Panelists at the World Economic Forum Annual Meeting in Davos, Switzerland, discussed the importance of addressing mental health, the role stigma plays, and next steps once the conversation opens up.
With countries dedicating less than 1%, on average, of their health budget to mental health, in addition to other institutional and social barriers, many people living with mental illness find themselves with little to no support, according to a panel discussion at the World Economic Forum Annual Meeting in Davos, Switzerland. In addition to the moral case for addressing mental health, there is also an economic one. Around the globe, mental illness costs $2.5 trillion in lost productivity and represents the leading cause of disability.
But mental health is not one issue; it's woven into many facets of life, explained Prince William, Duke of Cambridge, who drew on his work with the homeless, veterans, addicts, and underprivileged youth. He explained that throughout his work, he noticed that there was an underlying theme at the heart of all of it: mental health.
The first step in addressing and acting on mental health, agreed the panel members, is to break down the stigma surrounding mental illness.
“It’s a quiet epidemic, because we don’t talk about it openly,” said Bernard Tyson, chairman and chief executive officer, Kaiser Permanente.
He labeled the US healthcare system a “fix-me” system, where actions are taken only after something happens or someone gets sick. “On top of that, we decided to seperate the head from the body,” he said. “So, we work on the body, but when something is going on with the head, we send you to another room, we create another record, and then we put a negative stigma around it where you can’t talk about it.”
As the panel discussed efforts to mitigate stigma and open up the conversation, New Zealand Prime Minister Jacinda Ardern cautioned that opening the conversation does not mean that stigma goes away. She explained that conversations have to happen not just at the national level, but also at the individual level, and prominent figures can help by speaking out about their experiences with mental health and personalizing the conversation. She used Prince William, who's been vocal about his experiences with mental health, as an example.
Dixon Chibanda, MD, MMed, psychiatrist and professor at the University of Zimbabwe, opened up about Friendship Bench, an initiative he launched in 2006 in Zimbabwe and has since expanded to other countries, including the United States. The psychological intervention, delivered by grandmothers on the basics of cognitive behavioral therapy, allows people struggling with mental health to come and speak with someone and open up.
Businesses also have a role in this, explained John Flint, the chief executive officer (CEO) of HSBC. Entering the role a year ago, Flint came in with the ambition of building “the healthiest human system in the industry.” He explained that as the CEO of a hierarchal company, he felt that if he spoke out about mental health, others in the company would follow and open up the dialogue.
He added that including people who have survived mental illness into the conversation is critical. “Those who have recovered often possess a resilience and resourcefulness, an interest in human nature, and empathy the rest of us don’t possess,” he said.
So, once mental illness is acknowledged and stigma is addressed, what happens next? It’s not just about having more resources for people, it’s having the right ones, explained Chibanda.
“For instance, in low- and middle-income countries, most invest in psychiatric institutions, which is an outdated concept,” he said. “If the few resources that are in these countries could be focused in the community, it would make a huge difference.”
Ardern added that interventions should be applied early, as 3 out of 4 people experiencing mental health issues will first experience them under age 25. She pointed to schools as an important setting for intervention, having nurses and counselors available for students.
According to Tyson, health systems have to be reconstructed to be able to effectively address mental illness. He explained how Kaiser has started redesigning their delivery system, putting mental health specialists in primary care units and implementing new technology where patients can reach out to specialists online.