This year’s theme for the World Mental Health Day is “Depression: a global crisis”.
Depression is a common illness worldwide, with an estimated 350 million people affected. Depression is different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life. Especially when long-lasting and with moderate or severe intensity, depression may become a serious health condition. It can cause the affected person to suffer greatly and function poorly at work, at school and in the family. At its worst, depression can lead to suicide. Suicide results in an estimated 1 million deaths every year, more than half of which are associated with antecedent mental disorders. The burden of depression and other mental health conditions is on the rise globally and taking cognizance of this the World Health Assembly in May 2012 called for a comprehensive, coordinated response to mental disorders at country level.
Although there are known, effective treatments for depression, fewer than half of those affected in the world receive such treatments, while in some countries of the Region only about 10%–20% of people suffering from depression receive treatment.
Barriers to effective care include a lack of resources, lack of trained health care providers and social stigma associated with mental disorders.
Studies from the Region show that only a quarter to a third of people consulting primary health care services suffering from depression and anxiety-related disorders are accurately diagnosed and managed.
Depression like all other mental disorders affect, and is affected by, other physical disorders such as cancer, cardiovascular disease, diabetes and asthma. It can be a precursor of physical diseases, a consequence of those diseases, or the result of interactive effects.
There is evidence that depression predisposes people to developing myocardial infarction, and conversely, myocardial infarctions increase the likelihood of depression. People with mental health conditions also have high mortality rates. For example, people with major depression have an 40% overall increased risk of mortality than that of the general population largely because of physical health problems (such as cancer, diabetes and HIV infection), as well as serious consequences, such as suicide, which is the second most common cause of death among young people worldwide.
Prevention programmes have been shown to reduce depression. Effective community approaches to prevent depression include school-based programmes for the prevention of child abuse, or programmes to enhance cognitive, problem-solving and social skills of children and adolescents. Interventions for parents of children with behavioural problems may reduce parental depressive symptoms and improve outcomes for their children. Similarly integrating early recognition and management of depression in general health care using a biopsychosocial approach can help not only improve the quality of life of individuals and their families but also reduce the socioeconomic burden on communities and systems.
WHO has recently launched management protocols for common mental disorders, including depression, as part of the mental health gap action programme (mhGAP) for use by non-specialist health personnel. The recommended treatment options for moderate-severe depression consist of basic psychosocial support combined with antidepressant medication or psychotherapy.
By focusing on depression this year, World Mental Health Day aims at raising public awareness about this mental health issue. It is expected that the Day will promote debate and focus attention on this major public health issue which is currently not being adequately addressed and attract resources for prevention, promotion and treatment services.