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50 million years of work could be lost to anxiety and depression

World Health Organisation says that without more treatment, 12 billion working days will be lost to mental illness each year to 2030

Global failure to tackle depression and anxiety is costing the world nearly $1 trillion a year in lost productivity and causing “an enormous amount of human misery”, according to a study that urges the international community to make mental health a priority rather than leave it languishing in the shadows.

The analysis, led by the World Health Organisation (WHO), found that without scaled-up treatment, a staggering 12 billion working days – or 50 million years of work – will be lost to depression and anxiety disorders each year between now and 2030. It puts the annual loss to the global economy at $925bn (£651bn).

However, the cost of increasing psychosocial counselling and antidepressant medication over the next 15 years is only $147bn. Not only would such an investment drive a 5% improvement in labour force participation worth $399bn, it would also add a further $310bn in improved health returns.

The study, published in Lancet Psychiatry and based on health treatment costs and outcomes in 36 countries, is billed as the first worldwide estimate of the health and economic benefits of investing in treating the most common mental illnesses.

Its authors say every $1 invested in scaling up treatment for depression and anxiety leads to a $4 return in better health and ability to work. They argue that all countries, regardless of wealth levels, need to invest more in mental health services. According to the WHO, governments on average spend only 3% of their health budgets on mental health, with the proportion ranging from less than 1% in low-income countries to 5% in high-income ones.

The study is published as finance ministers, development agencies and academic experts gather in Washington DC for the annual World Bank-International Monetary Fund spring meetings. Among the items on the agenda is how to improve mental healthcare.

Jim Yong Kim, president of the World Bank Group, said the study showed that the current approach to mental health services was no longer economically viable.

“Despite hundreds of millions of people around the world living with mental disorders, mental health has remained in the shadows,” he said.

“This is not just a public health issue; it’s a development issue. We need to act now because the lost productivity is something the global economy simply cannot afford.”

The study notes that common mental health conditions are on the rise: between 1990 and 2013, the number of people with depression and/or anxiety grew by almost half, from 416 million to 615 million.

Almost 10% of the world’s population – about 740 million people – is affected, with mental disorders now accounting for nearly a third of the global burden of non-fatal diseases.

Wars and humanitarian emergencies, which bring trauma, depression and anxiety – and make existing psychotic disorders such as schizophrenia harder to treat – only add to the urgency to act. According to WHO estimates, as many as 20% of people are affected by depression and anxiety during emergencies.

“We know that treatment of depression and anxiety makes good sense for health and wellbeing; this new study confirms that it makes sound economic sense too,” said Dr Margaret Chan, director general of the WHO.

“We must now find ways to make sure that access to mental health services becomes a reality for all men, women and children, wherever they live.”

Improving mental health provision is a key target in the sustainable development goals: the world has already committed to reducing premature deaths from non-communicable diseases by a third over the next 15 years through prevention, treatment and the promotion of mental health and wellbeing.

Arthur Kleinman, professor of medical anthropology and psychiatry at Harvard University, said every country needed to ensure that mental health was treated as a humanitarian and development priority.

“We need to provide treatment, now, to those who need it most, and in the communities where they live,” he said. “Until we do, mental illness will continue to eclipse the potential of people and economies.”

Jones, S. (2016) ‘50 million years of work could be lost to anxiety and depression’, Guardian, 12 April [Online]. Available at www.theguardian.com/global-development/2016/apr/12/50-million-years-work-lost-anxiety-depression-world-health-organisation-who (Accessed 14 August 2016).

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Article 2

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Depression is ‘triggered by life traumas, NOT genes’: Experts warn too much money is spent on researching biological factors

  • Psychologists warn too much is spent on researching biological factors
  • Experts say mental illness is mostly caused by life events and social crises
  • Said money should be redirected towards understanding everyday triggers

Too much money is spent researching biological factors for mental illness when it is mostly caused by life events, psychologists have warned.

Funding bodies such as the Medical Research Council (MRC) have spent hundreds of millions on genetics and the biology of mental illness with limited success and not enough on understanding social factors.

Although scientists have discovered genes that make people more susceptible to certain disorders, experts say that the real causes of depression and anxiety are social crises such as unemployment or childhood abuse.

They say that money should be redirected towards understanding everyday triggers. Speaking on Radio 4’s Today programme Peter Kinderman, Professor of Clinical Psychology at Liverpool University, said: ‘Of course every single action, every emotion I’ve ever had involves the brain, so to have a piece of scientific research telling us that the brain is involved in responding emotionally to events doesn’t really advance understanding very much.

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Genes are not the key in determining whether a person will suffer from depression according to recent research from Northwestern Medicine study.

Environment is a major factor, and nurture can override nature.

When rats genetically bred for depression received the equivalent of rat ‘psychotherapy,’ their depressed behavior was alleviated.

And, after the depressed rats had the therapy, some of their blood biomarkers for depression changed to non-depressed levels.

The study also found genetic influences and environmental influences on depression likely work through different molecular pathways.

Rats bred for depression and rats that were depressed due to their environment showed changes in the levels of entirely different blood markers for depression.

Being able to differentiate between the two types of depression eventually could lead to more precise treatment with medication or psychotherapy.

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‘It detracts from the idea that trauma in childhood is a very, very powerful predictor of serious problems like experiencing psychotic events in adult life, so of course the brain is involved and of course genes are involved, but not very much, and an excessive focus on those issues takes us away from these very important social factors.’

Mental health issues cost Britain £70billion a year according to the Organisation for Economic Cooperation and Development.

The think-tank said mental health was the cause of 40 per cent of 370,000 new claims for disability benefit each year.

Almost half of all adults will suffer from a mental health condition in their lifetime and one in four people have been diagnosed with some type of mental health problem, most commonly depression. Despite this, the MRC spends only 3 per cent of its research budget on mental health. And most of that goes towards understanding genetics or neuroscience.

Professor Richard Bentall, who also works at Liverpool University, said: ‘It’s a tragedy actually. The UK MRC is one of the biggest funders of medical research in the UK but if you look at the things that they fund, by far the majority are things like brain scanners or gene sequencing machines, almost none of it is going towards understanding psychological mechanisms or social circumstances by which these problems develop.

‘It is impossible to get funding to look at these kinds of things.’

The MRC said it was hoping to increase the amount of money allocated to studies into mental illness.

Dr Rob Buckle, of the MRC, said: ‘I think it has been a long-standing debate, the issue of nature versus nurture, and the MRC needs to make sure it funds the research which is going to have the most impact wherever it comes from.

‘The issue here is that mental health is a very complex issue and the fundamental thing is to get a better understanding of the causes and progression of mental illness.

‘We would like to spend more of our budget on mental health research and we totally accept this is interdisciplinary and involves neuroscientists and psychiatrists and social scientists and we do fund work around social impacts on mental health.’

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  • Title: find ways to make sure that access to mental health services becomes a reality for all men, women and children, wherever they live.”
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