News
Millions Lack Needed Mental Health Care, WHO Finds
Lisa Schlein
July 14, 2015 11:57 AM
GENEVA—
Hundreds of millions of people worldwide who suffer from mental disorders get little or no treatment, the World Health Organization reports. Its Mental Health Atlas 2014 finds that though mental illness constitutes 10 percent of the global health burden, it draws just 1 percent of the financial and human resources needed.
The Atlas provides the most comprehensive look to date at the global state of mental health. It contains data from 171 countries, representing 95 percent of the world’s population.
The report finds every country, region, age group and strata of society suffers significantly from mental disorders. Yet, it says the mental health field attracts very few nurses and other health care professionals and draws minimal spending.
A wide health-care gap separates poor and rich countries. The ratio of mental health care providers in low- and middle-income countries is one per 100,000 people compared to one per 2,000 in wealthy countries, the report said.
The financial gap also is broad. Poor countries spend less than $2 per capita each year on mental health, compared to more than $50 in high-income countries, according to the report.
Stigma interferes
Communities and countries do not pay enough attention to mental health problems because of stigma, Shekhar Saxena, director of WHO’s Department of Mental Health and Substance Abuse, told VOA. He said people shrink from speaking about their problems for fear of losing status in their societies or losing their jobs and relationships.
“There is a misconception that once a person is mentally ill … nothing much can be done about it, which is far from the truth,” Saxena said. “WHO’s documents have very clearly highlighted the fact that largely mental disorders are treatable. People can become all right – completely all right or partially all right – can go back to their job[s], can look after their normal roles and functioning in a very satisfactory way.”
Mental health disorders are continuing to increase, WHO said, with one in four people affected at some point over a lifetime. But three out of four people with severe disorders receive no treatment.
Serious consequences
Health systems’ inadequate responses are having serious consequences, it said, warning that depression will be the leading cause of disease burden by 2030.
Data from the Atlas show 900,000 people a year commit suicide, which also is the second most-common cause of death among young people.
The report also said people with mental health ailments suffer a wide range of human rights violations.
It’s much better to treat people with mental disorders in community-based settings than in institutions, WHO’s report said. Unfortunately, it noted the majority of spending – 82 percent – goes to mental hospitals, which serve a small proportion of those who need care.
Your phone knows if you’re depressed
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Time spent on smartphone and GPS location sensor data detect depression
The more time you spend using your phone, the more likely you are depressed. The average daily usage for depressed individuals was about 68 minutes, while for non-depressed individuals it was about 17 minutes.
Spending most of your time at home and most of your time in fewer locations — as measured by GPS tracking — also are linked to depression. And, having a less regular day-to-day schedule, leaving your house and going to work at different times each day, for example, also is linked to depression.
Based on the phone sensor data, Northwestern scientists could identify people with depressive symptoms with 87 percent accuracy.
“The significance of this is we can detect if a person has depressive symptoms and the severity of those symptoms without asking them any questions,” said senior author David Mohr, director of the Center for Behavioral Intervention Technologies at Northwestern University Feinberg School of Medicine. “We now have an objective measure of behavior related to depression. And we’re detecting it passively. Phones can provide data unobtrusively and with no effort on the part of the user.”
The research could ultimately lead to monitoring people at risk of depression and enabling health care providers to intervene more quickly.
The study will be published July 15 in the Journal of Medical Internet Research.
The smart phone data was more reliable in detecting depression than daily questions participants answered about how sad they were feeling on a scale of 1 to 10. Their answers may be rote and often are not reliable, said lead author Sohrob Saeb, a postdoctoral fellow and computer scientist in preventive medicine at Feinberg.
“The data showing depressed people tended not to go many places reflects the loss of motivation seen in depression,” said Mohr, who is a clinical psychologist and professor of preventive medicine at Feinberg. “When people are depressed, they tend to withdraw and don’t have the motivation or energy to go out and do things.”
While the phone usage data didn’t identify how people were using their phones, Mohr suspects people who spent the most time on them were surfing the web or playing games, rather than talking to friends.
“People are likely, when on their phones, to avoid thinking about things that are troubling, painful feelings or difficult relationships,” Mohr said. “It’s an avoidance behavior we see in depression.”
Saeb analyzed the GPS locations and phone usage for 28 individuals (20 females and eight males, average age of 29) over two weeks. The sensor tracked GPS locations every five minutes.
To determine the relationship between phone usage and geographical location and depression, the subjects took a widely used standardized questionnaire measuring depression, the PHQ-9, at the beginning of the two-week study. The PHQ-9 asks about symptoms used to diagnose depression such as sadness, loss of pleasure, hopelessness, disturbances in sleep and appetite, and difficulty concentrating. Then, Saeb developed algorithms using the GPS and phone usage data collected from the phone, and correlated the results of those GPS and phone usage algorithms with the subjects’ depression test results.
Of the participants, 14 did not have any signs of depression and 14 had symptoms ranging from mild to severe depression.
