Mental health in an unequal world
As we mark this year’s WHO Mental Health Awareness Day, it’s an opportunity to reflect on the call for “Mental health care for all.” It’s a simple ask, but in reality, the challenges are multifaceted – and exacerbated by Covid and climate change.
The aim, set by the World Federation for Mental Health, is to highlight the fact that access to mental health services remains unequal. Between 75% and 95% of people with mental disorders in low and middle-income countries are unable to access mental health services at all, and access in high income countries is not much better. 1
Things have come a long way in acknowledging mental health issues. This is thanks in part to many celebrities speaking out, from Freddie Flintoff talking about bulimia 2 to Ariana Grande raising awareness of anxiety. 3 As a result, discussing mental wellbeing, and the problems and challenges of mental illness has become far less stigmatised.
It goes without saying that anyone can be affected by poor mental health. Success or wealth do not guarantee immunity. However, inequality in society means that some people are far more likely to experience mental illness and are also much less likely to receive effective support. Some significant factors that increase vulnerability to mental health issues include poverty, ethnicity, disability, sexuality and gender identity. 4
This is best illustrated with some stark and shocking facts from the Centre for Mental Health. 5
Mental health inequality
- Men and women from African-Caribbean communities in the UK have higher rates of post-traumatic stress disorder and suicide risk and are more likely to be diagnosed with schizophrenia.
- Children from the poorest 20% of households are four times as likely to have serious mental health difficulties by the age of 11 as those from the wealthiest 20%.
- Women are ten times as likely as men to have experienced extensive physical and sexual abuse during their lives: of those who have, 36% have attempted suicide, 22% have self-harmed and 21% have been homeless.
- Children and young people with a learning disability are three times more likely than average to have a mental health problem.
There are many more examples collated here. It’s eye-opening and can certainly lead to a reassessment of the belief that ‘bad choices’ are to blame.
Getting help
It is a compounding issue that the groups facing high levels of mental health difficulty are those that experience greatest difficulty in accessing services. There are so many layers to this – including discrimination or fear of discrimination. Natalie Creary, director of Black Thrive, explains, “Systemic racism can foster distrust in the healthcare system and make people reluctant to seek help.” 6
As the World Federation for Mental Health reports, many people with a mental illness do not receive the treatment that they deserve and together with their families and carers continue to experience stigma and discrimination. 7
It’s also apparent that when we are advised to do many brilliant and scientifically proven actions to improve our wellbeing, many of them are only possible if you have certain privileges in your life. For example, going for a walk in nature requires access to greenspace, free time, being able-bodied and feeling safe doing so. Even something as basic as getting plenty of sleep requires suitable accommodation, a safe environment, and enough respite from multiple jobs, shift work or caring responsibilities.
A pandemic pressure
Covid has exacerbated mental health challenges, for everyone. Levels of depression increased during the pandemic in the UK, with 21% of adults experiencing some form of depression between 27 January and 7 March 2021. This was not an equal process as it disproportionately affected young adults, women, the disabled and the clinically extremely vulnerable. 8 Similar impacts were seen globally. 9
Climate change
Any conversation about global inequality and the problems that arise must include climate change. Impacts on everyday life are more severe in poorer and more disadvantaged countries. A Save the Children report highlights that babies born this year will face seven times more heatwaves and almost three times more crop failures than their grandparents. 10
As Maslow’s Hierarchy of Needs explains 11, our basic physical requirements must be addressed first (that is food, shelter, water etc). When these are threatened, for example by an emergency caused by climate change, the capacity for individuals and governments to address higher needs (such as mental health) is reduced.
What can we do?
At Holden & Partners, we have aimed to support our employees through the pandemic, but we also want to contribute to the mental health of other people.
Where investments are concerned, we can impact on global inequality by tackling climate change and by investing directly in mental health. For example, Ninety One’s Global Environment Fund features in many of our investment portfolios, contributing towards clean energy and climate action.
An investment example of direct exposure to mental health and general wellbeing can be found in the underlying holdings of FP WHEB Sustainability, a fund held throughout our range of investment portfolios, which has a considerable (11%) allocation to their ‘Wellbeing’ investment theme. 12 Orpea, a top ten holding in the fund, is a leading operator of nursing homes for people with physical and mental dependency.13 The company provides psychiatric care to people with mental health issues under national health schemes across Europe.
We can all show our solidarity on Friday 8th October, joining thousands of schools, workplaces and communities, by wearing a yellow item of clothing for #HelloYellow to raise awareness of mental health. There are lots of fundraising ideas here.
We have received lots of positive feedback about our updates. If you’ve found them useful and informative, we would be delighted for you to share them with friends, family and work colleagues. We are always keen to spread the word about our unique approach to financial planning and investing.
Please note that any thresholds, allowances, percentage rates and tax legislation stated may change in the future. The content of this communication is for your general information and use only; it is not intended to address your particular requirements. This communication should not be deemed to be, or constitute, advice. You should not take any action without having spoken with your usual adviser.
2. BBC One – Freddie Flintoff: Living with Bulimia
4. Mental health inequalities: factsheet | Centre for Mental Health
5. Mental health inequalities: factsheet | Centre for Mental Health
6. How Covid-19 has impacted mental health inequality – and how to get help – Which? News
8. Coronavirus and depression in adults, Great Britain – Office for National Statistics (ons.gov.uk)
9. The outbreak of COVID-19 coronavirus and its impact on global mental health – PubMed (nih.gov)
11. Maslow’s hierarchy of needs | Psychology Wiki | Fandom (wikia.org)
12. https://www.whebgroup.com/media/2021/09/20210903-WHEB-Factsheet.pdf
13. https://www.orpea-group.com/le-groupe/qui-sommes-nous-en/our-business