Mental Health: An Impact-Focused Overview

It’s easy to overlook just how much mental illness can affect a person’s life. For those with severe conditions, the challenges can be truly debilitating. But even milder mental health struggles can take a real toll, making everyday life harder in ways that aren’t always obvious. 

Right now, hundreds of millions of people around the world are facing these challenges—making mental health a global issue on par with other major global health issues.

Yet despite its widespread impact, mental health has received far less attention and support than other health concerns, especially in low-income regions where access to care is limited. For those motivated by this issue, expanding mental health care and prevention efforts in these areas could be a powerful way to improve lives. Read on to learn more about why this is the case, and what you could do to help.

What is mental health?

Broadly speaking, mental health refers to a person’s emotional and psychological wellbeing. Much like physical health, the better a person’s mental health, the better they’re able to function and cope with life’s challenges. Unfortunately, widespread disorders like depression, anxiety, bipolar disorder, schizophrenia, and eating disorders can make this much harder.

The effects of poor mental health are often serious. Though the exact effects depend on the mental disorder (as well as the individual suffering from it), common consequences of mental illness include: 

In this article, we’ll look at the global scale of poor mental health, address potential solutions, and touch on the best ways for individuals to help.

How important is mental health?

To put it bluntly, mental illness is an enormous source of suffering, lost wellbeing, and even death. There are three important aspects to this. First, mental disorders are widespread in how many people they affect. Secondly, they are often severe in their effects for those who experience them. And third, they also have broader negative consequences for society. All this means the global scale of poor mental health may be larger than most people realize.

Let’s start first with the fact that poor mental health affects many people worldwide. One widely-cited estimate from the Global Burden of Disease, a highly regarded authority for health data, claims that 970 million people experienced mental health conditions in 2019.

This would mean that around 1 in 8 people alive today are living with the burden of a mental illness.

Of these many millions of people suffering from mental illness, the majority are affected by depression and anxiety. These disorders are far more common than the next-most-prevalent sources of poor mental health, such as bipolar disorder and schizophrenia—though these still affect tens of millions of people.

Estimate of the share of global population who experience mental disorders, by type of disorder.

This brings us to the next point, that mental health conditions often bring serious negative effects for the wellbeing of those who suffer from them. For severe mental disorders, these effects can be even worse than the most painful and disabling physical health conditions.

One way to measure this is using something called a disability-adjusted life year (DALY), which lets us compare the severity of a range of mental and physical conditions. According to the World Health Organization, who use this metric in their decision-making, both severe depression and acute schizophrenia are even worse than advanced cancer or the effects of a severe stroke.

Another approach was taken by the 2017 World Happiness Report, which measured the most significant causes of misery across several countries. Within the countries they studied, mental illness was the single largest source of misery—more than poverty, physical illness, or unemployment.

These facts may not be surprising for those who have experienced severe mental health issues, or have been close to others who have. One account from a person suffering from paranoid schizophrenia gives an insight into how intense the condition can feel: “I quickly became confused in my thinking and obsessed that I was being followed. Often, when I got back to my bedsit after work I would huddle in the corner of the room in fear.”

Zooming out, it’s possible to put some numbers to the total health toll mental illness takes globally. Using the disability-adjusted life year metric mentioned earlier, researchers behind the Global Burden of Disease estimate that over 125 million health years of life were lost due to mental disorders in 2019. This amounts to around 5% of the total lost from all sources, including physical illnesses and accidents.

To put this in perspective relative to other important health burdens, this is about half the total disease burden of cancer, and around three times the years of healthy life lost to malaria.

However, this may be an underestimate. For one, it does not attribute life years lost via self-harm and suicide to mental disorders. A more recent study that incorporates the effects of self-harm and suicide (and that takes a wider classification of mental disorders) provides an even more severe estimate, claiming that 418 million years of healthy life were lost to mental disorders in 2019.

Researchers at the Happier Lives Institute have also argued that measuring conditions using disability-adjusted life years systematically underestimates the negative effects of mental health. Instead, they suggest we adopt a different metric (wellbeing-adjusted life years), which they believe more accurately captures the negative effects of mental health.

So, under other plausible assumptions, the total burden of mental illness could be even higher than the (already) high Global Burden of Disease estimates suggest.

Yet this still doesn’t paint the whole picture of the problem caused by mental illness. Having hundreds of millions of people suffering from mental disorders also has large, indirect consequences to wider society.

Mental disorders can be costly to treat, and can make people less able to work, meaning there’s a significant financial toll from poor mental health. One estimate from the OECD attributes losses of as much as 4% of global GDP. Other recent research estimates that as much as 8% of GDP is lost through poor mental health in high-income parts of North America. Though these economic effects aren’t our primary focus of concern, they are worth noting as a negative by-product of an already significant problem.

To sum this all up, poor mental health is a significant disease burden of a similar scale to many of the most serious and widespread sources of poor physical health.

How well can we solve poor mental health?

While the burden of mental health is significant, an important question concerns whether we can address it effectively. The picture here is complicated, but we’ll give an overview of some of the most common and promising approaches.

