The biggest non-story in global health

Neon Brain

It’s what I like to call the “most neglected disease” in all of global health.

Mental illness.

Paul Southworth, a visiting scholar on malaria and vaccine science at the NIH, seems to have been diverted from his primary studies by one of the great anomalies of global health — this gap between the disease burden of mental illness and the amount of funding and attention devoted to solving the problem.

In a blog post entitled “What We’re Not Talking About,” Southworth first lays out the evidence that mental illness is one of the world’s biggest killers. Yes, it kills as well as disables.

Here’s a pie chart that shows Disability Adjusted Life Years (aka DALYs), which takes a number of factors into account to measure diseases, injuries and disorders according to their impact on survival.

Causes of death and disability, by 'Disability Adjusted Life Years' (DALY)

As you can see from the pie chart, mental illness (aka “neuropsychiatric disorders”) is the biggest slice in the pie. Yet it is rarely even mentioned at global health meetings or confabs, says Southworth:

At global health events I have attended, mental health has barely been mentioned and when it has, it has been very much a peripheral issue considered of little importance.

This is obviously not borne out by the evidence regarding global burden of disease, he notes. And he goes on to cite studies demonstrating that treatment for mental illness can be done effectively and inexpensively even in poor countries.

Here’s a story I did a while ago about two Seattle women, the UW’s Debra Kaysen and Shannon Dorsey, who are among those proving mental illness can be tackled in even some of the poorest and most war-torn or unstable parts of the world.

There really is no rational reason for continuing to ignore mental illness in global health, Southworth says:

This is not a problem we can sweep under the rug until we’ve solved every other health problem. As has been said so many times, “there is no health without mental health”. Mental illness kills as many people each year as malaria and causes more disability than any other illness. There are huge advantages to be gained both to societies and to individuals by including mental health as a key part of the global health agenda instead of a fringe issue to be sniffed at.


About Author

Tom Paulson

Tom Paulson is founder and lead journalist at Humanosphere. Prior to operating this online news site, he reported on science,  medicine, health policy, aid and development for the Seattle Post-Intelligencer. Contact him at tom[at] or follow him on Twitter @tompaulson.