Almost four years ago, in 2018, a group of researchers — including experts from disciplines such as economics, epidemiology, neuroscience, primary care, psychiatry, psychology, and public health from Australia, Brazil, Canada, China, Italy, Japan, India, US, UK, the Netherlands, and Zimbabwe — were prompted by the scientific journal The Lancet in partnership with the World Psychiatric Association (WPA) to think about why depression remains a neglected global health crisis, despite abundant evidence that much can be done to prevent and aid recovery of people suffering from it even in resource-limited settings and to propose avenues for action.
A Commission on Depression was thus established. A task that was already urgent in a world where an estimated 5% of adults suffer each year from depression, with onset more often in young people who may have to endure consequences over a lifetime became even more pressing with the COVID-19 pandemic, with social isolation, bereavement, uncertainty, hardship, and limited access to healthcare taking a serious toll on the mental health of millions.
The Commissioners began with several observations: up to now we have failed to address the global burden of depression; we know, however, a great deal about the burden of depression; prevention and treatment work if delivered well; we know what needs to happen now to reduce the burden of depression, and there are substantial knowledge gaps that need to be addressed to discover more effective interventions and ways to apply them at scale.
These observations were examined and several key messages and recommendations were presented in a report — the Lancet-World Psychiatric Association Commission: time for united action on depression — to be launched during a webinar on Wednesday, 16 February 2022 at noon GMT. Above all, the Commission calls for concerted and collaborative efforts to improve care and prevention, fill knowledge gaps, and increase awareness to tackle one of the leading causes of avoidable suffering and premature death worldwide. Considering four primary stakeholders — the general community and people with the lived experience of depression; practitioners who are in a position to prevent and treat depression; researchers who lead scientific endeavours to reduce the burden of depression; and decision-makers who design policies and finance their implementation — making depression a priority means pushing for a public health approach that covers both depression’s social structural determinants and the severity, breadth, and for many people, durability and persistence of its consequences.
The role of the general community, including people with lived experience of depression and their families, is highlighted by the Commission not only in terms of what these stakeholders can do — for example, seek help early to increase the chances of preventing or recovering from an episode of illness, or seek treatment that is informed by evidence-based practice, with decisions made collaboratively, and if possible engaging family, friends, community, and peer supporters; but also in terms of prompting the other stakeholders to hear those who have experienced depression. Thus, decision-makers, health care practitioners, and researchers are urged to work together with people with lived experiences of depression to design policies, treatments, and research goals, among others.
The evidence, experience, and growing momentum support the call for united action to integrate prevention and care for depression into existing health and social systems and transform mental health care globally. A whole-of-society approach to the prevention of depression can be expected to result in benefits similar to those from prevention programs in other fields of medicine, such as heart disease and cancer. Investing in actions to reduce the burden of depression enables individuals to regain and maintain their health and well-being, hope for the future, and the necessary cognitive capabilities to be effective in their work and personal lives. In the face of the lifelong effects of depression, especially in adolescents, there is no excuse for the investment and action gap, and the time to act is now. Join us for the global launch of the Lancet-World Psychiatric Association Commission: time for united action on depression on Wed, 16 Feb at noon GMT.
- Richard Horton, Editor-in-Chief, The Lancet
- Miriam Lewis Sabin, Senior Editor, The Lancet
- Afzal Javed, President, World Psychiatric Association (WPA)
- Helen Herrman, Chair, The Lancet-WPA Commission on Depression
- Vikram Patel, Co-chair, The Lancet-WPA Commission on Depression
- Christian Kieling, Co-chair, The Lancet-WPA Commission on Depression
- Opeyemi Lawal, Director, Asido Foundation for Mental Health
- Vivek H. Murthy, U.S. Surgeon General
- Soumya Swaminathan, Chief Scientist, World Health Organization
- Anna Stavdal, President, World Organization of Family Doctors (WONCA)