The goal of the research is to passively detect depression and different levels of emotional states related to depression, Saeb said.
The information ultimately could be used to monitor people who are at risk of depression to, perhaps, offer them interventions if the sensor detected depression or to deliver the information to their clinicians.
Future Northwestern research will look at whether getting people to change those behaviors linked to depression improves their mood.
“We will see if we can reduce symptoms of depression by encouraging people to visit more locations throughout the day, have a more regular routine, spend more time in a variety of places or reduce mobile phone use,” Saeb said.
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This research was funded by research grants P20 MH090318 and K08 MH 102336 from the National Institute of Mental Health of the National Institutes of Health.
College Student Mental Health Resource
‘Affordable Colleges Online’ created this guide to inform college students (and their friends and families) on the various on-campus and online resources they can use should a mental health concern arise:
Depression and Heart Disease
February is American Heart Month. People with heart disease are at a higher risk for depression. In fact, up to 33 percent of heart attack patients end up developing some degree of depression – three times the rate compared to the general population.
How are depression and heart disease linked? People with heart disease are more likely to suffer from depression than otherwise healthy people. Angina and heart attacks are closely linked with depression. Researchers are unsure exactly why this occurs. They do know that some symptoms of depression may reduce a person’s overall physical and mental health, increasing the risk for heart disease or making symptoms of heart disease worse. Fatigue or feelings of worthlessness may cause a person to ignore their medication plan and avoid treatment for heart disease. Having depression increases the risk of death after a heart attack.
What are the signs and symptoms of depression? Not everyone will experience the same symptoms of depression, but symptoms may include:
• Ongoing sad, anxious, or empty feelings
• Feeling hopeless
• Feeling guilty, worthless, or helpless
• Feeling irritable or restless
• Loss of interest in activities or hobbies once enjoyable, including sex
• Feeling tired all the time
• Difficulty concentrating, remembering details, or making decisions
• Difficulty falling asleep or staying asleep, a condition called insomnia, or sleeping all the time
• Overeating or loss of appetite
• Thoughts of death and suicide or suicide attempts
• Ongoing aches and pains, headaches, cramps, or digestive problems that do not ease with treatment
Treating depression can help a person manage their heart disease and improve their overall health. Common treatments for depression are psychotherapy, medication, or combination of both.
Visit the National Institute of Mental Health website for more information on depression and heart disease.
To take a free, anonymous mental health self-assessment that screens for depression and other common mental health conditions visit our online screening.
Holidays and Your Health
The holidays are upon us. For many people, this joyous time of year can also be very stressful. According to an online poll by the Anxiety and Depression Association of America, nearly three-quarters of people reported that the holiday season makes them feel very or a bit more anxious and/or depressed.
The following are a few tips* on how to manage some of the stresses that are often associated with the holidays.
- Set reasonable expectations and don’t expect the holiday season to be perfect.
- Practice healthy drinking habits. Alcohol is a depressant and can exacerbate feelings of stress and sadness. Too much alcohol can also interfere with healthy sleep and interrupt natural sleep cycles.
- Keep up your exercise regimen, as it will provide effective stress relief and productive alone time. A short daily walk can have a big impact.
- Set spending limits and stick to them. Over-spending during the holidays can lead to continued stress down the road.
- Treat your body well with balanced nutrition but don’t feel guilty when indulging during the holidays. Moderation is key and is a far healthier response to holiday treats than starvation.
- Create a space and time for yourself during family gatherings. Take a walk outside, find a quiet corner in the house, or make a quick trip to the store to gather your thoughts and relax.
- Plan any shopping and cooking in advance. Setting a schedule and making priorities will prevent too much from piling up at the last minute.
- Talk to someone. Seek support and affirmation of how your expectations for the season don’t always match with reality. A good listener and a little laugh can be great stress relievers.
Sometimes “holiday blues” are more than just passing emotions and can be something more serious like depression, anxiety, or a related disorder. If you have prolonged anxiety, sadness, or a mood that interferes with sleeping, eating or other usual activities, you may want to talk with a health professional.
*From Screening for Mental Health, Inc., “Help Your Community Deal With Holiday Stress”
1 in 5 Primary Care Visits were Mental Health-Related
The Centers for Disease Control and Prevention’s November 28, 2014, Morbidity and Mortality Weekly Report (MMWR), highlighted that in 2010, 20% of all visits to primary care physicians included at least one of the following mental health indicators: depression screening, counseling, a mental health diagnosis or reason for visit, psychotherapy, or provision of a psychotropic drug. The percentage of mental health–related visits to primary care physicians increased with age through age 59 years and then stabilized. Approximately 6% of visits were for children that were 11 years old or younger and approximately 31% of visits were for adults aged 75 years or older were associated with mental health care. The data was obtained from the 2010 National Ambulatory Medical Care Survey, which can be found at http://www.cdc.gov/nchs/ahcd.htm
* A mental health visit was defined by at least one of the following: ordering or provision of depression screening, psychotherapy, or other mental health counseling; a mental health diagnosis or reason for visit; or a psychotropic medication that was ordered, supplied, administered, or continued at the visit. Mental health diagnosis, reason for visit, and psychotropic medications were based on certain categories. Source: Olfson M, Kroenke K, Wang S, Blanco C. Trends in office-based mental health care provided by psychiatrists and primary care physicians. J Clin Psychiatry 2014;75:247–53.
