Madrid, April 19, 2022.-  In today’s world Mental Health is one of our main assets. We should take care and properly manage it in every home, company, institution, or group. I had previously published an article on this website about the high importance of the mental health of Company Directors and its direct impact on the company economical results. The mental health of Executives and their abilities to manage the mental health of their employees is more important today than ever.

In this regard,  I have just read a Study, prepared by Deloitte: “2022 Global Health Care Outlook. Are we finally seeing the long-promised transformation?”. And its conclusions on the relevance of mental health are so enlightening:

Recent health, climate, and political crises have both highlighted and exacerbated the world’s mental health challenges. In particular, the COVID-19 pandemic has shone a light on fissures and failings within the global mental health system and the institutions surrounding and supporting it. In fact, it has illuminated the fact that mental health is more than a health issue alone, clearly highlighting the sociology of mental health in ways previously given lip service, but never really having been responded to in a concerted, systemized way. 

Public health agencies have warned that a wave of depression and anxiety, post-traumatic stress disorder, and other mental ill-health issues are on the horizon due to multiple crises in 2020 inciting urgent calls to action. In addition to COVID-19’s impacts, multiple studies have found a strong link between heavy social media use and an increased risk for depression, anxiety, loneliness, self-harm, and even suicidal thoughts. Mental and behavioral health is also moving up the priority list in government, provider, health plan, and employer health equity discussions. 

Mental health and behavioral health difficulties place a significant and under-recognized burden on the global economy, public and private health care systems, people’s social needs, and basic human rights. The human cost is immense: 

• Between a quarter and half of the global population is affected by a mental health challenge at some point in their lives.
• Nearly 800,000 people die by suicide each year, which is roughly one death every 40 seconds. Suicide is the second leading cause of death in the world for people aged 15-24 years.
• Between 2011 and 2030, the cumulative economic output loss associated with mental health difficulties is projected to be $16.3 trillion worldwide.
• Secondary consequences of mental ill-health are estimated to cost employers USD $2,000 per employee per year from absenteeism, presenteeism (employees habitually coming to work when they shouldn’t—especially coming in sick or working overly long hours), leaveism (improper use of leave), and unnecessary turnover.
• Deloitte research comparing the cost of poor mental health to UK employers in 2017 and in 2020 shows an increase from £33 billion–£42 billion to up to £45 billion annually, due mainly to a significant increase in presenteeism and leaveism.
• Direct and indirect costs of mental ill health are estimated at over 4% of global GDP, more than the cost of cancer, diabetes, and chronic respiratory disease combined. By 2030, mental illness costs are expected to reach more than USD $6 trillion annually.

According to Deloitte research, another challenge to enabling effective mental health programs is a persistent workforce shortage. Despite increasing use of peer support workers, there just aren’t enough psychiatrists, psychologists, nurses, social workers, occupational therapists, and other mental health workers to deal with the number of people who need help: The median numbers of mental health workers per 100,000 population vary. The global median of mental health workers is nine per 100,000 people (varying from below two per 100,000 in low-income countries to over 70 in high-income countries). That’s less than one mental health worker per 10,000 people.

Replacing the traditional hour-long psychotherapy session with brief solution and goal-focused models of therapy may ease workforce shortages without treatment outcomes suffering. In addition, adoption of digital approaches to mental health care could become an essential tool. These efficacious, convenient, and affordable apps can be used in conjunction with traditional, face-to-face therapy, or as the platform to provide synchronous or asynchronous support from a mental health therapist. A growing body of evidence shows that these types of platforms have increased accessibility by removing social stigma and the challenge of traveling to an in-person appointment. They are also facilitating access for those who have previously shied away from face-to-face therapy.

Funding models are a longstanding barrier. For decades, mental health care has been tremendously under-resourced compared to physical health care. Mental health spending made up just 0.4% of global aid spending on health between 2000 and 2014. Low-income countries today spend an average of just 0.5% of their health budgets on mental health, with most of the money going to hospitals that function more like asylums than treatment centers. Even though funding levels are inching up, mental health has not yet risen to a priority area on the global health agenda.

Necessity and opportunity are aligning for countries to produce transformative versions of mental health care that will be less expensive than traditional medicalized care. Doing so calls for: 

• Emphasizing living/lived experience and shifting from prescriptive treatment to consumer empowerment and participatory decision- making 
• Recognizing that mental health is part of a broader overall health experience in that it impacts and is impacted by physical, social, and relational well-being 
• Identifying entrenched disparities and inequities in diagnosing and treating mental illness
• Designing models of care that augment face-to-face therapies with digital support 
• Migrating from institutional to community mental health program delivery 
• Focusing on early intervention and prevention 
• Encouraging multi-stakeholder collaboration—governments, health care providers and insurers, community organizations, academic institutions, public companies, media outlets, and consumers—to advocate for mental health awareness and fund initiatives 
• Training health systems and care providers to implement models of care that promote access and outcomes 
• Utilizing the power of relationships and human connection through the inclusion of family, friends, and community supports in mental health prevention and treatment efforts 

Deloitte adds and deepens its conclusions: Digital technologies have great potential to transform global mental and behavioral health systems to be more accessible, affordable, scalable, and fit-for-purpose. Case in point: the increased use of virtual mental health services by females under age 45 during the COVID-19 pandemic. Studies have shown that the pandemic has affected women—mothers in particular; —more profoundly than men, and that lack of adequate domestic and emotional support can have detrimental mental health consequences. For women who are pregnant or new moms during the pandemic, isolation can be especially difficult. However, this demographic appears to be taking advantage of virtual mental health services’ flexibility and convenience: There is clearly a spike in usage and utilization during evening hours and much of that footprint is occupied by working mothers.

Applying digital technologies in mental and behavioral health care continues to trend positive—at a macro level there’s been a huge R&D push for solution development. Technology giants, existing mental health providers, and disruptive innovators are working independently and collaboratively with health care providers, insurers, governments, public health agencies, and academic institutions to advance digital solutions that address various mental health conditions. But there are two concerning bottlenecks: identifying evidence-based, clinically efficacious, and effective solutions among the myriad being developed, and ensuring that consumers make the best selection to meet their specific needs. 

The COVID-19 pandemic has helped to accelerate the development and adoption of digital health apps:Apple’s and Google’s online app stores now offer over 10,000 apps related to mental health. Online services such as internet-based Cognitive Behavioral Therapy (iCBT) courses are becoming more common. Even computer games, wearables, and augmented reality are being showcased for their utility in mental and behavioral health intervention. Most are being marketed directly to consumers, who have been adopting them at dramatic rates during COVID. 

Regulated, evidence-based, mental health apps can help improve access to advice and support as well as help to reduce symptoms of anxiety and depression. However, the overwhelming majority of available mental health apps and online programs are not evidence-based, and many are unlikely to be effective. Also, there currently is no quality control mechanism nor regulatory oversight of digital mental health solutions, raising ethical concerns about these new tools and services and illustrating the need for trusted agents or governing bodies to forge a path to establish safety and quality digital mental health standards. 

After reading the Deloitte Study on mental health, we should all be well aware of its importance in our day to day life and be aware that if we do not take care and manage it properly,  behind the smiling and competitive looks of a person, executive or director;  hell, inefficiency and danger can be hidden.