There is no doubt that mental illness is a major cause of human suffering around the world. But it can be harder to solve than other deep-seated issues like illness or poverty, in part because mental well-being is so hard to quantify.
This is what the Mental Health Million project at Sapien Laboratories, a nonprofit founded in 2016 to study the human mind, is expected to respond. The group released its second annual report last month. Mental State of the World Reportsurveying more than 220,000 people in 34 countries with its Mental Health Quotient (MHQ) quiz.
The questionnaire grew out of the group’s frustration with the lack of a single, comprehensive scoring tool to capture the entire mental well-being of a population, not just in terms of disease or disorder, but also on the positive side. . After reviewing a number of existing clinical tools or questionnaires, they arrived at a list of 47 items to be used as questions in the MHQ scale, which could be completed as an online questionnaire by respondents in 15 minutes. approximately. The survey is freely available online to anyone who wishes to complete it, and study participants were actively recruited primarily through Facebook and Google ads. (The researchers note that this may not result in a representative sample of the population, although the same methodology was used in all the countries studied.)
These inputs are used to calculate an aggregate score between -100 and +200, with the full range divided into categories on a spectrum ranging from “distressed” to “thriving”. The 47 items in total are also organized into five domains based on the aspect of well-being they focus on – mood and outlook, drive and motivation, social self, mind-body connection and cognition – with separate scores for each. The MHQ has been valid and shown to give reliable results on retakes, and “negative” scores are strongly correlated with qualifying for a DSM-5 diagnosis, and the results are also predictive of productivity.
The first results of the survey are not reassuring.
The children are not well
One of the key findings was a worrying drop in mental well-being in the 18-24 age group. It’s a surprise: previous mental health surveys — though mostly American-only and using different measurement tools — tended to show a U-curve of well-being over a lifetimewith the youngest and oldest groups doing best and a decline for middle-aged people.
As concerns about the state of young people’s mental health have grown in the United States – a new CDC investigation found that more than four in 10 teenagers reported feeling “constantly sad or hopeless” – Tara Thiagarajan, founder and chief scientist of Sapien Labs, told me: “this is not an isolated problem of one country . It’s a global problem.
This trend was already present before the Covid-19 pandemic but worsened considerably between 2019 and 2021, with the total percentage of people in the “struggling” or “distressed” range doubling between 2019 and 2021, reaching 30%. Notably, the decline was more closely correlated with the stringency of containment measures than with the direct damage of the pandemic.
Researchers have considered various possible causes – income inequality, political instability, civil unrest – but none of these factors has been systematically worsening around the world.
One factor is truly universal: the growing use of smartphones and access to the Internet. Despite long-standing concerns that smartphones and exposure to social media harm mental health, especially among young people, existing studies showed mixed results.
But the researchers behind the Mental Health Million report believe the key factor may not be the internet itself, but time spent on the internet. Recent global statistics suggest that people with internet access spend on average 7-10 hours a day online, which could crowd out the in-person interactions essential to building a strong social self.
Building skills and social relationships takes time and experience. But Thiagarajan thinks the younger generation has “arrived at the age of 18-24 and at university with a tenth of the expertise to solve social problems, to live together, to coexist productively without conflict. And I think a lot of the turmoil and conflict can be tied to that, because at 18 you now have the same experience of interacting with people that a 7 or 8 year old had in the past.
Why wellness is important
If the current decline in mental well-being among young people were linked to internet use crowding out in-person social time, it follows that the isolation of lockdowns would have particularly affected the 18-24 year old cohort. And previous studies show that lower mental wellbeing scores at the country level are correlated with higher rates of suicide, sexual violence and violent assault, especially for the 18-24 age group. years.
The Mental Health Million team hopes that the MHQ will provide a better understanding of this key issue. It is admittedly flawed – the questionnaire is only available online, in only four languages (English, Spanish, French and Arabic), and would have mostly attracted participants who were able to see online advertisements. This population may be unrepresentative in many ways; on the one hand, especially in poorer countries, Internet users are likely to be the wealthiest and most educated segment of the population, and differ from the average in other respects.
Even in countries where internet access is more widespread, young people who spend the most time on the internet and could therefore be hardest hit by the resulting negative well-being effects are likely to be over-represented; conversely, for older adults, internet savvy may be better connected and educated than the norm for that age group, which could contribute to the consistently high well-being reported in the 65+ cohort . Cultural factors could also affect how people interpret survey questions, as well as their connection to the concept of well-being and mental illness; this makes patterns found at the country level with cultural indicators more difficult to analyze.
Wealth is not always synonymous with happiness
Countries and cultures seemed to affect mental well-being in other unexpected ways. Against all expectations, a higher national GDP was correlated in the survey with a self-reported well-being. English speaking countries – USA, UK, Ireland, Canada, Australia and New Zealand; all developed and wealthy countries — had the worst average scores. “We were very surprised to see that,” says Thiagarajan.
The report also examined cultural factors at the country level, using indicators compiled by the Globe Project and by Geert Hofstede at Maastricht University. Of the factors examined, performance orientation, which measures the extent to which rewards and recognition are based on job performance, had the strongest negative impact. correlation with average MHQ scores in a country – despite the fact that societies high on this dimension tend to be more economically prosperous, with higher levels of human development.
On the other hand, the factors of high power distance (cultures that accept an unequal and hierarchical distribution of power), uncertainty avoidance (cultures that emphasize social norms and rules), and collectivism in group or familial (societies that express pride, loyalty, and cohesion within families) are all positively correlated with mental well-being. As the report puts it, “Overall, these relationships paint a surprising but coherent picture: a culture where we are each for ourselves and judged and sorted by our performance can be beneficial for economic growth but detrimental to our collective mental well-being.
Mental Health Million acknowledges that its survey data and report are only a first step and further research is needed. Their data is available to researchers on demand, and about 20 organizations are already working with him in hopes of finding ways to improve mental well-being around the world. According to Denver Brown, a professor of psychology at the University of Texas who studies the effects of physical activity and sleep on mental health, “these results suggest that we cannot take a siled approach to understanding mental well-being. “.
In the past, the effects of policies on mental health were difficult to measure; when decisions were made regarding Covid-19 lockdowns, it was almost impossible to factor the welfare of the population into the cost-benefit analysis. But the costs to mental wellbeing are real, and the Mental Health Million Project shows we can’t ignore it.
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