For John Mooney, it was a career highlight. In March the Irish cricketer took a crucial catch that gave his team the victory in a World Cup match and eliminated the higher-ranked Zimbabwe. But afterwards the Zimbabwe Herald, a daily paper with links to Zanu-PF, the thuggish ruling party, claimed that Mr. Mooney had lied when he said that his foot had not been touching the boundary, meaning the catch should have been disallowed. The article cited previous interviews in which the sportsman had spoken frankly about his long battles with drink, depression and suicidal thoughts. Under pressure, it claimed, a “man of such a character” could not be trusted to have “the honesty, let alone the decency” to tell the truth.
So begins this week’s Reading.
The essay provides an excellent summary of the impact of mental health on our society and our economy. It also notes reasons for hope. Indeed, Mr. Mooney’s story is moving: after the Zimbabwe Herald attack, fearing that others may be reluctant to talk about their mental illness in light of his harassment, Mr. Mooney chose to publicly speak about his battle with depression. The article notes:
The reaction was heartening. Messages and thanks are still coming in.
This essay is readable and concise. “Out of the shadows: The stigma of mental illness is fading. But it will take time for sufferers to get the treatment they need” is a must read. Here’s the surprise: it was published in an economics magazine.
Welcome to 2015, where thoughtful analysis on mental health issues isn’t just for the psychiatry journals anymore.
Here’s the link:
[Because of browser issues, try cutting and pasting this link if it doesn’t open.]
The article is short and worth reading. It makes a powerful case for action on mental health.
· “One in five working-age people in rich countries suffer from a mental condition each year… But mental ailments are far less likely to receive treatment than physical ones. Over three-quarters of those suffering severe conditions, and over 90% of those with moderate ones, are treated by non-specialists or not at all…”
· “One study estimates that depression is 50% more disabling than angina, asthma or arthritis, as measured by a health score that combines factors such as reduced mobility and pain.”
· “The resulting misery is huge. Put together, mental illnesses account for more suffering and premature death in rich countries than heart disease and strokes, or than cancer…”
· “British police spend as much as two-fifths of their time dealing with cases that involve mental illness, though few have the necessary training.”
· “Across Europe, 40-70% of prison inmates are mentally ill.”
But good news:
· The stigma is dropping particularly fast in Australia where the government named Patrick McGory, a psychiatrist, “Australian of the year” in 2010.
· “In Britain mental-health nurses join police officers on patrol… In a pilot scheme, the approach led to police detaining 26% fewer mentally ill people and sending more who needed acute care to psychiatric assessment rather than a jail cell.”
· “Last year a group of big European businesses launched a charter to target the impact of depression at work.”
· And the Mental Health Commission of Canada’s work gets mention – “Canada’s voluntary psychological safety standard for business, published in 2013, mirrors initiatives to improve physical safety. It includes a guide on how to cut stress at work, for example by cracking down on bosses who harangue their underlings or set unachievable deadlines, and suggests training some managers to spot the signs of common problems such as anxiety and depression.”
I like this article. I also like the idea of this article. A discussion about mental illness naturally fits in an economics magazine.
As a clinician, I’m well familiar with the tragedy of mental illness. Last month, I discharged a man from the inpatient psychiatric unit whose admission had been precipitated by a manic episode in which he believed he had a special connection to God. He left calm and pleasant – so much healthier, if smaller. He had lost his semester of university; he had strained friendships; he had burned bridges.
But mental health issues affect, as The Economist notes, policing and prisons. And, yes, they affect the productivity of our society. The issues of mental illness are, then, not just tragic, but also economic – one doesn’t exclude the other.
The Economist essay runs with the following graph depicting disability-adjusted life years. Note that the disability associated with mental illness is larger than cardiovascular disease or cancer for people under 70. (!)
(The 29 January 2015 Reading also referenced disability-adjusted life years, which draws on WHO and European data.)
A productive workforce is a healthy workforce – and that includes mental health.
What’s the Canadian perspective? In 2011, the Mental Health Commission of Canada (MHCC) released an analysis considering the economic impact of mental illness. The RiskAnalytica pegged it at $48.6 billion a year – and almost surely an underestimate, according to even the study’s authors.
Source: RiskAnalytica for MHCC
As stigma fades, as these issues gain more attention, the economic impact of mental illness needs to be addressed. That’s why the work of the Mental Health Commission of Canada has been so important (and a tip of the hat to the MHCC’s corporate partners). But we also need dollars and cents: the federal and provincial governments would be well advised to increase funding for mental health, just 7% of total health spending in 2012; the MHCC recommends 9% by 2022.
There is, in other words, a larger societal debate that needs to take place. But note: when The Economist is writing about mental illness – and writing so thoughtfully about mental illness – we know that conversation has begun.
The MHCC’s “The Life and Economic Impact of Major Mental Illnesses in Canada” can be found here:
Reading of the Week. Every week I pick a reading — often an article or a paper — from the world of Psychiatry.