If very high and increasing mental health problems are reported from any society, then the most obvious response is to increase the availability of mental health services. However, if despite this, the trend of high incidence of such problems persists, then isn’t it time to inquire at a wider level regarding what problems of society are causing this and then to take remedial action to remove or reduce these causes? If the high incidence of mental health problems is also reported in the context of children and adolescents, then apart from providing better mental health care to them, it may be no less important to examine the distortions and problems of the world inherited by them which are difficult to cope with.
These issues are better examined in the context of those countries where there is a stronger data/information base. In October 2021 three leading child health organizations in the USA issued a statement warning that a child mental health emergency already exists in the USA. In April 2022 the US Preventive Services Task Force recommended that children as young as 8 should be screened for anxiety.
In September 2011 the then largest study on mental health in Europe found that “ Europeans are plagued by mental and neurological illness, with almost 165 million people or 38% of population suffering each year from a brain disorder such as depression, anxiety, insomnia or dementia” ( Reuters report– Nearly 40% of Europeans suffer mental illness).
In 2015, in Japan suicide was listed as the number one cause of death among children in the 10-18 age-group. In much of the western world this is the number two cause. Over half a million people in Japan (541,000) are identified as hikikomori–social recluses who withdraw from all contacts, sometimes for years.
In the USA 1 in 4 adults suffers from a diagnosable mental disorder in a given year, according to the National Institute of Mental Health Disorders. In 2019, a typical year, according to official data, 12 million Americans thought about suicide and 1.4 million attempted suicide. Suicide ideation affects 4.6% of population in a year and has seen steady increase during the last decade.
According to a statement released by the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry and Children’s Hospital Association in October 2021, “Rates of childhood mental health concerns and suicide rose steadily between 2010 and 2020 and by 2018 suicide was the second leading leading cause of deaths for youth age 10-24.” The pandemic intensified a crisis which was already very serious.
According to Trevor Project, 42% of LGBTQ youth in the USA covered in their study had experienced suicide thoughts. In the context of bullying, not just the victims but also the perpetrators of bullying have a higher suicide rate. By the age of 13, a third of bullies have already considered ending their life, according to a study published in the Journal of Adolescent Health. Children living in families having guns have suicide rates four times higher than those living in families without a gun.
According to UNICEF annual report on children for 2021, in the 10-19 year age-group 9 million teenagers in Europe are affected by mental health disorders, one half of them by depression and anxiety. A WHO report said in 2020 that 1 out of 4 children in Europe are affected by nervousness, irritation and problems in getting to sleep. 35% had started drinking alcohol by age 15. Only 41% of boys and 33% of girls said they were mentally healthy.
When levels of mental health problems are so high and increasing despite better availability of mental health services, it becomes important to situate a significant part of mental health problems not so much at individual level as within the wider social situation. Some aspects of this social situation leading to high levels of stress, depression and other mental health problems are examined here.
Let us first look at the marginalized and poorer sections of people for whom meeting all basic needs, particularly housing, is a big and increasing problem as well as source of stress and depression. In addition to these deprivations, many of these people face identity-based discrimination and violation of dignity relating to race, color, faith, gender and other identities, even a threat to safety, leading to tensions, distress and a suppressed, continuing anger/resentment. Such discriminated and deprived people are also more likely to be affected by incarceration, violent scuffles and substance abuse, leading to further increase of mental health problems. In situations of high socio-economic inequalities, more people are likely to have a feeling of having been left out and discarded.
There are high levels of stress and alienation at workplace. A Gallup poll at world level found that only 21% of the employees are engaged with their work, while almost half were stressed or worried the previous day at work.
An increasing drift away from more durable and stable social relationships is likely to be an important cause of depression and stress across most socio-economic categories. Widely pervasive feelings of securing dominance in social relationships and the violence inherent in this can be very stressful and depressing, as seen in domestic, school, workplace or street violence. A craving only for selfish gains and instant gratification as a base for relationships can be very distressing and disruptive, at both ends of relationships, sooner or later.
Lack of a wider purpose in life, in terms of contributing to welfare of society, can make life less meaningful to several people, a feeling which worsens if a person is pushed into a situation for performing tasks which a sensitive mind feels may be harmful for society. This can also lead to substance abuse.
Instead of promoting stable relationships of mutual help and cooperation, a society may actually in several ways spread the trends of envy, jealousy and getting ahead of others at all costs, linked also to very false notions of achievement and esteem which can leave a great many people feeling as losers.
A person who seeks happiness merely in consumerism, accumulation and sensual pursuits, even at the cost of harming others, needs to reduce his sensitivities to a point where close relations too are harmed. The sheer shallowness of this life leads to a relentless drive for seeking more excitement and sensual pleasures which is often self-defeating.
Society and its leaders often declare ideals and behavior patterns for citizens which are often deeply at odds with, or even the opposite of the trends that are actually promoted in society, leading to schizophrenic social conditions.
Conditions of war, civil strife, disasters and ecological ruin lead to increased stress among all affected people, particularly for women and children.
In this context some significant aspects of social reform should be emphasized. It is important to move towards greater equality as well as significant reduction of identity based discrimination and injustice. The most important aim of economy must be to ensure that basic needs of all are met. Society must give adequate attention to durable, stable relationships of affection and cooperation. Continuing efforts must be made to carefully minimize all violence whether at the level of family and gender, children and schools, youth and college, community and workplace, region and national/international level. Accidents and disasters, including those relating to ecological ruin should be minimized. In school and family, children should be trained more and more in values of peace, cooperation and compassion instead of being pushed along narrow careerist, highly competitive pursuits with high pressures of performance in this narrow sense. All this will help to create a society in which mental health problems are likely to be significantly reduced.
Note–Help is available. Anyone experiencing depression and self-harm thoughts can access helplines and other help.
Bharat Dogra is Honorary Convener, Campaign to Protect Earth Now. His recent books include A Day in 2071, Planet in Peril and Man over Machine—A Path to Peace.