A report published today by the World Health Organization shows that in 2019, nearly 1 billion people suffer from mental disorders, including 14% of adolescents worldwide. Suicide accounts for more than 1 in 100 deaths and 58% of suicides occur before the age of 50.
People with severe mental health problems die on average 10-20 years earlier than the general population, largely due to preventable physical illnesses.
The report notes that stigma, discrimination and human rights violations against people with mental health problems are widespread in communities and care systems around the world. 20 countries still criminalise attempted suicide. Across countries, the poorest and most disadvantaged in society are the most likely to suffer from mental illness and the least likely to access appropriate services.
While 70% of people with mental illness in high-income countries are reported to have access to treatment, only 12% of people with mental illness in low-income countries have access to mental health care services. For depression, there are large gaps in service coverage in all countries: even in high-income countries, only one third of people with depression have access to formal mental health care services. Estimates of the rate of provision of minimum appropriate treatment for depression range from 23% in high-income countries to 3% in low- and lower-middle-income countries
Reshaping the environment that affects mental health
This comprehensive WHO report draws on the latest available evidence to highlight the reasons and overarching areas for change, and the best ways to achieve it, by showing examples of good practice and describing people's personal experiences. It also calls on all stakeholders to work together to deepen the focus on and commitment to mental health, to reshape the environment that affects mental health and to strengthen systems that support the care of people's mental health.
The report notes that mental health needs continue to be neglected and that government spending on mental health is minimal, with two-thirds of it allocated to stand-alone psychiatric hospitals rather than to community mental health services that can provide the best care for people. For decades, mental health has been one of the most neglected areas of public health, receiving far less attention and resources than it deserves.
The report urges countries to accelerate the implementation of the Integrated Mental Health Action Plan 2013-2030, with several recommendations for action, grouped into three 'pathways for change' focusing on changing attitudes to mental health, addressing mental health risks and strengthening mental health care systems. The three pathways are as follows: deepening the focus on and commitment to mental health; reshaping the environments that affect mental health, including families, communities, schools, workplaces, health services and the natural environment; and strengthening mental health care by changing where, how and by whom mental health care is provided and accessed.
The latest Mental Health Atlas, published today by the World Health Organisation
The Mental Health Atlas is published every three years and summarises data from countries around the world on mental health policies, legislation, financing, human resources, service delivery and use, and data collection systems. It also constitutes a mechanism for monitoring progress towards the goals of the WHO Integrated Mental Health Action Plan.
The report shows that the proportion of government health budgets spent on mental health has remained virtually unchanged over the past few years, hovering at around 2%.
The number of people with access to care for specific mental health problems is still estimated to be less than 50% globally, with an average of 40% for depression and only 29% for psychosis.
Encouragingly, the proportion of countries reporting having a mental health promotion and prevention plan has increased, from 41% in 2014 to 52% in 2020. However, 31% of all plans reported by countries did not have dedicated human and financial resources, 27% did not have a clear plan and 39% did not have documented evidence of progress.
Statistics show that the global average number of mental health workers per 100,000 population has increased slightly, from 9 in 2014 to 13 in 2020. However, there are significant differences between countries at different income levels, with the number of mental health workers in high-income countries being more than 40 times higher than in low-income countries.
The reasons for the current discrimination against mental illness in society are, firstly, that some people are caught up in prejudice and believe that patients are morally tainted, and thus consciously or unconsciously violate the dignity of people with mental illness in their words and actions. Secondly, the atmosphere and mechanism of social care and concern are not yet sound, which makes it difficult for most people with mental illness to truly integrate into society. Once someone suffers from mental illness, their living space is drastically reduced to a line between home and hospital, and even if they recover, they still face many difficulties such as education, employment and marriage. In the face of this special social group, which is quite large in number, some functional departments have not responded effectively, and the corresponding social management systems and mechanisms need to be improved. Some media outlets do not play their proper role in guiding public opinion towards people with mental illness, but rather attract attention through distorted reports. Some journalists presume that people who have not been medically diagnosed and are behaving erratically are mentally ill, labelling them as such, and headlines such as "suspected mental illness" are repeated in the media, which to a certain extent reinforces people's prejudice against people with mental illness.
