Is mental health getting worse?
May 31st, 2009
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One of the things that various anti-industrialists like to talk about is the belief that life in an industrial society leads to a breakdown in mental health, including stress, depression and the other nasty things that go along with a “complicated” lifestyle.
According to some, the fact that many suffer from anxiety, depression, bipolar and other mental health issues is directly related to the use of vaccines, television, telecommunications, mechanized transportation and the other aspects of a fully industrial society. The answer, they claim, is to return to the “natural” state of things, where humans live in a cutthroat world of tribalism, subsistence agriculture and rampant disease. (make no mistake, this is how people lived “naturally”).
There is no doubt that the past century has seen more people seeking treatment for mental and emotional health issues, but this does not necessarily mean that they are rising. Mental health is one of the most difficult to track statistics due to the strong historical and cultural influences.
At one time, only those with very severe mental illness would be recognized as needing treatment, and in many cases this was limited to institutionalization. The concept of sane people seeing a therapist for stress, depression or other mental issues did not really become commonplace until the 1950’s to the 1970’s and was all but non-existent before the 20th century. Sigmund Freud is recognized as the founder of modern psychoanalysis, which he popularized in the early 20th century, and although many of his ideas have been discredited, the field was all but non-existent before Freud.
Even though modern talk therapy and cognitive behavioral therapy have roots going back to the late 1800’s, treatment was fairly limited before the arrival of psychoactive drugs. Lithium salts first entered use for treating manic depression in the 1950’s. Antipsychotic drugs were first discovered around the same time, but modern antipsychotic medications were not fully developed until the 1970’s. Selective serotonin reuptake inhibitors, the most popular class of drugs for treating general depression and anxiety did not exist before the early 1970’s and many of the most effective SSRI’s were not in widespread use until well into the 1980’s.
It is therefore likely that many people who suffered from mood disorders, depression, anxiety, bipolar syndrome, obsessive compulsive disorder or other mental and emotional health issues suffered in silence until quite recently. There certainly are documented examples of individuals who had these problems, so any notion that the conditions are in any way new is obviously false. Aberham Lincoln, Vincent van Gogh, Isaac Newton, Adolf Hitler and many many others show very clear signs of depression, anxiety disorders, paranoia or other mental health issues.
There have also been major incidents of mental health epidemics throughout history. After the American Civil War, a very large portion of veterans were severely traumatized and many were addicted to morphine and other opiates. Alcoholism and drug abuse became rampant and a dysfunctional underclass of veterans existed for decades. World War I also saw an epidemic of veterans with mental health disorders, at the time attributed to “shell shock.” China experienced many years of social and mental health problems related opium addiction.
In years past, populations with high incidence of mental illness, such as veterans with PTSD or the overworked lower classes rarely received any treatment. Those who were not institutionalized could be left homeless and incapable of functioning in society. Such cases make it extremely difficult to get a good representation of the number of individuals who suffered from mental illness and of what type.
Despite the lack of good data on the number of persons with mental health issues, there is one statistic that provides some incite: the suicide rate. Since suicide is almost always associated with extreme mental illness or disturbance, it can give some indication of the number of persons suffering from such conditions. Although it is an imperfect indicator, it can give some idea of the mental health of the population, especially when it comes to severe depression. Data is from the WHO.
The United States
A quick look the past half century shows that suicide rates in the United States have remained relatively constant. However, this does not tell the entire story. The demographics of suicide in the US indicate that the rate increases with age, and since 1950 the average age of the population has gone up due to higher life expectancy. Taking this into account, the adjusted rate has actually gone down slightly.
The US is not unique in this respect. The same can be seen in Canada. Like the US, suicide rates increase with age in Canada. Data indicates a modest rise in suicide in Canada, but this is to be expected given the increase in population age. There has been a general trend of reduction in suicide since 1980.
The UK has seen a small reduction in suicide rates across the board.
Australia has seen the rate rise slightly and then fall again. The rate of suicide in 2003 in Australia is no higher than it was in 1965.
In years past, Sweden had a reputation for having a problem with suicide. Although the rate was somewhat higher than many other European countries, this is no longer the case. The rate of suicide has decreased by almost a third since its peak in the early 1970’s
In France, there was a slight increase but as of 2003, rates are on par with what they were in 1955.
Conclusion: The rate of suicide in a society can be effected by any number of factors including cultural influences and economics. It is therefore expected that it will rise and fall slightly, but the numbers do not indicate any generalized rise in industrial countries. In many cases, they indicate the opposite, a general reduction in suicide per capita.
