Mental Health in an Unequal World

The theme observed for this year’s World Mental Health Day (October 10, 2021) was ‘Mental Health in an Unequal World.’ The subject is apt and relevant for these times of social protest against various forms of inequality: classism, sexism, racism, discrimination based on sexual orientation, religion, age, or disability. The list is long, and the gap between the well-off and those living in poverty continues to widen. This has led to a system that perpetuates widespread poverty, financial insecurity, and emotional unrest, leaving ordinary people to suffer the consequences through no fault of their own. Access to diminishing life-sustaining resources is skewed towards the privileged, while those in need continue to lead a life of disadvantage.

This year’s theme of mental health in an unequal world focuses on the inequities in mental health care. While all people may experience mental health-related issues regardless of their race and background, the risks are not equally distributed. During the Covid-19 pandemic, the stark contrast between the haves and have nots became even clearer than before. Awareness and access to basic healthcare, both physical and mental, have been lacking in large sections of the world. While there is a higher level of awareness than in previous generations, there is still some stigma attached to seeking help. Free and open access to mental health care remains limited and inadequate.

In response to these inequities, the Mental Health Foundation (MHF) released a 2020 report on “Tackling social inequalities to reduce mental health problems.” Here are some sobering facts about the risk factors for mental health conditions:

Childhood adversity accounts for 30% of adult mental health problems.
Adverse life events such as serious illness, job loss, or grief are risk factors for mental health issues.
Individuals from the lowest socioeconomic groups are at the highest risk of mental health problems.
Children and adolescents from disadvantaged communities are 2-3 times more likely to develop mental health problems than their economically well-off counterparts.
Lack of access to employment opportunities that give job satisfaction is associated with decreased quality of life, sense of self-worth, social status, and personal goals achievement.
Women with low literacy levels are 5 times more likely than those with average literacy skills to develop depression. Early school withdrawal is associated with increased substance abuse, mood disorders, and suicidal ideation.
Poor-quality housing that is unsafe and insecure can lead to mental health problems and exacerbate existing illnesses.
Being bullied has been associated with a range of mental health problems. Bullying and violence against people belonging to the LGBTQ+ community, in particular, put them at substantial risk for poor mental health outcomes.
Social isolation is a significant risk factor for deteriorating mental health and suicide.

Following are some of the MHF’s recommendations aimed to demonstrate “how everyone can flourish equally” to achieve a more equitable society, particularly in the realm of mental health:

Structural measures. These consist of actions that target economic and social influences that pose as risk factors for mental health problems. Some examples include attempts to reduce income inequality, unemployment rates, poverty levels, the incidence of domestic violence, discrimination, and homelessness.
Measures that strengthen community assets. Such efforts include enhancing social connectedness, nurturing community environments, promoting participation in community decision-making, and spreading awareness about risk factors and community resources to support mental health and wellbeing.
Measures at the individual level. These measures include educating individuals on how to take care of their mental health, enhancing peer support, and showing people ways to contribute to the mental health and wellbeing of their families and communities.

Every individual has the right to adequate mental health care. Having access to mental health resources should not be treated as a luxury for the privileged but a basic human right and necessity for all people to lead a life with dignity.

About the Author: Debanjali Saha is a counseling psychologist who works primarily with young adults using a compassion-focused approach in therapy. She is passionate about self-compassion, a topic she has been researching since 2014. She has started a wellness community called Couch of Compassion, where she tries to help people relate to themselves with kindness through her writing and workshops.

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