Medicine, especially social medicine, has made it clear that people with mental illness are no more dangerous than healthy people, and that some of their strange behaviour is due to abnormalities in their thinking, emotions and behaviour, which stem from disorders of brain function and are not fundamentally different from lesions of other organs, and are treatable and curable. Discrimination in society adds to the psychological burden of people with mental illness and accelerates the 'short-circuiting' effect of social morality
According to a survey by the National Council for Welfare, more than 50% of respondents are unwilling to live with or be close neighbours to people with mental illness or to work together; 70% believe that such people experience discrimination and even stigma from others in their daily lives
Mental illness is affected by discrimination.
i. being reluctant to seek help or treatment
ii. feelings of being misunderstood by family, friends and colleagues
iii. reduced job opportunities and access to their preferred schools, difficulties in finding housing, etc.
iv. exposure to bullying, physical violence or harassment
v. health insurance that does not adequately cover treatment of mental illness for patients
vi. the belief that they will never succeed in their challenges or improve their situation.
The survey, published in the prestigious US journal The Public Interest, a psychological science journal, identified shame as a major barrier to treatment for many people with mental illness, and that shame is one of many factors that may influence access to care and have a profound impact on people with mental illness.
Patrick Corrigan, a psychological scientist at the Illinois Institute of Technology, says in the report that prejudice and discrimination against mental illness is as impermissible as the illness itself, invariably preventing people from achieving their personal goals and preventing them from pursuing effective treatments.
To avoid the public stigma, patients may choose to forgo treatment or want to avoid it altogether out of fear of negative stereotyping. Public stigma can also affect the beliefs and behaviours of those around people with mental illness, including friends, family and mental health care providers.
According to surveys, the suicide rate in Korea has increased dramatically among young people in the 10th generation and in the 30-40th generation age group, and according to the "Causes of Death Statistics" published by the Department of Statistics in 2018, the number of suicides reached 13,670, which equates to an average of 37.5 people taking the plunge every day, 26.6 per 100,000 people, and nearly 80% of the causes of suicide are related to psychological and mental stress. However, due to the conservative culture of Korean society, most people with mental health problems do not seek medical help because if they are found to have sought treatment for mental health problems, they will be seen as 'abnormal' and subjected to discrimination.
In 2016, the proportion of people suffering from mental illness in Korea was about one in four people who had suffered from a mental illness in their lifetime. However, it is shocking that even though the number of people suffering from mental illness is high, the number of people taking the relevant medication is very low, confirming that they are afraid to seek medical help or feel that it is not necessary. In addition to the patients' own fear of discrimination, the stabbing of a psychiatrist at Samsung Hospital in Gangbuk and the arson attack on a psychiatric patient in a Jinju flat have led to calls for better management of the mentally ill, leading to more discrimination. According to surveys, the number one mental illness in Korea is alcoholism and the number two mental illness is anxiety disorder, both of which are more than twice as common as depression, with the rate of anxiety disorder increasing.
Korea has been educated in Confucianism since a long time ago, and this thinking has been ingrained since ancient times, even more so than in Taiwan. This is why we now see that Koreans place great importance on the orderliness of the young and the old, respect for their seniors, and high self-esteem, all of which are influenced by the incorporation of Confucianism into school education. Although there is nothing wrong with this idea, what is important is how it is put into practice. Some Koreans have a long and orderly upbringing, which has resulted in people being bumped into by elders at underground stations without apologising. This has led to a vicious cycle of bullying by seniors.
The Korean investigative programme 'Want to Know the Truth' interviewed past critics of Shirley, and their responses really showed the twisted nature of human nature! Their responses included: "I didn't really tell her to die, I don't care if she dies or not! I don't care if she dies or not!", "Can you be an artist if you are so vulnerable? An artist has to stand in front of the public! I don't care if she dies! Even though there were attempts to implement the Shirley Law to eradicate the acidic culture, they were eventually prevented from doing so due to the "infringement of freedom of speech".
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