This entry was posted on Sunday, May 31st, 2009 at 5:48 pm and is filed under Bad Science, Culture, Enviornment, History, Misc, Quackery. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
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May 31st, 2009 at 6:40 pm
Diagnostic tool and a population less frightened by mental health issues has meant more people are seeking help, rather than suffering in silence. This has given the appearance in treatment facilities that there is an increase in patients.
In fact some would say that the opposite is true; too many people are seeking medication for conditions like depression, hyperactivity, and attention deficit disorder who do not meet all the criteria for medical intervention.
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May 31st, 2009 at 7:00 pm
An excellent post. In a similar vein, I’ve just written about the claim that 1 in 4 people suffers from mental illness here…
Suicide rates are not a perfect measure of mental health, of course. In particular, advances in medicine and “suicide prevention” (e.g. reducing the packet size of paracetemol so it’s harder to OD on it) will have probably reduced the number of people who actually kill themselves.
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May 31st, 2009 at 10:06 pm
Neuroskeptic said:
No, it’s a very imperfect measure. It’s the only thing I could think of that would provide some kind of subjective statistic in this area at all. I think it’s a valid assumption that if mental health was getting dramatically worse suicide would go up, even given the measures.
The other thing is suicide rates don’t necessarily show how many attempted suicide and did not succeed and this is again something that can be skewed, for example, based on the availability of firearms (which is a quick and effective way of doing it) or of information on how to do it effectively.
So yes, it is only a so-so indicator and not perfect at all. I can’t find any reliable numbers for depression and other mental health disorders as a percent of the population for any time earlier than the mid 1980’s.
The best I found for acurate numbers are some from the canadian government which indicated a modest increase in admissions for psychosis and anxiety related mental illness since 1987 – the increase was roughly proportional to the expansion of mental health screening in general.
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June 1st, 2009 at 1:39 am
At the end of the trial, the judge ruled that the woman suffered from mental illness and ordered her confined to Razi Sanitarium in the capital. Naturally Nasty
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June 1st, 2009 at 3:13 am
one could argue that today we are over medicated and attribute too much to mental health issues. The fact is it is normal to feel stressed out or sad sometimes. It is certain that in the past people had mental illness that went untreated. In the distant past it was endured when depression or OCD or something like that was present.
People can function with these condtions. People are aware they have them but learn to live. In the past there was no other option.
There is no evidence that mental health is any worse in an industrial society. Today we only gripe about things because we have had most of the major worries of survival taken away from us. People fail to appreciate how well they really are.
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June 1st, 2009 at 5:09 am
“No, it’s a very imperfect measure. It’s the only thing I could think of that would provide some kind of subjective statistic in this area at all.”
True – it’s hard to think of a better one.
The number of people recieving inpatient treatment for psychiatric disorders (i.e. the number of beds in mental hospitals, roughly) might be another quite good measure, but I’ve struggled to find the stats on that. And you’d have to account for the fact that there was a massive exodus from mental hospitals after the introduction of antipsychotics in about 1955. However, it might be a useful measure up until that point.
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June 1st, 2009 at 12:21 pm
The suicide rate is a good choice, although it is worth mentioning that it is influenced heavily by social mores. As the attitude towards mental health changes, the suicide rate will likely change as well. I rather suspect that the slight decline may be due not so much to better mental health care but to the notion that depression isn’t something to be ashamed of, which may make people think twice when they get a suicidal impulse. “What if this is just the depression talking? I should wait.” Interviews with unsuccessful suicides suggests that it’s rarely the result of a long, drawn-out process of consideration but is instead an impulsive action — and often it’s not the first time they’ve had such an impulse.
I wonder if suicides are more common in cultures such as Japan, where the tenets of bushido remain strong? We do occasionally hear of disgraced executives killing themselves to spare their family shame. And in places such as India and the Mideast, where honor killings happen, I wouldn’t be surprised if some commit suicide for that reason as well.
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June 1st, 2009 at 2:00 pm
Calli Arcale said:
I didn’t mention Asian countries, especially Japan because of this. Suicide is generally the result of mental illness in the west, but in Japan and some other countries with a strong tradition of Budism and nationalism, suicide can be strongly influenced by cultural practices and is not necessarily a mental health issue.
In Japan the rate of suicide is extremely high and seems to fluxate more than other countries. I think this is probably related to economics or politics (when more people feel they have failed economically etc)
You can find information on varying countries here: http://www.who.int/mental_health/prevention/suicide/country_reports/en/index.html
In Japan, the 2006 suicide rate was about 24 per 100,000 and 35 per 100,000 males. That is fairly high compared to other industrial countries. It’s not extremely high, but it’s definitely more than North America or Europe.
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May 6th, 2011 at 8:23 am
We could compare national financial investments in mental health programmes, with suicide or inpatient levels (1950 – 2005).
Given the broad uniformity of suicide figures, the result could be even more depressing.
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