Out of the shadows – World Bank & World Health Organisation on Mental Health
I have just attended a joint meeting of the World Bank and the World Health Organisation in Washington – the topic was mental health and the pressing need to make it a global development priority. It was good to see that mental illness is now, at last, being seen as part of the non-communicable disease crisis that is afflicting every part of the planet.
Margaret Chan, WHO Director General, flagged up recent research showing the global cost of anxiety and depression as being $1 trillion per year and Jim Yong Kim, World Bank President, framed the issue as one of development and not just public health.
The meeting, titled Out of the Shadows, sought to shine a light on a subject still characterised in many parts of the world by fear, stigma and neglect. Even in the “developed” world the imbalance of resources devoted to mental health compared to physical health is stark. Innovative models of service delivery were showcased from around the world and ranged from individual placement and support in the most deprived communities to high tech psychological therapies.
Workplace interventions are of particular interest to me but progress in that area seems remarkably slow. There appears to be a widespread reluctance by many health professionals to engage with the private sector, even in relation to companies’ own employees. Perhaps that is a reflection of a lack of shared experience and language but some of it also appears to be driven by political dogma which has no place in responding to human distress and misery.
It is heartening to see the progress that has been made in addressing mental illness over the past 30 years. There remains much to do but the profile the issues now have and the range of key players that see the need for action gives cause for hope. The downside is that the positive aspects of good mental health and wellbeing are only mentioned briefly in any discussion before the focus shifts entirely to illness and healthcare systems. The medical model of health that has dominated the past 100 years is not sustainable. Spending 17.5% of GDP on healthcare (as the USA did in 2014) diverts resources from other essential areas and untold harm will be caused to emerging economies that try to emulate the model.
We need to not only accept and address the social determinants of disease but also to reframe political thinking to consider citizens’ wellbeing as the priority. Having a positive – wellbeing – as the end point aspired to is much more motivational than the simple avoidance of harm – illness. Promoting the elements that have been shown to improve wellbeing will reduce ill health while at the same time advancing human happiness and societal progress. That has to be a better framework than one based on the fear of pestilence – whether that is physical or mental.
Dr Paul Litchfield
Also launched at the conference is the World Economic Forum Global Agenda Council on Mental Health and their new guide for improving wellbeing at work.
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