For the first time, the United Nations has formally placed mental health on equal footing with chronic diseases like cardiovascular conditions and cancer.
The new declaration, negotiated over five months and overwhelmingly backed by heads of state and health ministers, will be presented for final approval at the UN General Assembly soon, according to the World Health Organization (WHO).
The document calls for a global shift in treating mental health not in specialised institutions, but in everyday clinics, aiming to reach 150 million more people by 2030.
But while global leaders agree on the principle, clinicians say the main problem remains unchanged, i.e. access.
Out of more than a billion people living with mental health conditions today, less than 7% are estimated to receive effective treatment, and waiting times for services often last for months.
“Outdated health systems have spent decades treating mental health problems as an afterthought, yet they worsen conditions like diabetes, cancer and heart disease every minute,” said Dr Hannah Nearney, medical director at Flow Neuroscience, a Britain-based company that developed an at-home, brain stimulation-based depression treatment.
“Mental illness reduces a person’s ability to take good care of their physical health and affects sleep, immunity and stress hormones, making the body less able to fight chronic disease.
“Why it isn’t treated as urgently as physical illness is only a rhetorical question.”
Multiple health conditions
A new study of over 275,000 Europeans, published in the Journal Of Affective Disorders, showed that people with depressive symptoms have 57% more chronic conditions than others, and those with chronic diseases are 1.5 times more likely to have depression.
“When a patient walks into a general practitioner’s office, their mental health should be managed with the same urgency as blood pressure or temperature,” said Flow Neuroscience global medical director Dr Kultar Singh Garcha.
“The main problem isn’t awareness, it’s accessibility.
“Treatments exist, but too few are scalable or visible to frontline doctors.”
Long waits and overprescription remain widespread worldwide.
“Imagine waiting months for an appointment, and after 10 minutes, you leave with another prescription to add to your list,” said Dr Garcha.
“Patients managing chronic disease already take multiple drugs, and we need options that don’t add to that burden.
“We also don’t need those extra side effects that often come with antidepressants.”
Both clinicians agree that it simply puts more burden on primary care providers without actually solving the problem.
They urge faster adoption of novel technologies such as brain stimulation.
Among non-drug options, at-home brain stimulation is emerging as one of the few clinically-proven, scalable treatments.
For example, there is a clinically-backed device, already used in Britain’s National Health Service (NHS), that can be prescribed and remotely monitored by clinicians.
In a recent NHS pilot, patients saw a 71% reduction in depressive symptoms.
“We saw firsthand that what we need already exists, but unfortunately, it’s only at some clinics in the UK at this point.
“While more countries are adopting this, the issue is that even some clinicians are not aware solutions exist.
“Integrated into primary care, these at-home treatments make mental health care more accessible and affordable,” said Dr Garcha.
“They reduce waiting times, free up clinicians, and help patients get relief sooner, before symptoms escalate into crisis care.”
Experts say broader regulatory support will be key to making these treatments reimbursable and available through public health systems.
“Even before the UN declaration is formally adopted, its overwhelming support signals the end of the idea that mental health comes second,” concluded Dr Nearney.
“The next step (already here), is building real access.
“Recovery in any chronic disease starts with a healthy brain.”