Sunday is World Mental Health Day. In the last two years or so, we all have finally woken up to the importance of mental health and its importance in our lives. Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act and also helps determine how we handle stress, relate to others, and make healthy choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood.

Mental and physical health are equally important components of overall health.  For example, depression increases the risk for many types of physical health problems, particularly long-lasting conditions like diabetes, heart disease, and stroke. Similarly, the presence of chronic conditions can increase the risk for mental illness. It’s important to remember that a person’s mental health can change over time, depending on many factors.  When the demands placed on a person exceed their resources and coping abilities, their mental health could be impacted.

There is no single cause for mental illness with many factors contributing to the risk for mental illness, including early adverse life experiences, like trauma or a history of abuse, experiences related to other ongoing or chronic medical conditions, biological factors or chemical imbalances in the brain, use of alcohol or drugs or having feelings of loneliness or isolation.

The World Mental Health Day celebrated on 10 October is an international day for global mental health education, awareness and advocacy against this social stigma. It was first celebrated in 1992 at the initiative of the World Federation for Mental Health, a global mental health organisation with members and contacts in more than 150 countries. On this day, each October, many awareness programmes bring attention to mental illness and its major effects on peoples’ lives worldwide with some countries having an awareness week as part of the awareness programme.

Up until 1994, the day had no specific theme other than general promoting mental health advocacy and educating the public. In 1994 World Mental Health Day was celebrated with a theme for the first time: “Improving the Quality of Mental Health Services throughout the World”. On World Mental Health Day 2018, the then UK Prime Minister Theresa May appointed UK’s first suicide prevention minister as the government hosted the first-ever global mental health summit.

The theme for the 2021 edition of the World Mental Health Day is “Mental Health in an Unequal World”. This theme was chosen because the world is increasingly polarised, 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.

The theme will highlight 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, and access in high-income countries is not much better. Lack of investment in mental health disproportionate to the overall health budget 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 and 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 mental health problems. 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 to the patients that need them in everyday practice. The stigma and discrimination experienced by people who experience mental ill-health not only affects that persons physical and mental health, it also affects their educational opportunities, current and future earning and job prospects, and also affects their families and loved ones.  This inequality needs to be addressed so that people with mental health issues are fully integrated into all aspects of life. Research has shown that those with physical illness also often experience psychological distress and mental health difficulties. As an example, one can take 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 and 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.

So if you or someone you know have issues relating to mental health, please reach out to an expert. If that is not possible, at least talk to someone sympathetic to you and your condition. If there are hotlines or numbers where you can speak with someone, anonymously, please do so and if possible, reach out to a medical expert, even if it is your general physician or family doctor who can point you in the right direction in terms of treatment and counselling. I have always advocated meditation, so try and incorporate some meditation into your daily routine, even if it is as little as five to ten minutes a day, it helps!