In the wake of numerous mass shootings seemingly tied to mental health issues, U.S. legislators from both parties – Paul Ryan and Nancy Pelosi – are calling for meaningful action to improve diagnosis and treatment of mental health disorders. The calls come on the heels of the U.N.’s inclusion of mental health and well-being in the newly adopted global goals.
Historically, mental disorders such as depression and anxiety were stigmatized and received far less research and policy attention. Today, the U.N. includes mental health in its Sustainable Development Goals. The third goal, “Ensure healthy lives and promote well-being for all at all ages,” includes a target that reads, “By 2030, reduce by one-third premature mortality from noncommunicable diseases through prevention and treatment and promote mental health and well-being.”
The wording for the mental health goal is much more vague than the specific one-third reduction target for noncommunicable diseases. But any progress would be an improvement, as the burden of mental disorders has only been worsening over time while significant progress has been made in other diseases.
Since the ’90s, the burden of mental disorders has grown (see Figure 1) as the global population has grown and aged. For depression specifically, the burden grew by 54 percent between 1990 and 2013. The burden of anxiety grew by 42 percent over that same period. Even when you adjust the numbers to take into account changes in population size and age, however, it is clear that no discernible progress has been made against these diseases (see the data here).
Figure 1: Burden of mental disorders globally, both sexes, 1990-2013
Note: These data come from the Global Burden of Disease 2013 Study. Access the data visualization here: http://ihmeuw.org/3q5y. Substance use disorders were excluded from this chart with the exception of the category “other mental and substance use disorders.”
Mental disorders weigh heavily on the most economically productive age group, 15- to 49-year-olds. Figure 2 shows a square pie chart, known as a tree map, where the size of each box represents the proportion of disease burden from different causes in this age group. As indicated by the red circles, depression accounted for 4.8 percent of total disease burden in 2013, which was greater than the burden of tuberculosis (3.3 percent of total disease burden) but less than HIV (6.1 percent) in this age group. Anxiety made up 2.0 percent of disease burden, which was about same as the burden of diabetes (2.1 percent). Schizophrenia and bipolar disorders made up 1.4 percent and 0.9 percent of disease burden, respectively, among 15- to 49-year-olds globally in 2013.
Figure 2: Burden of disease by cause among 15- to 49-year-olds, both sexes, 2013
Note: These data come from the Global Burden of Disease 2013 Study. Access the data visualization here: http://ihmeuw.org/3q75.
As mentioned in previous Humanosphere articles, depression is among the top global health problems today. When you rank diseases and injuries in terms of the suffering and early death they cause, depression ranked 11th in 2013. Depression’s ranking has increased since 1990, when it ranked 16th globally. The burden of depression ranks even higher in females, ranking fifth in 2013. The original Global Burden of Disease study in 1993, included in the World Development Report launched that year, was the first study to reveal the magnitude of the global mental health crisis.
When you look at the leading causes of disability worldwide exclusively (Figure 3), four types of mental disorders are among the top 20 causes: depression (second), anxiety (ninth), schizophrenia (12th) and bipolar disorder (18th).
Figure 3: Leading causes of disability worldwide, both sexes, 1990 and 2013
Note: These data come from the Global Burden of Disease 2013 Study. Access the data visualization here: http://ihmeuw.org/3q71.