Mental Health

The World Health Organization estimates that 1 in every 8 people in the world lives with a psychiatric disorder, with a 13% rise in psychiatric disorders and substance use seen in just the past decade.  The 2 most common psychiatric disorders, depression and anxiety, cost the global economy $1 trillion a year. In the United States, the Centers for Disease Control and Prevention estimates that more than 1 in 5 adults lives with a psychiatric disorder, and approximately 1 in 25 adults lives with serious mental illness (e.g., schizophrenia, bipolar disorder, major depression). Despite these striking statistics, the World Health Organization reports that the median global governmental expenditure on mental health is only 2%.  Although great strides have been made in the understanding of many areas of physical health over the past several decades, it can be argued that the same strides have not been made in the understanding of mental health.  This could be attributed to several factors, including the inherent challenges related to studying brain function, a largely crisis-based mental health–care system (particularly in the United States) that does not prioritize or enable the study of prevention, and widespread stigma that has made mental health issues less acceptable to disclose than physical health issues, thereby hindering our understanding of what it means to struggle with mental health.  It is also important to note that mental health and social factors are inextricably linked. Psychiatric disorders are not evenly distributed within populations, and like many health conditions, it is often the most structurally marginalized communities, both historically and currently, who bear the harshest burden of these disorders. Insofar as advancements in psychiatry have been particularly slow compared with those in other areas of health, it is important to reflect on how subpopulations affected by these disorders may not be those that we have chosen to prioritize for research and innovation.  Given this current context, there has never been a more important time for a special collection focused on mental health in the American Journal of Epidemiology.  Papers selected for inclusion in this collection present cutting-edge research in mental health in various forms—from new examinations of standing complex problems, to a focus on marginalized populations, to methods innovation. We hope this collection of articles is the first step in propelling the field toward overdue advancements in psychiatric epidemiology.

Jaimie L. Gradus and John R. Pamplin II, Guest Editors

The Papers