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Dossier Mental Health 1 - Good Days, Bad Days

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Psychological problems are on the rise worldwide. Even though taboos around psychological ailments are now making room for a new reality, those affected still suffer from prejudice. Resilience is the key to mental health.

The fact that with the move of Prince Harry’s wife, Meghan Markle, into the British Royal Family, two worlds collided, has been public knowledge since long before the couple’s flight to the US. The Royal Family, however, seemed especially incensed when the Duchess spoke openly about her mental health. In an interview with Oprah Winfrey in March 2021, Meghan reported that she was plagued by thoughts of suicide. “At the time, I was afraid to mention it. I simply did not want to live any more. It was a very real, clear and frightening thought that was always present”, she said. Asking the Royal Family for psychological help, she was told “no”. The reason, says Meghan, was their fear of damage to their reputation.

When the burden weighs heavy
No longer trivializing, disguising or hiding – Duchess Meghan joins the lineup of celebrities who are putting an end to the denial of mental health problems. Last year, American gymnast Simone Biles made headlines with her resignation from the Olympic Games. Due to mental health problems, the four-time Olympic champion quit in the middle of the 2020 finals. “Sometimes I really feel that I am carrying the weight of the world on my shoulders”, the star gymnast wrote later.With her openness, the 19-time World champion struck the right chord with many fans and colleagues. “Gratitude and support are what Simone Biles deserves“, tweeted White House spokesperson Jen Psaki. Former champion swimmer Michael Phelps said this decision broke his heart. “As somebody who‘s struggled with depression and anxiety, Biles‘ opening up and talking about mental health is a big, powerful step forward toward blowing the stigma out of the water”, Phelps told “People” magazine following the award ceremony for the Hope Award for Depression Advocacy.In 2017, following his retirement, the winner of 28 Olympic medals declared openly that he suffered from depression, and since then, he has been advocating for more openness when it comes to psychological illness. According to Phelps, many people are still afraid to talk about their illness because they fear stigmatization and dismissal. “We just need more people to open up and continue to break this wall down”, emphasized Phelps.

It can happen to anyone
The experiences of celebrities clearly show that even fame and wealth are no guarantee for a carefree life – and that psychological illness can affect anyone. It is a fact that recently, more and more people have been suffering from mental illness. According to a study by the University of Queensland in Australia and the University of Washington, the COVID year 2020 resulted in an additional 53 million cases of severe depressive illness and 76 million cases of anxiety which can be attributed to the pandemic. This translates to a worldwide increase by 28 percent and 26 percent, respectively, the researchers report in “The Lancet”. Women and young people are especially affected. And according to the World Health Organization (WHO), the war against Ukraine caused an additional decline in health in Europe. Throughout the European WHO region which, in addition to the EU, also includes Ukraine and Russia, more than 150 million people had already suffered from psychological health problems in the year prior to the war.

A lack of treatment options
At the same time, the care for these patients leaves much to be desired. Even though the European region enjoys the best ratio worldwide when it comes to psychiatric care (per 100,000 residents, 50 psychiatric professionals are available, among them psychiatrists and nurses, as well as social workers and speech therapists), according to the WHO, even here, only about every third person with depression gets help. Norway cares particularly well for those with psychological illness. On average, 48 psychiatrists look after 100,000 people whereas in some other European countries, one psychiatrist may be responsible for the same number of people. The authors of the “Lancet” study are appealing to governments: “This pandemic has created an increased urgency to strengthen mental health systems in most countries.”

The pandemic illustrates the need to strengthen health care systems in most countries.”

Authors of a study published in “The Lancet”

Widespread stigmatization
In addition to experiencing a lack of care, many of those affected by mental illness worldwide suffer from prejudice. A longitudinal study conducted at Indiana University in Bloomington revealed that while among Americans, stigmatization of people with depression has declined since 1996, rejection of those with a diagnosis of, for example, schizophrenia or alcoholism, has further increased. With respect to Germany, a longitudinal study by the University of Greifswald arrives at a similar conclusion. “It is encouraging to find more progressive attitudes toward mental illness among millennials and to see public stigma around depression significantly decreasing”, says Brea Perry, co-author of the American study. “However, the increasing stigmatization of schizophrenia and alcohol dependency is concerning. Taken as a whole, our findings support rethinking stigma and retooling stigma reduction strategies to improve public attitudes surrounding mental illness. There is a lot of work left to be done”, emphasizes Perry.Frequently, work turns out to be the best medicine for those afflicted with mental illness – professional rehabilitation is an important step back to an active life. Unfortunately, however, society is not helpful. In many European countries, people with psychological ailments do not have ready access to the labor market, and they frequently end up in workshops for the disabled. In this respect, the US is more advanced: increased acceptance of the inclusion of those with mental illness has been observed for some time. “First place, then train” is what Americans call this approach of placing people in companies without prior training. Studies show that their success in securing a regular job is twice that of those previously trained in a workshop.

Strengthening resilience
In order to ensure that psychological illness will not be exacerbated further, especially in times of pandemic and war, health experts worldwide are advocating for a strengthening of resilience – that psychological strength which helps us deal with crises and tragedies. The foundation is laid in childhood – for example, through a reliable and loving environment. Preschools and schools, too, feature more and more concepts for the support of resilience. Of course, psychological resilience can still be actively exercised during the adult years. In its program “Road to Resilience”, the American Psychological Association (APA) lists ten important factors, among them, for example, actively building relationships and accepting change, as well as acting in a goal-oriented and proactive manner.Meanwhile, advocacy groups and foundations around the world, such as the Mental Health Foundation of New Zealand, do important work to further the acceptance of those affected. In Switzerland, the magazine “Anxy” addresses those with psychological illness who, as authors, describe their own experiences. The honesty of affected celebrities and the new openness with which psychological suffering is discussed on social media may be the first step on the long journey towards the inclusion of those suffering from psychological illness. In the best case scenario, increased resilience will lead to better mental health worldwide.

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