A reuters article last week reported that according to a release from Mayor Bill de Blaiso’s office ahead of his mental-health initiative, one in five adult New Yorkers suffer from depression, substance misuse, suicidal thoughts or other psychological disorders every year. This seems to have caused some surprise in some quarters but the figure is largely in line with the available epidemiological evidence. Studies on depression (major depressive disorder) have consistently given background yearly prevalence of a figure between 3% to 8% depending on the country, with most clustering around 5%. Anxiety disorders, depending on how they are defined, have a yearly prevalence in excess of 3%. Conditions such as attention deficit hyperactivity disorder (ADHD) are reported to affect 8% of US children now. Learning difficulties are often defined against normative data, so by definition around 5% of the population would have a learning difficulty in any domain one tests, and this is broadly what the prevalence studies say. Suicidal ideation is often a feature of depression but can occur in other groups too. Maybe the largest contribution would be from the ‘substance misuse’ group. Considering many authorities define substance misuse as anything that constitutes harmful use, and that includes alcohol use in excess of 14 units per week for women and 21 units per week for men, it is easy to see how 1 in 5 New Yorkers might have a `psychological disorder` when the term is used as broadly as it is here. Politicians seem to be waking up to the fact that many people experience a problem with their mental health during their lifetime, and that these problems can have an impact on people`s friends and family. Given this high visibility, being seen to be doing something for what has often been a `Cinderella` field can play well. There is no doubt that mental health has a disproportionate impact on quality of life, and initiatives to improve mental health and wellbeing are very welcome.
