mental illness


Visualizing the global burden of mental illness in women | 

Mental Illness
Flickr, porschelinn

Mental health problems have a profound impact on men and women worldwide, but the toll of these diseases weighs most heavily on women. Worldwide, depression is responsible for more healthy years lost than HIV/AIDS or malaria in women of all ages.

Globally, depression (also known as major depressive disorder, or MDD) was the top cause of disability among females in 2010 (see screen grab). Disability from depression increased by 37% in females between 1990 and 2010. Anxiety, another mental disorder, ranked sixth. In comparison, depression and anxiety were the second- and 11th-leading causes of disability in males, respectively, in 2010. Clearly, mental health is an important issue for males as well as females, but these diseases are more prominent in females. In 2010, the rate of healthy years lost from depression was 1.7 times higher in females than in males.

Top 10 causes of disability globally, females, 2010

women mental health

Looking beyond causes of disability by factoring in fatal diseases, depression continues to stand out as a leading cause of healthy years lost in females. Continue reading

One student’s view of the UW global health and justice confab: Watermarks | 

 Over the weekend, the University of Washington held a student-run conference on global health. This was the 9th year for the Western Regional International Health Conference and this year’s theme was on social justice and health. Here’s one UW student’s perspective as she jumped from one session to another. 


By Cyan James, special correspondent

Quick: tell me what’s watermarked on Angola’s 5-kwanza note?

Stumped? I thought so.

Turns out there’s a statue portrayed on every Angolan 5-kwanza, and it’s no Venus de Milo or David—it’s The Man Who Thinks Too Much, a bent, stylized figure who cradles his head in his hands (a little like Rodin’s ‘Thinker,’ but with more of a headache.)

In Angola, ‘thinking too much’ is an expression for depression. One of the panelists at the UW conference speaking on mental health, Dr. Paul Bolton of Johns Hopkins University, said jokingly: “Dumb people don’t get this disease.”

More seriously, Bolton pointed out that if Angola saw fit to watermark their currency with a symbol for depression, it could mean Angola takes depression seriously. Or at least knows about it.

It still surprises people to hear that depression is, in fact, one of the world’s biggest killers and causes of disability. Yet it remains neglected on the global health agenda. In 1990, health researchers — now based in Seattle — looked at the leading causes of death and disability and found mental illness was one of the most damaging diseases globally.

As I jumped from session to session at the University of Washington’s 9th Annual Western Regional International Health Conference, I found myself persuaded that mental health on a global scale remains both an important and largely invisible problem. One of the themes of the meeting was finding hidden paths to improving global health.

Like the watermark on Angola’s paper currency, mental illness is always there but often unseen.

I study mental health genetics in UW’s public health genetics PhD program. And I study a lot, so maybe I wasn’t exactly thrilled about spending a semi-rainless weekend back at school. But I went, mostly for the chance to talk about mental health and other ‘hidden’ global health subjects. 

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The biggest non-story in global health | 

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.

World Health Organization

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.

Why is mental illness so low on the global health agenda? | 

Flickr, by Dierk Schaefer

Seattle recently hosted a big international meeting in which many of the world’s leaders in the fight to improve health met to parse data, debate statistical methods and struggle toward consensus aimed at informing the global health agenda.

Given this focus on data, are the biggest contributors to the global burden of disease also getting the most attention and resources?

Consider two major causes of death and disability worldwide — maternal mortality and mental illness.

Today, the international community, or at least the global health community, has made reducing the number of maternal deaths and complications in childbirth worldwide a top priority. The Gates Foundation has made this a primary mission of its global health program. This priority, which really targets both mothers and children, represents two of the UN’s eight Millennium Development Goals.

Maternal health is wisely regarded as a critical, high-value goal for global health because of the important (and not always measurable) magnified benefits to a family and community that come from focusing on women’s reproductive health and the health of newborns.

Yet, surprisingly, mental illness actually kills and maims more young mothers worldwide.

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