Mental health is a universal human right, as the slogan for this year’s World Mental Health Day states. Yet to exercise a right you must first know it exists, and recognising mental health issues is not, for many of us, easy. Hidden by social stigma, such issues may seem rare occurrences. Like that old man wearing ragged dirty clothes and a blanket all year long, standing on the same spot for hours or walking into the traffic.
I certainly did not expect mental illness to come so close. A cancer, a stroke, diabetes, maybe – but not mental illness. And yet, three years ago I suddenly found myself immersed in a midsummer nightmare, where a loved one needed psychiatric hospitalisation after entering a world of demons and fairies created by her brain. That experience taught me that mental health issues are not outliers – they represent half a quartile.
In 2019, one in every 8 persons in the world had a mental disorder. Among these, 301 million (1 in 25) suffered from anxiety disorders, and 280 million (1 in 27) suffered from depression. Less frequent conditions include bipolar disorder (about 1 in 200), conduct-dissocial disorder (about 1 in 200), schizophrenia (1 in 300), or eating disorders (1 in 550).
Eating disorders more than doubled during the pandemic
During the Covid-19, mental health worsened. The first one to tell me about it was my herbalist, who was selling more remedies for anxiety than usual. Worries over the outcome of the pandemic, job losses, economic problems… Preliminary data indicates there was a 28% increase in the number of cases of major depressive disorder and a 26% increase in cases of anxiety disorders. Covid-19 was especially hard on young people. In the US, female adolescents were most affected. In this group, eating disorders more than doubled during the pandemic.
The situation was made worse by the disruption to mental health services caused by the pandemic. Outpatient appointments were fewer, shorter or had to be postponed. Admissions to emergency departments were also limited. And face-to-face services were largely reduced, to be replaced – when possible – by online ones. I have heard of a hospital in Barcelona where, during the strictest period of lockdown, medical personnel had to wear protective equipment from head to toe, and patients were isolated by being locked in their rooms. It was stressful for patients and carers alike. Doors didn’t fare that well either.
Those in this story are far from just numbers
Many accuse statistics of being cold, impersonal numbers. But those in this story are far from just numbers. They include my friend from university, who suffered a psychotic breakdown out of the blue. And a dear one’s auntie. It is the woman I cross in the street who walks slowly with a blank stare. And a work colleague’s brother. It is the lady writing in the café bookshop while she talks to herself and jiggles. And the greengrocer, and the homeless arthritic lady at the corner, who both suffered from depression and were able to fight it with treatment. And a high-school peer, the son of the couple downstairs, and a distant cousin who all committed suicide. And also, those black gloomy days as an undergraduate student that meant I just scratched a pass in Design of Experiments and Data Analysis. Whom do the statistics include in your case?
Mental health disorders can have severe consequences for patients and their families. They can have an adverse effect on overall health, decrease performance in study or at work, and strain family and social relationships. To improve treatment outcomes and costs it is important to try to catch them early. While half of mental health conditions occur by age 14, most of them are neither detected nor treated.
You know you need to check outliers before dismissing them
However, mental health conditions are complex and identifying them is not like applying a t-test. However, you can apply some of your statistical skills to spot when loved ones need support.
Get to know your indicators, the warning signs that may indicate the presence of a problem, and learn about the subject matter, mental illness. The occasional occurrence of a symptom might not be alarming per se, but you know you need to check outliers before dismissing them. If in doubt, call the expert in the subject matter, your doctor. If the anomalous situation persists, that might indicate a problem. Be attentive to repetitive patterns, look out for trends, sudden step-changes and cyclical or alternating behaviours (as in bipolar disorders). And if the impossible seems to become true – say you’re convinced you’ve been contacted by aliens to save the planet – be aware of the limitations of your observations: some brain injuries and mental health conditions can make you see or hear things that do not exist.
Seek confirmation and help from an independent, trustworthy source: a friend, a colleague, a family member, as well as your doctor. Thinking like a statistician could save lives.
And remember, mental health is your right, and the right of those around you.
Jordi Prats is an environmental modeller and data scientist.
