Mental health: 'awareness' is only the starting point

Earlier this month, on October 10, the world marked World Mental Health Day, a cause that surely merits more than 24 hours. World Mental Health Week or Month would be far more fitting given the magnitude of this problem. Since 1992, when it was first observed, the day has traditionally been about raising awareness. The old conversation about awareness, however, is becoming repetitive and starting to feel dated. It is time we broadened the conversation and also discussed social factors that may be at the root of this global crisis. The current rise in mental health problems disproportionately affects young people. Even before Covid-19, mental health problems were spiking in many nations, with young people accounting for the bulk of the increase. A UK-wide study found, for example, that the rates of generalised anxiety disorder trebled among men aged 18- 20. They rose from around 5 per cent in 1998 to just under 15 per cent in 2018. Similarly, data from the UK's National Health Service revealed that the use of antidepressants doubled between 2008 and 2018 – from 36 to 70.9 million prescriptions per year. At the more tragic end of the spectrum, the US Centers for Disease Control and Prevention reported a substantial increase in the rate of suicide by young people over the past decade. Suicide by Americans under the age of 25 increased by 56 per cent between 2007 and 2017, making it the second leading cause of death, after accidents, in the US among this age group. One might argue that the apparent rise in mental health problems in the US, in this case, is accounted for by a lowering of the diagnostic threshold – that is, a relaxing of the criteria by which we diagnose such conditions. Similarly, some people argue that the mental health crisis is merely a consequence of more people now being open and willing to report their symptoms. While both arguments might account for some of the increase, they do not explain all of it. Well-designed research studies over decades consistently report increases in depression and anxiety symptoms. For example, a study reported in the Journal of Child Psychology and Psychiatry explored trends in adolescent mental health in the UK spanning a quarter-century. Using identical criteria to assess symptoms, the research team observed a steady rise in childhood depression, with an increase of at least 70 per cent when the study ended in 1999. This trend has continued. A 2019 study published in the Journal of Abnormal Psychology reported similar increases in the US in child and adolescent mood disorders between 2005 and 2017. Why do some young people appear to be facing such a hard time, psychologically speaking? One possible reason could be existential threats. When I was a child, between bike rides and playing with action figures, I would occasionally worry about nuclear annihilation. Besides such fears that every child goes through, today's youth worry also about the climate and the prospect of a future without employment as robotics and Artificial Intelligence reduce the need for humans on the job. We might also add to this list the threat of future infectious illness pandemics, far deadlier and more contagious than Sars or Covid-19. And while everyone, regardless of age, encounters these worries, the young may experience despair about the future far more acutely. After all, it is the young who more fully expect to witness such problems during the prime years of their lives. Given these looming fears and during a pandemic, it is particularly important to foster realistic optimism and resilience. Our worst-case scenarios are rarely realised, and new opportunities, ones that we never imagined, frequently arise as if from nowhere. There is always hope and becoming overwhelmed by despair often prevents us from searching for and implementing solutions. In the words of the 13th century Persian poet, Jalal Al Din Rumi: "Ours is not a caravan of despair". Perhaps future world mental health days could explore the psychological affect of hostilities such as discrimination, hate crimes, unemployment, pollution, and deforestation. These are relevant topics in the context of mental health. Imagine that a city decided to clean up its coastline and plant 10,000 trees. In doing so, it brought young people from all walks of life together and got them involved in the clean-up and the planting. What kind of affect would that have on mental health? We can't meaningfully address the mental health crisis if we don't focus on such social and environmental issues too. No matter how dire personal crises seem, there is always hope. This sentiment is reflected in an Arabic saying: if the end of time comes while you are planting a tree, keep planting. Justin Thomas is a professor of psychology at Zayed University and a columnist for The National

Mental health: 'awareness' is only the starting point

We can't address the crisis if we don't also focus on related social issues