A brutal civil war in South Sudan has over 3 million people on the run according to David Milliband, president of the International Rescue Committee. In Yemen, a cholera outbreak puts many more at risk. The resilience demonstrated by impacted individuals is inspiring. At the same time, these humanitarian crises are associated with upsurges in post-traumatic stress disorder, depression, anxiety, and other mental health concerns. And that is on top of already overwhelming mental health needs around the world.
This barrage of bad news – arriving by text messages, tweets, news alerts, Facebook, and even old fashioned TV and radio – can leave us feeling quite hopeless and helpless. This is bad news for our mental health where we know that hope and self-efficacy are strong predictors of mood, anxiety, healing, and recovery.
So, what do dominoes have to do with bad news and mental health?
SIM Card to Empire State Building in 29. A domino can knock over another domino that is 1 1/2 times its size. This means that if you start with a domino about the size of a SIM card (5 mm high x 1 mm thick), 28 dominoes later you could knock over a domino the height of the Empire State Building. This is our metaphor for advancing mental health globally. At the turn of this century, global mental health was barely a SIM card. Today, scientific research, funding opportunities, training programs and global networks are steadily growing – maybe we are somewhere around domino 5.
Six degrees of Kevin Bacon. Like it or not, we’re all connected – and not just to Kevin Bacon. Consider Nick Christakis’ work on social networks that powerfully demonstrates how our seemingly negligible actions can impact people we have never met. In fact, each contribution an individual makes to the public good is tripled over time by others who are directly or indirectly influenced as a consequence. This understanding of social networks has implications for both mental health promotion and building treatment capacity.
The dominoes of emotions. With billions of posts, Facebook offers a unique opportunity to study how feelings spread. So what happens when it rains? For every one person affected directly, rainfall alters the emotional expression of one to two other people, suggesting that online social networks may magnify the intensity of global emotional synchrony. And Facebook has demonstrated that manipulating someone’s News Feed clearly has an impact on mood. When they reduce positive news on the News Feed, people produce fewer positive posts and more negative posts; when they reduce negative news, the opposite pattern occurs.
Does bad news travel faster and further than good news? So we know from experimental evidence that emotions are contagious in social networks. But what’s more contagious, positive or negative emotions? In the rain study, every rain-induced sad post generated an extra 1.29 more negative posts than normal among people’s friends. But happy posts had even stronger impact. If a user posted an upbeat statement, an extra 1.75 positive posts were generated. While the jury is still out, there’s at least initial evidence to suggest that positive emotions are more contagious.
Ed Zigler and a remarkable story of the domino effect. Commonly referred to as the “father of Head Start,” Ed Zigler was my mentor at Yale who taught me what it means to translate big ideas for social change into reality. Dr. Zigler devoted his life to increasing early educational opportunities for generations of children he never met. It was an extraordinary moment when Zigler was preparing to undergo surgery and the anesthesiologist, Dr. John Paul Kim, realized that he was about to care for the man who gave him his head start in life. The son of Cambodian refugees, Kim’s family lived below the poverty line in the US, and his mother has told him all through his life that it was Head Start that set his life on the course that landed him at Yale-New Haven Hospital.
The domino effect is everywhere visible when it comes to mental health. We have a ways to go, but the cascade is in motion. The data are clear that operating with hope and agency is good for our own mental health and what we do has the potential to impact the lives of many we will never meet. Know that your actions matter. Pick your domino.