World Mental Health Day is celebrated worldwide every year on Oct 10, a month after observing World Suicide Prevention Day on Sept 10. “Make mental health & well-being for all a global priority”, the theme for this year’s World Mental Health Day, aimed to raise awareness of mental health issues around the world and to mobilize efforts in support of mental health. This theme was chosen to address the inequalities exposed by the COVID-19 pandemic and its impact on people’s mental health globally. The recent Oxfam report on poverty has highlighted the impact of COVID-19, especially among the low-income group. The lowest decile of the income group has had its median monthly household income reduced by more than 22.9 percent, whereas the top 10 percent has increased its median monthly income by 6.3 percent. The ratio of the income level between the top 10 percent to the lowest 10 percent had increased from 34.3-to-1 in 2019 to 47.3-to-1 in 2021.
The World Health Organization estimates that during the first year of the pandemic, both anxiety and depressive disorders increased by more than 25 percent. The impact on mental health was particularly felt by marginalized groups and individuals due to the existing health and social inequalities, as evidenced by several studies. The suicide rates among older adults and young people have become a major concern during COVID-19. The isolation and disruption of social services have caused considerable disruption to the well-being of older adults. Spontaneous school closures and suspension of extracurricular activities have shown to cause adverse effects on the mental wellness among schoolchildren. These concerns have also been felt worldwide.
These findings call for urgent global action to prioritize mental health and address the inequitable social determinants. Affordable and accessible mental health services must be ensured at the community level so that no one is left behind, which is the slogan of the Sustainable Development Goal (2030) of the United Nations.
Similarly, countries around the world must increase investment to ensure access to mental health care for everyone and to raise awareness against the stigma and discrimination surrounding mental health. Stigma and discrimination sometimes can be the cause of unmet needs rather than the inadequate supplies of services. This problem may not be solved by simply training more social workers, clinical psychologists, and psychiatrists, as research has indicated that lack of perceived need for treatment, rather than unavailability of mental health professionals, was the prevalent reason for people fulfilling mental health problem diagnostic criteria not seeking help. Removing barriers of seeking help by destigmatizing the mental illness is very important. Promoting better understanding of mental illness in the community can make our society more inclusive. The patients and the carers can be felt better supported. We also should explore multiple pathways to providing help to the vulnerable. Open Up (www.openup.hk), the 24-hour online emotional support system run by five NGOs and the University of Hong Kong, is an excellent example of making use of the latest technology to provide an online and offline support system to help youth at risk.
The theme is also applicable and resonates with many of the challenges that are faced within suicide prevention. According to the WHO, an estimated 703,000 people in the world lose their lives to suicide every year. Behind each suicide, a substantial number of people are attempting suicide. Millions of individuals around the world are impacted by this, including suicide survivors, their families, communities, and countries. Suicide prevention must be considered and included while drafting mental health policies and strategies. As a global priority within the sustainable-development-goals target of reducing suicide deaths by one-third by 2030, urgent action is required to address this public health challenge. The WHO’s “World Mental Health Report” for 2022 suggests developing national suicide prevention strategies as an intervention to promote mental health and protect those at risk. Despite the recent efforts of many NGOs, including the Hong Kong Jockey Club Charities Trust, Hong Kong is still lacking a blueprint for promoting and enhancing mental health in the community.
The development of suicide prevention strategies needs to complement decriminalization efforts in countries where suicide is still a criminal act, punishable by law. This is a crucial steppingstone to tackling the issues of stigma and discrimination that can be associated with a suicide and to ensuring individuals can access appropriate mental health support services. The International Association for Suicide Prevention supports the decriminalization of suicide and suicidal behavior so as not to penalize those who attempt suicide or the families who lose someone through suicide. This is a major step toward ensuring that mental health and well-being are a global priority for everyone.
The “Comprehensive Mental Health Action Plan 2013-2030” also sets suicide prevention as an important priority and recommends actions to prevent suicide with the collaboration of the health sector with other sectors simultaneously. It also urges member states to develop and implement comprehensive national suicide prevention strategies with a focus on groups and individuals at an increased risk of suicide. Overall, the plan aims for the engagement of all stakeholders to promote mental health, prevent mental disorders and suicide, and facilitate the treatment and recovery of people with mental disorders.
Based on the evidence and policy recommendations, we call upon stakeholders to engage in efforts for the prevention of suicide and the promotion of mental health and well-being. Increasing awareness, strengthening mental healthcare systems, reducing the treatment gap, addressing social inequalities, and increasing national-level commitment and investment in mental health are key steps toward realizing the theme for this year’s World Mental Health Day. We believe our actions, no matter how big or small, can make a difference to the betterment of our community.
The author is the director of Hong Kong Jockey Club Centre for Suicide Research and Prevention at the University of Hong Kong and a national representative of the International Association of Suicide Prevention.
The views do not necessarily reflect those of China Daily.