Kathleen M. Pike, PhD

Making Mental Health and Well-Being for All a Global Priority

High-income country, Low-income country; Northern hemisphere, Southern hemisphere; East, West. Regardless of where you call home, mental health is core to the well-being of individuals, families, communities, and nations. Each year on October 10th – World Mental Health Day – The World Federation for Mental Health leads a global campaign focused on a particular theme to raise awareness about mental health.

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These are tumultuous days around the world, and many individuals are reporting increased mental health concerns. With this recognition, World Mental Health Day 2022 calls on us to “make mental health and well-being for all a global priority.” In that spirit, highlighted below are five groups within our global population who have particular mental health needs that have been the subject of previous Five on Fridays.

1. Forcibly Displaced Persons. Around the world, more than 100 million people are currently displaced. That’s more than 1% of the world’s population. This group includes people who are internally displaced (who leave their homes but remain within the borders of their home country), refugees (who flee their home country and cross international borders), and asylum-seekers (who seek protection outside their home country because they fear persecution or have experienced violence or human rights violations). These populations demonstrate tremendous resilience and psychological fortitude. Nonetheless, they are at increased risk for mental health concerns, including depression, anxiety, and post-traumatic stress disorder, given the trauma(s) associated with displacement. Many Columbia University faculty are working in various ways to bring appropriate and effective mental health interventions to different communities of displaced persons around the globe. One such example is the work that Professors Jennifer Mootz and Michael Wessells are collaborating on with colleagues in Mozambique, where an escalating religious insurgency has resulted in approximately 2,000 civilian deaths and 674,000 internally displaced persons. Supported in part by a 2022 Columbia Global Mental Health Program Council grant, they are working to identify technologies that could potentially facilitate the detection and treatment of mental health needs among these communities in northern Mozambique.

2. Workers around the World. Mental health matters at work. We spend more of our waking hours working than engaged in any other activity. Approximately 15% of working-age adults have a mental disorder at any point in time, and WHO estimates that untreated depression and anxiety alone lead to approximately 12 billion working days lost annually, representing an annual cost to the global economy of nearly US $1 trillion, driven predominantly by lost productivity. Since the pandemic, burnout among workers has been at an all-time high. In many countries, workers have few rights and little protection. In many parts of the world, mental health is not part of overall health benefits despite the strong links between mental health and other aspects of our health and well-being (nevermind work performance and productivity). Recognizing the need to improve workers’ mental health, WHO recently released new Guidelines on Mental Health at Work, and our Mental Health + Work Design Lab team is excited to contribute to the development of the Mental Health at Work Index that will help organizations assess and improve their workplace mental health efforts.

3. Historically Disenfranchised, Marginalized, and Oppressed Peoples. Audre Lorde said, “I am not free while any woman is unfree, even when her shackles are very different from my own.” When individuals experience discrimination and marginalization based on race, ethnicity, gender, religion, sexual orientation, or disability, they are at risk for poor mental health due to social and systemic inequities, lack of access to high-quality, culturally-appropriate mental health services, prejudice, and cultural stigma surrounding mental health care. Data from numerous studies with diverse populations globally, including Black Americans, women, Asian Americans, and the LGBTQ+ community, document the mental health costs of stigmatization and social inequality. Unlocking these shackles is key to making the vision of mental health and well-being a reality for all.

4. Youth. Children and adolescents around the globe are reporting significant mental health concerns. In the United States, even before the pandemic, rates of depression and anxiety in teens were on the rise. We see a similar trend globally. A 2021 meta-analysis of the global prevalence of depressive and anxiety symptoms in children and adolescents during Covid-19 showed increased rates of clinically elevated anxiety and depression symptoms for youth. And young people are reporting elevated rates of climate change anxiety. In a 2021 global survey with 10,000 young people aged 16-25, findings showed that 59% were either very worried or extremely worried about climate change, and over 45% said their feelings about climate change negatively affected their daily life and functioning. What we do to meet the mental health needs of young people today foretells their future and the future of generations to come.

5. Older Adults. Our world is a youth-centric one, even though people live longer today and global age demographics are shifting. In 2020, people aged 60 years and older outnumbered children under five years of age, and by 2050, people over 60 are expected to constitute 22% of the global population. Older adults have demonstrated remarkable resilience in the face of gut-wrenching losses during the height of the pandemic. But loneliness and isolation, exacerbated by the pandemic, are commonly reported by older adults. They are also well-documented risk factors for adverse mental health. Approximately 15% of older adults face real mental health concerns, either new or enduring, with depression and anxiety the most common. Columbia University Mailman School of Public Health Dean Linda Fried co-chaired the National Academy of Science Global Commission on Healthy Aging, which recently published the Global Roadmap for Healthy Longevity. With nearly 200 Fellows who are part of our Health and Aging Policy Fellows Program community, we know that effective policy making can make a world of difference to improve quality of life for older adults, but time is of the essence, and enhanced mental health for older adults will require structural change and radical efforts, in the U.S. and around the globe.

Mahatma Gandhi said, “the true measure of any society can be found in how it treats its most vulnerable members.” Displaced. Working. Disenfranchised. Marginalized. Young. Old. Mental health risks are real. Some individuals and some groups are more vulnerable than others. I hope we will each consider what we can do to help make the World Federation for Mental Health’s vision of mental health and well-being for all a reality globally.

Picture of Kathleen M. Pike, PhD

Kathleen M. Pike, PhD

Kathleen M. Pike, PhD is Professor of Psychology and Director of the Global Mental Health WHO Collaborating Centre at Columbia University.

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