by Daniel Vigo, Graham Thornicroft, Rifat Atun
Lancet Psychiatry 2016; 3: 171–78
The authors argue that the global burden of mental illness is underestimated and examine the reasons for under-estimation to identify five main causes: overlap between psychiatric and neurological disorders; the grouping of suicide and self-harm as a separate category; conflation of all chronic pain syndromes with musculoskeletal disorders; exclusion of personality disorders from disease burden calculations; and inadequate consideration of the contribution of severe mental illness to mortality from associated causes. Their estimates place mental illness a distant first in global burden of disease in terms of years lived with disability (YLDs), and level with cardiovascular and circulatory diseases in terms of disability-adjusted life-years (DALYs). The unacceptable apathy of governments and funders of global health must be overcome to mitigate the human, social, and economic costs of mental illness.