Global Burden Mental Illness

Estimating the true global burden of mental illness

Daniel Vigo, MD

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 Prof Graham Thornicroft, PhD

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 Prof Rifat Atun, FRCP

DOI: http://dx.doi.org/10.1016/S2215-0366(15)00505-2

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Jump to SectionIntroductionBurden of mental illness: measurement challengesThe psychiatric–neurological interfaceCategorising suicide and intentional self-harmChronic pain syndromesIncluding people with personality disordersPremature mortalityRevising DALYs (2013) estimates for mental illnessRevising YLDs (2013) estimates for mental illnessDisproportionately weak global response to mental illnessDiscussionSupplementary MaterialReferences

Summary

We argue that the global burden of mental illness is underestimated and examine the reasons for under-estimation to identify five main causes: overlap between psychiatric and neurological disorders; the grouping of suicide and self-harm as a separate category; conflation of all chronic pain syndromes with musculoskeletal disorders; exclusion of personality disorders from disease burden calculations; and inadequate consideration of the contribution of severe mental illness to mortality from associated causes. Using published data, we estimate the disease burden for mental illness to show that the global burden of mental illness accounts for 32·4% of years lived with disability (YLDs) and 13·0% of disability-adjusted life-years (DALYs), instead of the earlier estimates suggesting 21·2% of YLDs and 7·1% of DALYs. Currently used approaches underestimate the burden of mental illness by more than a third. Our estimates place mental illness a distant first in global burden of disease in terms of YLDs, and level with cardiovascular and circulatory diseases in terms of DALYs. The unacceptable apathy of governments and funders of global health must be overcome to mitigate the human, social, and economic costs of mental illness./.../ (ask for full text)