Addressing Europe’s Mental Health Crisis
It is possible that you know someone who lives with a mental health issue. In fact, it is increasingly likely that you do. The statistics are troubling: cases are growing, with more than 150 million people in Europe now living with mental health issues.[1] There is a significant imbalance in these statistics, with women more likely to suffer from these conditions than men.[2]
Mental health issues are not things that people bring on themselves, nor are they things anyone can simply ‘get over.’ The causes are complex, and come from a mixture of biology and genetics, upbringing and nurture, and environment.[3]
In a recent conversation I had with Professor Dr. Mazda Adli, Director of the Mood Disorders Research Group at the Charité – University Medicine Berlin, it was clear that the causes are not just related to a simple ‘nature versus nurture’ argument. There are a wide variety of factors that affect our mental health, and many of them relate to how we live every day.
How modern life affects our mental health
Today, half of the world’s population live in urban city areas. By 2050, that number is expected to rise to two thirds of all people.[4] Research has started to link this urban lifestyle to certain illnesses, such as depression and anxiety, which are higher among people who live in or grew up in cities – 20% more likely, in the case of depression.[5]
There are many factors that might be impacting this, such as reduced green space and air pollution, and social factors like crime, social inequality and loneliness could also play a part.[3],[4],[6],[7]
Many of us experienced the lack of green space and loneliness first-hand during the lockdowns of the COVID-19 pandemic. From March 2020, instances of anxiety and depression doubled in some countries, with women, young adults, and people with pre-existing mental health conditions most at risk.[8],[9]
As the stresses of modern life continue to impact all of us, and with mental health issues on the rise and healthcare services stretched, it's time to think of fresh solutions on a societal level.
The importance of early intervention
It is widely recognised that early intervention in mental health issues is key to a fast and effective recovery.[10] Recognising symptoms early on and accessing treatment quickly can prevent worsening mental health in the future, saving time and money, and improving quality of life.[11]
So why do barriers to early intervention in mental health remain, when compared with physical illness and injury?
Despite huge advancements in mental health care, the health sector is still working to improve awareness and overcome stigma. I believe education is key to spotting the signs and symptoms, and – if it starts early enough with youth and adolescents – it could have a powerful impact on wider society. Currently, even when symptoms have been recognised, existing stigmas and misinformation are still common and unfortunately can prevent people from seeking help when it would be most beneficial.
These challenges are made worse due to care disparities between mental and physical health, long treatment waitlists, and barriers to access based on geography and economic situation.[12]
What can we all do to help level the playing field?
Education is one of the key factors in changing the mindset around mental health.[13] By integrating mental health awareness and education into schools, we can start to dismantle stigma and stereotypes, and change how we approach mental health as a society.
It’s crucial that we improve parity between mental and physical health, and start seeing mental health conditions as real, tangible issues that cause significant distress to the people who live with them.
To achieve this, we cannot rely on governments and healthcare providers alone. Everyone should play a part in this change – whether that means educating ourselves on symptoms to watch out for, or reaching out to people who may be lonely in these trying times.
We, each of us, have the power to impact mental health issues, no matter how small we feel the impact might be. It really is going to take this sort of concerted, individual and group effort, if we are to see the tide of mental health issues turning in the opposite direction.
References
[1] WHO: The Pan-European Mental Health Coalition. Available at: The Pan-European Mental Health Coalition (who.int) [Last accessed: April 2023]
[2] EIGE-2021 Gender Equality Index 2021 Report: Health. Available at: https://eige.europa.eu/publications/gender-equality-index-2021-report/gender-differences-mental-disorders-begin-early-life#:~:text=Analysis%20of%20GBD%20data%20shows,of%20women%20and%20men%2C%20respectively [Last accessed: April 2023]
[3] Mental health problems – an introduction. Available at: https://www.mind.org.uk/information-support/types-of-mental-health-problems/mental-health-problems-introduction/causes/?gclid=Cj0KCQjw8qmhBhClARIsANAtboctblvhdH7bXhr6MYg0WLAqzMr0L8s7miXK1JTDRqlMN2dZWfNXxEQaAiofEALw_wcB [Last accessed: April 2023]
[4] Urban development. Available at: https://www.worldbank.org/en/topic/urbandevelopment/overview#:~:text=Today%2C%20some%2056%25%20of%20the,people%20will%20live%20in%20cities [Last accessed: April 2023]
[5] Cities increase your risk of depression, anxiety and psychosis – but bring mental health benefits too. Available at: https://www.kcl.ac.uk/cities-increase-your-risk-of-depression-anxiety-and-psychosis-but-bring-mental-health-benefits-too [Last accessed: April 2023]
[6] Astell-Burt T, Feng X. Association of Urban Green Space With Mental Health and General Health Among Adults in Australia. JAMA Netw Open. 2019;2(7):e198209
[7] Khan A, Plana-Ripoll O, Antonsen S et al. Environmental pollution is associated with increased risk of psychiatric disorders in the US and Denmark. PLOS Biology 2019:17(10);e3000513
[8] Tackling the mental health impact of the COVID-19 crisis: An integrated, whole-of-society response. Available at: https://www.oecd.org/coronavirus/policy-responses/tackling-the-mental-health-impact-of-the-covid-19-crisis-an-integrated-whole-of-society-response-0ccafa0b/ [Last accessed: April 2023]
[9] Research briefing: Mental health impacts of the COVID-19 pandemic on adults. Available at: https://post.parliament.uk/research-briefings/post-pn-0648/ [Last accessed: April 2023]
[10] Early intervention in mental illness. Available at: https://www.health.vic.gov.au/prevention-and-promotion/early-intervention-in-mental-illness [Last accessed: April 2023]
[11] The Importance of Early Intervention For People Facing Mental Health Challenges. Available at: The Importance of Early Intervention for People Facing Mental Health Challenges - Mental Health First Aid. [Last Accessed: May 2023]
[12] Insight: Mental health: Achieving ‘parity of esteem.’ Available at: https://commonslibrary.parliament.uk/mental-health-achieving-parity-of-esteem/ [Last accessed: April 2023]
[13] Integrate mental health and wellbeing across curriculum and culture. Available at: https://www.annafreud.org/schools-and-colleges/5-steps-to-mental-health-and-wellbeing/promoting-wellbeing/integrate-mental-health-and-wellbeing-across-curriculum-and-culture/ [Last accessed: April 2023]
Martin Price is Vice President, Health Economics, Market Access & Reimbursement at Janssen and is a passionate mental health advocate. In the first episode of our series on mental health, Martin is joined by Dr Mazda Adli [Prof. Dr. med. Mazda Adli, Chief Physician, Fliedner Klinik Berlin, Professor and Specialist in Psychiatry and Psychotherapy] to discuss the importance of early intervention in mental health, specifically considering issues around stigma, parity of esteem and health literacy.