrow has been designated as World Mental Health Day by the World Health Organisation (WHO).
This year’s theme of “mental health for all” is an appropriate ambition given the lack of resources available in many parts of the globe to support people suffering from depression, anxiety and other disorders.
In a joint statement last month, WHO, the World Federation for Mental Health and United for Global Mental Health estimated that nearly one billion people are currently living with a mental disorder; three million are dying every year from alcohol misuse (which is often connected with mental health issues); and one person is taking their own life every 40 seconds somewhere in the world.
Further mental health statistics released by WHO make for equally grim reading with estimates that mental, neurological and substance use disorders account for 10 per cent of global diseases and 30 per cent of the non-fatal disease burden. Depression is reported to be one of the leading causes of disability, affecting 264 million people with those affected with severe mental disorders dying 10 to 20 years earlier on average than the general population.
The global economy loses an estimated US$1 trillion a year in productivity due to depression and anxiety. WHO also estimates that around one in five children and adolescents on the planet live with a mental disorder.
A major study released last month by the University of Nottingham and King’s College London outlined the initial impact of the pandemic here in the UK, showing a substantial increase in the level of mental health-related issues since lockdown began, especially amongst women and young people, compared with previous, published norms. The study found that 64 per cent of participants reported symptoms of depression while 57 per cent reported symptoms of anxiety. Considering the threshold where someone would qualify for high-intensity psychological support in the NHS, the team conducting the study observed that 31.6 per cent reported moderate to severe depression while 26 per cent reported moderate to severe anxiety.
With Covid-19 impacting on social engagement and on many people’s ability to earn a living throughout the world, these figures could be further inflated going forward.
Here in Scotland, where many of my GP colleagues have already reported a marked rise in mental health issues since lockdown, we face further social restrictions over the next six months. We must therefore ensure we maintain a strong focus on providing the appropriate support.
In 2017, the Scottish Government set out its 10-year strategy to tackle mental health issues with an ambition to address these with the “same commitment, passion and drive as we do with physical health problems”. This is a welcome approach in a nation with an estimated one-in-three people affected by mental illness in any one year and one with a disproportionately high number of people taking their own lives.
While the suicide rate across the UK sits at 11.2 deaths per 100,000 people (with men accounting for three-quarters of fatalities), the figure in Scotland is substantially higher at 16.1 deaths per 100,000, second only to Northern Ireland.
With new social restrictions now in place, many people will need to be supported to overcome relationship difficulties which can be exacerbated when couples have little respite from each other for long periods. This includes providing extra resources for charities which have found themselves on the front line since last March.
If we want to seriously tackle mental health-related issues, we must also adapt a cautious approach to the over-zealous use of ‘Zoom medicine’. While there are some notable advantages to online appointments, there is also immense value in face-to-face consultations where GPs are far more likely to pick up on body language or off-the-cuff patient comments which can point to a mental rather than physical health issue.
There is a risk that healthcare professionals fail to pick up clinical clues through a computer screen or down a phone line, where it’s also far more challenging to provide compassionate and empathetic care.
More broadly, we must ensure we are able to open up access to healthcare so people with non-Covid concerns are able to access specialists and avoid suffering the anxiety that can ensue if they find themselves unable to get a diagnosis for a potentially life-threatening condition.
The challenge of improving Scotland’s mental health extends beyond the scope of the medical profession and government – everyone in society has a role to play. We need to use more moderate language within the media and across wider circles to create a more positive dialogue around coronavirus. Without sugar-coating the threat of Covid-19, we need to avoid sensationalised stories that can increase anxiety and focus more attention on promoting positive public health messages backed up with supporting facts and consistent accompanying guidance.
On an individual basis, we must support each other. This includes reaching out to others in a safe manner while social restrictions are in place and taking regular exercise which, as numerous studies have shown, has such a positive impact on our entire well-being.
Finally, I would urge those with concerns about their mental health to seek support. There are numerous effective, evidence-based treatments available while the stigma around this issue continues to be eradicated. No one should suffer in silence any longer.
Dr Sheila O’Neill is a GP and clinical director of the Glasgow Medical Rooms. She is a member of the Royal College of General Practitioners and was one of the first female GP trainers in the West of Scotland
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