In the Pixar blockbuster Inside Out, 11-year-old Riley’s animated emotions—Joy, Anger, Fear, Disgust, and Sadness—battle it out for supremacy in a film that’s proven as mesmerizing to adults as it is to kids. Now it’s time to take popular fascination with this imaginary character into the real world, where mental health is far too often overlooked, underfunded, and treated as an afterthought.
Consider that one in four people on our planet suffer from depression, anxiety or some other mental illness over their lifetimes. In15 minutes--the time it might take you to grab a cup of coffee at Starbucks—25 people will end their suffering by taking their own lives. In high-income countries and low-resource settings alike, good mental healthcare is all too rare. During my three-plus decades working in the field of global mental health, I have seen troubled people chained to trees, locked up in prison, banned from work, and banished to garden sheds – and this is not just in faraway, rural villages but happening right here in the United States where we have taken to incarcerating individuals with mental health problems rather than providing mental healthcare.
As outrageous as it sounds, while mental illness has been recognized by the UN as the leading cause of disability in the world, mental health is barely noted in the several hundred page document. Yes, we have a toehold in that the SDGs include two brief references to mental health; however, the indicators that will be used to measure the ultimate success of the SDGs make absolutely no mention of mental health.
This needs to change. We all know that metrics matter, that we focus on what we measure. Just as Riley and her family learned not to split off Sadness from Joy, the UN needs to recognize that untreated mental health problems increase risk for other illnesses and even decrease life expectancy (pdf). If the UN fails to prioritize mental health in the SDGs, it will not only be ignoring its own data and abandoning hundreds of millions of people worldwide who need care, but also sabotaging its ability to succeed with so many other goals given their intimate link to mental health.
While few of us will be at the UN negotiating tables, all of us can take action by taking the issue to Ambassador Samantha Power, our U.S. representative to the UN. The stakes are high—and not just for those dealing with their own mental health issues. Mental illness will account for more than a third of the global economic burden of non-communicable diseases by 2030, posing a major threat to global economic growth.
Like so many millions throughout the world, I have personally experienced the depths of depression when Sadness eclipsed Joy following life changing loss and trauma. I am one of the lucky ones as these things go. I had a community of family and friends who refused to look away and pretend all was okay, and I had access to care that enabled me to claw my way out of the dark hole of despair so that Sadness and Anger could make room for Joy and ultimately Hope once again.
Everyone deserves this chance. With over $602 million in gross revenue worldwide in its first six weeks, Inside Out reflects a growing global fascination with the brain and its workings. As the UN considers its global goals, its decision-makers must recognize the larger message of Riley’s story: That ignoring mental health is a recipe for disaster.
Pike is professor of Psychology, Departments of Psychiatry and Epidemiology; executive director and scientific co-director of the Global Mental Health Program at Columbia University; and a Public Voices fellow with the OpEd Project.