Remember how I mentioned that I love birthdays and anniversaries? Today is the 69th birthday of the World Health Organization (WHO). Founded on 7 April 1948, WHO has the unique constitutional mandate to build a better, healthier future for people all over the world. Each year on its birthday, WHO celebrates World Health Day by identifying a health condition that it has prioritized as central to achieving its mission and laudable mandate.
The bittersweet news is that this year’s priority health condition is depression. Joined by many students and members of our Global Mental Health Program, I was invited to speak on a panel at the United Nations (UN) this morning. I had the opportunity to listen to UN ambassadors, WHO representatives, and members of civil society share their ideas and experiences about how to address this enormous public health concern. I spoke about why we at Columbia GMHP are so passionate about advancing research, education and training in mental health, and particularly, depression. So what is there to say?
What is depression? Most of us have a gut feeling for what depression is, but here are some technical details: Depression is characterized by persistent sadness and a loss of interest in activities that we normally enjoy, accompanied by an inability to carry out daily activities. We can have feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness, and poor concentration. The WHO is in the process of revising the exact guidelines for depression with the development of the ICD-11. The new ICD-11 guidelines are being developed with input from all regions of the world and will be complete in 2018. Our WHO Global Clinical Practice Network of 13,186+ members are helping to ensure that the ICD-11 guidelines help us all communicate better about all mental illnesses, including depression.
Some stats. Depression is the leading cause of ill health and disability worldwide. More than 300 million people live with depression today and the rates are continuing to rise across low, middle, and high income countries. Prevalence ranges from a low of 2.6% among men in the Western Pacific Region to a high of 5.9% among women in Africa. Adolescents and young adults, women of childbearing age, particularly following childbirth, and older adults are particularly vulnerable to depression. At its worst, depression can lead to suicide, which is now the second leading cause of death among 15 to 29-year olds.
Is depression caused by biological or environmental factors? Depression runs in families. Genes are important. Environment matters as well. Our genes are not our destiny. Our biology takes expression in the environments in which we live. The risk of becoming depressed is increased by certain environments like poverty and unemployment, life events such as loss of a loved one through death or a relationship break-up, and other health conditions like cardiac illness and drug use. Especially important in today’s world, when individuals are exposed to political violence, interpersonal violence and/or endure dislocation associated with humanitarian emergencies, they are at increased risk for depression. In fact, as many as 1 in 5 people report depression and/or anxiety in refugee settings.
Return on Investment. Depression and anxiety disorders cost the global economy US$1 trillion each year, but every $1 invested in scaling up treatment for depression returns $4 as a result of better health, ability to work, and community engagement. And that ROI doesn’t even take into account the positive impact on caregivers and family members when the affected individuals get better, so the real return is even greater. Recognizing that effective treatments for depression are a great investment, WHO has enlisted the partnership of Columbia GMHP colleagues, Drs. Lena Verdeli and Myrna Weissman, to disseminate a treatment called Group Interpersonal Psychotherapy. Our Global Mental Health Program looks forward to assisting with training and disseminating this intervention as well.
Depression: Let’s Talk. Today, World Health Day, marks the launch of the year-long campaign called “Depression: Let’s Talk.” At the core of the campaign is the message that talking about depression is a vital component of recovery. The campaign hopes to break the silence and get more people talking about depression – with a family member, friend, health provider, or trusted mentor – at home, in schools, communities, the workplace, and social settings.
Together we can write a brighter future. To learn more about the campaign and World Health Day: Click here.