The theme for World Mental Health Day 2021 'Mental Health in an Unequal World: Together We Can Make a Difference' is very important because of the global challenges that we all face.
This theme was chosen by a global vote including WFMH members, stakeholders and supporters because the world is increasingly polarized, with the very wealthy becoming wealthier, and the number of people living in poverty still far too high. 2020 highlighted inequalities due to race and ethnicity, sexual orientation and gender identity, and the lack of respect for human rights in many countries, including for people living with mental health conditions. Such inequalities have an impact on people's mental health. Poverty, described by the WHO in 1995 as 'The world's most ruthless killer and the greatest cause of suffering on earth' continues. The gap between the rich and the poor continues to widen, irrespective of nation and we cannot continue to turn a blind eye.
We know that access to mental health services remains unequal, with between 75% to 95% of people with mental disorders in low- and middle-income countries unable to access mental health services at all. Access in high income countries is not much better. In addition, lack of investment in mental health is disproportionate to the overall health budget and contributes to the mental health treatment gap.
Many people with a mental illness do not receive the treatment that they are entitled to and deserve. Mental health service users together with their families and carers continue to experience stigma and discrimination. The gap between the 'haves' and the 'have nots' grows ever wider and there is continuing unmet need in the care of people with a mental health problem.
Research evidence shows that there is a deficiency in the quality of care provided to people with a mental health problem. It can take up to 15 years before medical, social and psychological treatments for mental illness that have been shown to work in good quality research studies are delivered in everyday practice to the patients that need them.
The stigma and discrimination experienced by people who experience mental ill health not only affects that person's physical and mental health, stigma also affects their educational opportunities, current and future earning and job prospects, and their families and loved ones. This inequality needs to be addressed because it should not be allowed to continue. We all have a role to play to address these disparities and ensure that people with lived experience of mental health are fully integrated in all aspects of life.
People who experience physical illness often experience psychological distress and mental health difficulties. An example is visual impairment. Over 2.2 billion people have visual impairment worldwide, and the majority also experience anxiety and/ or depression and this is worsened for visually impaired people who experience adverse social and economic circumstances.
The COVID 19 pandemic has further highlighted the effects of inequality on health outcomes. No nation, however rich, has been fully prepared for this. The pandemic has and will continue to affect people, of all ages, in many ways: through infection and illness, sometimes resulting in death bringing bereavement to surviving family members; through the economic impact, with job losses and continued job insecurity; and with the physical distancing that can lead to social isolation.
We need to act, and act urgently.
The 2021 World Mental Health Day campaign 'Mental Health in an Unequal World' provides an opportunity for us to focus on the issues that perpetuate mental health inequality locally and globally. We want to support civil societies to play an active role in tackling inequality in their local areas. We want to encourage researchers to share what they know about mental health inequality including practical ideas about how to tackle this.
When WFMH was formed in 1948 the world had emerged from war and was in major crisis and much of this was tackled by collaboration between WFMH, WHO, UN, UNESCO and other global stakeholders and citizens with an interest in mental health wellbeing.
We are again in the midst of another global crisis that is resulting in widening health, economic and social inequalities. The 2021 World Mental Health Day campaign provides an opportunity for us to come together and act together to highlight how inequality can be addressed to ensure people are able to enjoy good mental health.
Be a partner, be an advocate.