† Includes physicians in primary care specialties: general and family practice, internal medicine, pediatrics, and obstetrics/gynecology.
§ 95% confidence interval
October 9th is National Depression Screening Day
Depression is a common health condition that affects an estimated 1 in 10 U.S. adults. Thursday, October 9th, 2014, is National Depression Screening Day (NDSD). NDSD, developed by Screening for Mental Health Inc., brings awareness about depression and promotes online screenings for depression and other common mental heath disorders. MHAM has partnered with Screening for Mental Health, Inc. for the last 8 years to provide these screenings.
Why online screening for depression? Because online depression screening is effective. Results from a 2009 independent research study by the University of Connecticut, commissioned by Screening for Mental Health, states that depression screenings are effective in connecting at-risk individuals with treatment. The study showed that 55% of participants, who completed an online depression screening and who agreed to participate in a follow-up survey, sought depression treatment within three months of the screening.
Who can take the online screening? The online screening is made available to everyone visiting the MHAM website and is taken anonymously. This screening is not a substitute for a diagnosis, but it will help determine whether or not a consultation from a health professional would be helpful. The self-assessment screens for depression and also for bipolar disorder, post-traumatic stress disorder, and generalized anxiety disorder.
Are you unable to take the screening on October 9th? No problem. The online screening is available 24/7, 365 days of the year! Take a few minutes to complete this free and anonymous mental health screening.
For more information and resources on depression visit our website at: https://mentalhealthmn.org/be-informed/mental-health-resources/depression
How are you feeling?
20 percent of adults will experience a mental illness in any given year. Most mental health conditions can be treated effectively with appropriate mental health treatment. Unfortunately, of those who do experience a mental illness, many do not get help.
For the past 8 years, MHAM has been providing online mental health screening for common mood and anxiety disorders. In those eight years, we have seen the number of completed surveys increase from a couple of thousand, to nearly 17,ooo in just the last year. An online screening is a quick assessment that you can do at anytime and can help you move closer toward improving your health.
The online screening is not diagnostic, but it will help you determine whether or not a consultation from a health professional would be helpful.
The online screening can be accessed via desktop, tablet, or smartphone, and it is free and anonymous.
It only takes a few minutes to complete the screening. First, select the statement that fits how you have been thinking or behaving. Then, answer the brief set of questions about yourself and how you are feeling.
When you are finished with your assessment, you will receive an explanation about your moods and behaviors. From these results and recommendations, it will help you decide if you need to contact a health professional. In addition, you will have access to informational materials and other resources about what you can do to get help.
Taking a few minutes to assess how you are feeling can help you take that next step. Take an online screening now!
Transitioning to College Life
With summer coming to a close, many young adults will be transitioning to college life for the first time. For most incoming students, the transition can be challenging. For students with mental health conditions, getting familiar with the mental health services and supports that their college or university offers can help with this transition.
The following services/supports are available at most colleges and universities and will vary in the type of services offered at each campus.
Academic Advising Centers – If you have non-emergency questions or concerns regarding your condition and would like to know who to talk with, your academic advisor may be a good person to contact first. They are aware of the different programs that may be offered on campus and can refer you to the appropriate resources and services.
Counseling Centers / Health Centers – Many campuses offer individual counseling, group counseling, and crisis services. The types of services offered will vary based upon available programs and staff capabilities. Depending on the type and severity of the condition, a referral to an outside agency may be necessary.
Disability Services – Provide reasonable accommodations for students that have a documented disability due to their mental health condition. These accommodations may include adjustments to programs, coursework, and policies.
Student Groups – These groups are primarily directed by students to create awareness for the student body and develop partnerships with key staff/programs. One such national program is “Active Minds.” This organization develops and supports student-run chapters on colleges and university campuses (including several chapters at Minnesota colleges and universities) that promote a dialogue around issues of mental health.
General Information on Mental Health – Most campuses will have a variety of information about mental health. Health services, counseling centers, and other areas in the college will often have information and resources on mental heath conditions (depression, anxiety disorders, eating disorders, etc.). Also, many colleges host health and wellness fairs and other events that highlight mental health issues.
Other resources:
ULifeline is an anonymous, confidential, online resource center, where college students can be comfortable searching for the information they need and want regarding emotional health.
http://www.ulifeline.org
Mental Health America provides some helpful information on mental health for returning students and for students that are attending for the first time.
http://www.mentalhealthamerica.net/back-campus
(Editor’s note: Republished article with updated information)