The two most prominent approaches to treating mental illness are pharmaceuticals and therapy treatments. These approaches are common for good reason—they are well-established and supported by extensive research, particularly in treating anxiety and depression.

Pharmaceuticals such as antidepressants and antipsychotics are supported by large bodies of evidence in their ability to reduce the symptoms of mental disorders. This is also true of a range of therapy methods, such as cognitive behavioral therapy and interpersonal psychotherapy, each of which can have significant positive effects.

However, despite the strong evidence base for both pharmaceuticals and therapy treatments, neither should be considered as cures, unlike many interventions in physical health. They reliably reduce symptoms, but aren’t magic bullets.

There are also reservations about the scalability of these interventions. Pharmaceuticals are affordable by high-income standards, but they’re often still priced too highly for many in poorer areas, and are often unavailable. This issue is even more pronounced for therapy interventions, which require trained facilitators who can only treat limited numbers of people at a time.

On a positive note, some promising work is being done to make therapy more scalable and affordable. Organizations like Kaya Guides, Vida Plena, and StrongMinds are already implementing programs intended to be scalable in lower-income settings, such as self-guided mental health programs and group programs. These programs may help in overcoming some of the inherent limitations in the scalability of mental health treatments, allowing more people to be reached.

It’s also worth considering things we can do to prevent poor mental health from arising in the first place. One potentially cost-effective intervention in this space involves limiting and regulating substances that contribute to mental disorders, such as alcohol and drugs. Some less intuitive but still promising interventions within prevention include banning dangerous pesticides that facilitate higher levels of suicide, or providing emotional education to preschool children.

Overall, the tractability of mental health looks somewhat mixed. There are proven interventions that we can be confident help to mitigate and prevent poor mental health. However, the feasibility of these interventions—particularly in areas with fewer resources and more social barriers for mental health treatment—provides some obstacles to deploying them at a global scale.

How neglected is mental health?

By and large, mental health has received less attention, funding, and other resources put towards it than physical health. Globally, governments spend an average of only 2.1% of their health budget on mental health, seemingly disproportionate to the disease burden of mental illness.

In absolute terms, this still represents fairly high expenditure. For instance, the UK spent £12 billion on mental health services in 2021/22, and the Netherlands spent close to €5 billion in 2023.

These figures are, as expected, much higher than those in low-and-middle-income countries (LMICs). These countries often fall far below the average in terms of the resources they put into mental health issues, with many falling below 1% of health expenditure.

Given their overall health budgets are often dramatically lower than those of high-income countries, this means many people living in lower-income regions lack access to basic mental health care.

As one indicator for this, the World Health Organization reported that, as of 2020, both Africa and South-East Asia have an average of less than three mental health workers for every 100,000 people. In contrast, Europe averages nearly 45 per 100,000.

Even worse, low-income countries had just 0.1 qualified psychiatrist for every 100,000 people. High-income countries had nearly 90 times as many.

Not only is there very little care for mental health in LMICs, the quality of this care is often below standard. A study from 2018 reports that under 4% of people diagnosed with major depressive disorders in lower-middle income countries received “minimally adequate treatment” for their condition. This number was over five times larger in high-income countries.

Overall, mental health is significantly neglected, though primarily in lower-income regions. While it receives more funding and attention than some of the most overlooked cause areas, such as farmed animal welfare, this is predominantly directed towards people in wealthier countries, with many in lower-income regions lacking even basic mental healthcare.

What can you do in mental health?

So, mental health is a high-priority global problem. But what can you do with your career to help?

One natural option to consider is a profession that works directly to treat people with mental disorders, such as therapy and psychology. This work is essential if we’re to make a big dent in addressing poor mental health globally. However, for those looking to create a broader impact, there are other avenues that may be even more effective than direct clinical work.

One example is psychological research, which could help identify even better mental health treatments and interventions. If these advancements are implemented on a large scale, they have the potential to benefit far more people than one individual clinician could reach. This route can be particularly appealing for those with a background in psychology and can often be pursued alongside clinical practice.

A little further outside the box, nonprofit entrepreneurship could be particularly helpful within the mental health space. Starting a charity that’s able to leverage money towards mental health, primarily in poorer countries, could allow many people to access effective treatment at a much lower cost than in high-income countries. Though this may not be what first comes to mind when thinking about mental health, starting effective new charities has managed to achieve a huge amount of good in tackling other problems.

The organizations we mentioned earlier deploying scalable therapy programs in low-income regions—Kaya Guides, Vida Plena, and StrongMinds—are great examples of this approach.

Software that helps users treat themselves also has the potential to be highly scalable and affordable for people in lower-income settings. Free or low-cost apps like Mind Ease can help large numbers of users, as can effective free web-based courses.

Other promising careers we’ve highlighted, such as grantmaking or civil service careers in LMICs, may also be able to unlock promising avenues within mental health by leveraging resources in the right ways.

Additionally, as with other cause areas, giving money to effective charities can do a large amount of good, even if you don’t dedicate your career to mental health. For instance, the Happier Lives Institute has researched several charities it believes can do a lot of good with the money you give. However, it is still unclear whether these charities are quite as cost-effective as the best charities working in global health more broadly.