Every year, the second week of October is observed as the World Mental Health Week and 10th October is observed as the World Mental Health Day. On this day, various organizations worldwide raise awareness regarding mental health and talk about how to increase access and utilization of mental health care services. The World Federation for Mental Health has announced “Mental Health in an Unequal World” as the theme for this year.
The global burden of mental health is ever increasing, and many countries have limited policies to address this. The world that we are living in is strikingly unequal with economic gaps widening over the decades. The Credit Suisse Global Wealth data book in 2020 states the 43.4% of the world’s wealth is held by the richest 1% while 1.4% is held by 53.6% of the world’s population. There are stark differences across different races in terms of income, access to housing and healthcare, unemployment rates. Gender gaps in terms of employment, pay grade, differences in gender roles and the discriminations arising out of them also contribute to making the world an unequal place.
Paul Farmer wrote in his book “Pathologies of Power” that the poorer sections remain neglected by policy makers and calls for equity in healthcare. The mental health needs of the vulnerable and marginalized populations often go unmet and/or undetected which leads to increased morbidity. The stigma and discrimination associated with mental illness is also higher in developing countries limiting access to mental health care facilities. Also, access to mental health care services remains unequal with majority in low- and middle-income countries unable to have access to these services.
Sexual orientation may also put individuals at a disadvantage for achieving mental wellbeing and the LGBTQIA+ community is at a higher risk of facing discrimination and stigma.
All these social inequalities pose a risk to mental health. Mental health itself takes a back seat while developing health care policies which results in lesser research, infrastructure, funds allocation and lesser integration into primary healthcare.
The impact of the COVID-19 pandemic on mental health has been palpable worldwide. The fear of being infected by the virus, the availability of adequate health infrastructure or lack thereof, the effects of the lockdown, financial insecurities, isolation have become major topics of concern since the start of the pandemic. These consequences of the pandemic also are varying across different countries, economic sections, age groups and gender. These also differ according to the pre pandemic lifestyles and social contact of the individuals. The long-term effects of the pandemic on mental health burden are yet to be seen in terms of the consequences of an expected recession, increasing poverty and the rise in demand for the mental health services.
The book “The Spirit Level: Why more Equal Societies Almost Always Do Better” by Richard Wilkinson and Kate Pickett highlights that unequal societies had higher prevalence of mental illness, infant mortality and crime rates and suggested redistribution of wealth as a solution. According to the authors, more equal societies have higher trust, lesser anxiety, and lesser need to “race” to the top.
The various aspects of social status like race and gender, having disabilities, belonging to LGBTQIA+ makes certain communities more prone to prejudice and exclusion. Such inequalities can be reduced by taking action across governments and communities to act collectively. Policy makers should be encouraged to reduce the socioeconomic inequalities and make mental healthcare more acceptable and accessible. Ultimately, we all as individuals must work together to create a less discriminating neighborhood, promoting a more inclusive environment, preventing abuse and encouraging equal access to the existing healthcare. Addressing these can help to reduce the mental health burden and foster a healthy environment.