World Mental Health Day 2022: About one billion people worldwide are living with a mental health condition, The Lancet Commission on Ending Stigma and Discrimination in Mental Health says. This accounts for one in eight people globally. Radical action can end stigma and discrimination against people with mental health conditions and their families worldwide. The Lancet Commission report, published on the occasion of World Mental Health Day on October 10, provides key recommendations to achieve the goal of ending stigma and discrimination against those with mental health conditions. 


One in seven people aged 10 to 19 years are living with a mental health condition, according to the report. 


People living with a mental health condition experience a double threat. One of the threats is the impact of the mental health condition, and the other revolves around the damaging social consequences of stigma and discrimination.


Increase in depression and anxiety during first year of Covid-19 pandemic


During the Covid-19 pandemic, there was an increase in awareness about the urgent mental health situation globally. In the first year of the pandemic, the prevalence of depression and anxiety was estimated to have increased by 25 per cent. 


What social issues do people with mental health conditions face?


Though a large proportion of people worldwide experience mental health conditions, mental health-related stigma and discrimination are widespread. Since mental health conditions are seen as a taboo, those living with these conditions are often looked down upon by society, or denied basic human rights such as job and education opportunities and access to healthcare, including mental health care. 


What does the Commission call for?


The Lancet Commission has compiled the work by more than 50 contributors from across the world, including people who have experienced a mental health condition. The Commission contains testimonies and poems from people with lived experience, and reviews the evidence on effective interventions to reduce mental health-related stigma. 


The rCommission calls for immediate action from governments, international organisations, employers, healthcare providers and media organisations, and active contributions from people with lived experience, to work together to eliminate mental stigma and discrimination.


Mental-health related stigma is ‘worse than the condition itself’: Commission Co-Chair


In a statement released by The Lancet, Commission Co-Chair Professor Sir Graham Thornicroft said many people with lived experience of mental health conditions describe stigma as 'worse than the condition itself'. He added that there is now clear evidence that the researchers know how to effectively reduce, and ultimately eliminate, stigma and discrimination. He further said that the Commission makes eight radical, practical, and evidence-based recommendations for action to liberate millions of people around the world from the social isolation, discrimination and violations of human rights caused by stigma.


Covid-19 has resulted in increased number of people experiencing mental health conditions


In the statement, Charlene Sunkel, a co-author on the report, said the Covid-19 pandemic has resulted in higher numbers of people experiencing mental health conditions and urgent action is needed to ensure these individuals do not experience the potentially severe consequences of stigma and discrimination, and that one must empower and support people with lived experience of mental health conditions to play active roles in stigma reduction efforts. 


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How stigma violates basic human rights


There are many forms of stigma related to mental health conditions. The stigma results in a wide array of underestimated consequences. The Lancet Commission reviewed evidence on the impact of mental health-linked stigma and discrimination and also completed its own survey of people with lived experience of mental health conditions from over 40 countries worldwide. According to the report, people with lived experience of mental health conditions often encounter stigma and discrimination which have a profoundly negative impact on their basic human rights in all aspects of life. This worsens their mental health. 


For instance, people with mental health conditions often have reduced employment opportunities and income because of the stigma and discrimination they face in educational and work settings.


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Other problems which people with mental health conditions face


Together, mental health conditions and poverty lead to destructive outcomes, especially in low- and middle-income countries. In some cases, people with mental health conditions are denied the right to vote, to get married, or to inherit property, the report says.


A major problem is that sometimes, healthcare professionals do not always know how best to diagnose and care for people with a mental health condition. Also, people with mental health conditions have a lower life expectancy than the rest of the population. Of the total expenditure on health, investment in mental health accounts for an average two per cent. Unlike most physical health conditions, mental health conditions are frequently excluded altogether from health insurance schemes. 


Zeinab Hijazi, one of the authors on the report, said everyone with a mental health condition is affected by stigma and discrimination, but it is especially important to acknowledge how young people and their caregivers are impacted. One in seven people aged 10-19 years experience a mental health condition, and misunderstandings about mental health and lack of acceptance continue to be a significant challenge for far too many young people worldwide, she further said.


Stigma can be reduced through social contact


The analysis made by the Commission highlights that forms of social contact, both in person and remotely, between people who have lived experience of mental health conditions, as well as those without, is the most effective evidence-based way to reduce stigma and discrimination. The Commission also emphasises on the need for people with mental health conditions to be strongly supported to lead or co-lead interventions that use social contact to reduce stigma and discrimination. 


Dr Petr Winkler, Director of the WHO Collaborating Center for public mental health research and service development, Czech Republic, said the Commission found that social contact, where the lived experiences of people with mental health conditions were shared with people who did not have such conditions, successfully reduced stigma when appropriately adapted to different contexts and cultures. He added that it is crucial that the world sees more organised social contact between people with and without lived experiences of mental health conditions in order to end stigma and discrimination.