18^th IFPE Congress
A world at risk from poor mental health
What do we know and what can we do?

Presentation

Mental health is one of the most neglected areas of public health . The data are alarming: nearly 1 billion people live with a mental disorder, 3 million people die every year from harmful alcohol consumption and one person dies every 40 seconds for suicide. Plus, billions of people across the world have been affected by the Covid-19 pandemic, which is having a further impact on people's mental health.

Mental and behavioral disorders are among the leading causes of disability worldwide and cause a significant burden on public health. The tools of epidemiology and biostatistics are fundamental to understand the occurrence and distribution of mental and behavioral disorders across people, space and time, and to investigate the causes and consequences of these disorders in order to develop more effective intervention strategies to treat and prevent them and to promote mental health. Prevention is becoming a major issue due to the populationbased studies of mental and behavioral disorders that proved the relevance to takle the course of the entire life span.

The COVID-19 pandemic has further highlighted the effects of inequality on health outcomes and this has affected the majority of the nations, often not prepared for this. The pandemic has and will continue to affect people, of all ages, in many ways: through infection and illness, bereavement to surviving family members; through the economic impact, with job losses and insecurity; and with the physical distancing that can lead to social isolation. There are indeed many reasons that urge actions to promote and protect mental health.

What do we know?

Inequity in mental health is still a big issue with the number of people living in poverty still far too high. Inequalities due to race and ethnicity, sexual orientation and gender identity, and the lack of respect for human rights in many countries, have a negative impact on people's mental health.

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 is often disproportionate to the overall health budget and contributes to the mental health treatment gap.

Many people with a mental illness do not receive the treatment that they are deserve and together with their families and carers continue to experience stigma and discrimination and suffer for neglected needs. Furthermore, research evidence shows that there is a deficiency in the quality of care provided to people with a mental health problem and prove that takes up to 15 years before medical, social and psychological treatments for mental illness that have been shown to work are delivered to the patients that need them in everyday practice.

What can we do?

The stigma and discrimination experienced by people who suffer from poor mental health not only affects that persons physical and mental health, stigma also affects their educational opportunities, current and future earning and job prospects, and also affects their families and loved ones, and people who experience physical illness often experience also psychological distress and mental health difficulties.

We should aim to focus on the issues that perpetuate mental health inequality locally and globally, and encourage researchers to share what they know about mental health inequality including practical ideas about how to tackle this.

Epidemiological data demonstrate the association between social disadvantage and worsening of mental health of the subjects. In addition to poverty, childhood adversity and violence have emerged as key risk factors for the onset and persistence of mental disorders that are circularly linked to income loss, often being associated with a low level of education and reduction of job opportunities and also of individual productivity.

Many of the aims explicitly address social determinants, such as those related to demographic (gender equality), economic (defeating poverty; defeating hunger; decent work and economic growth; business, innovation and education; reducing inequalities), neighborhood, environmental issues.

The COVID-19 emergency has further put mental health services on the ropes, which were already suffering from constant impoverishment. It is now necessary more than ever to benefit of the theoretical assumptions and international guidelines to promote the good practices in mental health, and center on the whole life of people, involving the community in an overall system of support and intervention that work on multi-sectoriality and integration. All these topics will be discussed in the IFPE Verona Congress.

Prof.ssa Mirella Ruggeri
IFPE President