Experts call for action to end mental health stigmatising

With radical action we can end stigma and discrimination against people with mental health conditions and their families globally, says The Lancet Commission on Ending Stigma and Discrimination in Mental Health, which sets out key recommendations to achieve this goal.

Recent estimates suggest one in eight people, nearly one billion people globally, are living with a mental health condition^[1]; this rises to one in seven 10- to 19-year-olds^[2]. These people experience a double threat: the impact of the condition itself and the damaging social consequences of stigma and discrimination.

The COVID-19 pandemic helped to shine a light on the urgent mental health situation globally and there was an estimated 25% rise in the prevalence of depression and anxiety in the first year of the pandemic^[3,4]. However, despite the high incidence of mental health conditions around the world, mental health-related stigma and discrimination is also widespread^[5]. This can lead to problems in accessing health care and increased likelihood of health complications leading to early death.

The Commission is the result of work by over 50 contributors from across the world, notably including people with lived experience of a mental health condition. The Commission reviews the evidence on effective interventions to reduce stigma and calls for immediate action to end mental health stigma and discrimination globally, including decriminalising suicide, providing mental health training for healthcare staff and developing guidelines for accurately depicting mental health in the media.

“Many people with lived experience of mental health conditions describe stigma as ‘worse than the condition itself’,” said Commission Co-Chair Professor Sir Graham Thornicroft from King’s College London^[6].

Stigma and discrimination are substantial issues in health care: healthcare professionals themselves do not always know how best to diagnose and care for people with a mental health condition and people with mental health conditions usually have a lower life expectancy than the rest of the population. Investment in mental health is on average only 2% of total health spending — although in Australia spending has increased to 7.6% of government health expenditure (2019–20)^[7]. Mental health conditions are frequently excluded altogether from health insurance schemes, unlike most physical health conditions.

In order to end mental health-related stigma and discrimination, the Commission calls on all governments, international organisations, schools, employers, health care, civil society and media to take action now and gives specific recommendations for each group.

For health and social care providers, the Commission recommends mandatory training sessions on the needs and rights of people with mental health conditions, co-delivered by people with such conditions.

References

^{[1] https://www.who.int/publications/i/item/9789240049338
[2] Institute of health Metrics and Evaluation. Global Health Data Exchange (GHDx)
[3] https://www.thelancet.com/article/S0140-6736(21)02143-7/fulltext
[4] https://www.who.int/publications/i/item/WHO-2019-nCoV-Sci_Brief-Mental_health-2022.1
[5] https://link.springer.com/content/pdf/bfm:978-3-319-27839-1/1.pdf
[6] Quotes direct from authors and cannot be found in text of Commission.
[7] https://www.aihw.gov.au/getmedia/Expenditure-on-mental-health-related-services-2019-20.pdf}

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