New Global Burden of Disease analyses show depression and anxiety among the top causes of health loss worldwide, and a significant increase due to the COVID-19 pandemic

Younger people were more affected by major depressive disorder and anxiety disorders in 2020 than older age groups. The additional prevalence of these disorders peaked among those aged 20-24 years (1,118 additional cases of major depressive disorder per 100,000 and 1,331 additional cases of anxiety disorders per 100,000) and declined with increasing age. According to the Global Burden of Disease 2019, self-inflicted injuries are a main cause of death worldwide in adolescent girls, and suicide is the leading cause of death for girls and women between 15 and 19 globally; 46,000 adolescents die from suicide each year, a top 5 cause of death in their age group. Complemented by the challenges of the pandemic, 1 in 7 children have been directly affected by the lockdown, and 1.6 billion children have suffered a loss of education from being fully or partially out of school in 2020. With school closures and wider social restrictions in place, young people’s ability to learn and interact with their peers has been hindered.

Furthermore, youth are more likely to become unemployed during and following economic crises, as mental health disorders directly impact lost contributions to economies at nearly $390 billion a year. Despite the economic loss, 2% of government health budgets are allocated to mental health spending globally, according to UNICEF. The greater impact among women and young people was likely because they are more impacted by the social and economic consequences of the pandemic, which has created a greater urgency to strengthen mental health systems through policy-based methods of action that address the burden of anxiety disorders and MDD globally.

Even before the COVID-19 pandemic, mental health disorders posed a significant burden worldwide. In 2019, depression was the second-leading cause of disability globally, and anxiety ranked eighth, both being the most common types of mental health disorders.

While men and women experienced similar rates of mental health disorders overall, depressive, anxiety and eating disorders were more common in women, while ADHD and autism spectrum disorders were more common in men.

Global disability-adjusted life-years (DALYs) by mental disorder, sex, and age in 2019

Health loss due to mental health disorders tends to peak between ages 25 and 34, increasing during childhood and adolescence and decreasing steadily into older ages. In 2019, this translated into over 80% of the burden of mental health disorders falling on those between 16 and 65 years, which are primary working ages.

Overall, the highest prevalence of mental health disorders was in the regions of Australasia, Tropical Latin America, and high-income North America. However, when looking only at depressive disorders, sub-Saharan Africa, North Africa, and the Middle East all stood out for high levels. For low-income countries that may lack funding or other resources for health infrastructure, it can be particularly challenging to address mental health needs as they are often overlooked. In addition to shortages of mental health services, other barriers can prevent people from receiving treatment, like social stigma or their own perceived need.

Despite policies aimed at reducing mental health disorders, not much has changed in the past two decades at the global level. Since 1990, the age-standardized rate of health loss has stayed roughly the same, and the total amount has increased by about 55%, a result of rising population size. The demand for mental health services has never been greater, and it is imperative that countries do not neglect this demand as they work to enhance public health services.

Mental health is a human right, and people in all countries, at all income levels deserve access to treatment and prevention resources.