The global crisis of depression: the low of the 21st century?

Abstract

Truly inspiring leadership for health is rare, and until November 2014, such leadership for mental health within public health seemed to have disappeared. Thanks to The Economist, I observed an inspiring address by Kofi Annan, opening a conference in London on 'The Global Crisis of Depression'. His supporting cast included politicians from the United Kingdom (Norman Lamb), Denmark (Nick Haekkerup) and Sweden (Elisabeth Svantesson); international leaders of business, economic planning and education; and political strategist Alastair Campbell's personal narrative of depression. Readers of Perspectives might value the prominent voluntary and community sector contribution (e.g. Time to Change or MQ: Transforming Mental Health). But the real leadership came from Annan, drawing on experience as Secretary-General of the United Nations (UN) and continuing advocacy for human rights, conflict resolution and the Millennium Development Goals.At the most conservative estimate, 350 million lives are overshadowed by depression.1 Depression is already the leading cause of disability in our world, with a global economic cost (2010 estimate) of US$800 billion and rising.2 Annan emphasised that lack of treatment and social support denies those who suffer their human rights (especially in critical circumstances like conflict or natural disasters). This lack of universal care is not just due to a lack of trained providers but is embedded within widespread social stigma and poor community understanding of mental disorders in general. Many wider ambitions for our world (including the Millennium Development Goals) will not be achieved without addressing depression as a global priority. Diminished work productivity may be the first problem to address. In a substantial question and answer session, Annan was at his most impressive: well-informed, evidence-based and constructive. For example, lessons learned about AIDS and employment in Brazil could be applied to the new World Health Organization (WHO) Mental Health Action Plan. Health gain was not restricted to treatment by clinicians, but non-clinical resources like teachers would play a vital part. His vision of schools and communities working together to prevent depression in young people echoed our recent asset-based review.3 Women were twice as likely to suffer from depression as men. As poor maternal mental health casts its shadow from one generation to the next, we need a new understanding of gender and depression. …