There is little doubt that mental illness is a major cause of human suffering around the world. But it can be harder to tackle than other deep problems like illness or poverty, in part because mental wellbeing is so hard to quantify.
That’s what the Mental Health Million project is all about Sapien Labs, a nonprofit organization founded in 2016 to study the human mind, aims to tackle. The group released its second annual last month Report Mental State of the Worldwho surveyed more than 220,000 people in 34 countries with his Mental health quotient (MHQ) questionnaire.
The questionnaire arose out of the group’s frustration at the lack of a single, comprehensive scoring tool that aimed to capture the full range of mental well-being in a population, not only in terms of disease or impairment, but also the positive side . After examining a number of existing clinical tools or questionnaires, they came up with a list of 47 elements to use as questions in the MHQ scale, which respondents could complete as an online questionnaire in approximately 15 minutes. The survey is available online for free to anyone willing to participate, and survey participants were actively recruited, primarily through Facebook and Google ads. (The researchers note that this may not result in a population representative sample, although the same methodology was used in all countries surveyed.)
This entry is used to calculate a total score between -100 and +200, with the entire range broken down into categories on a spectrum from “distressed” to “blooming”. The 47 total elements are also organized into five areas based on the aspect of well-being they focus on — mood and outlook, drive and motivation, social self, mind-body connection, and cognition — with separate scores for each. The MHQ has been validated and has been shown to give reliable results in resits, and “negative” scores correlate strongly with qualifying for a DSM-5 diagnosis, and the results are also predictive of productivity.
The initial results of the study are not reassuring.
The kids are not doing well
A notable finding was a worrying decline in mental well-being in the 18-24 age group. That’s a surprise: Previous studies on mental health – albeit mostly only in the US and using different measures – usually showed a U-shaped curve of well-being over the course of your lifewith the youngest and oldest groups doing best and a dive for the middle aged.
As concerns about the mental health of young people in the US have grown — a new CDC survey found that more than four in 10 adolescents felt “persistently sad or hopeless” – Tara Thiagarajan, the founder and chief scientist of Sapien Labs, told me, “It’s not a single country problem. It’s a global problem. ”
This trend was already in place before the Covid-19 pandemic, but deteriorated significantly between 2019 and 2021, with the overall percentage of people scoring in the “struggling” or “troubled” range doubling to 30 percent between 2019 and 2021. Notably, the decline correlated more closely with the severity of lockdown measures than with the direct damage from the pandemic.
The researchers considered several possible causes — income inequality, political instability, civil unrest — but none of these factors have consistently worsened around the world.
One factor is truly universal: increasing smartphone use and internet access. Despite of long-term care that exposure to smartphones and social media harms mental health, especially for young people, existing studies have yielded mixed results.
But the researchers behind the Mental Health Million report speculate that the most important factor may not be the Internet itself, but the time spent on the Internet. Recent global statistics suggest that people with internet access spend on average online for seven to ten hours a day, which could displace the face-to-face interaction essential to building a strong social self.
Building social skills and relationships takes time and experience. But Thiagarajan believes that the youngest generation “arrived and graduated at the age of 18-24 with a tenth of the expertise in solving social problems, coexisting and living together productively without conflict. And I think a lot of the turmoil and conflict might have something to do with that, because at 18 you now have the same experience dealing with people that a 7 or 8 year old had in the past.
Why well-being matters
If the existing decline in mental wellbeing among young people was related to internet use crowding out personal social time, it follows that the isolation of lockdowns would have hit the 18-24 cohort particularly hard. And previous studies show that lower rates of mental well-being at the national level correlate with higher rates of suicide, sexual assault and violent assault, especially for the 18-24 age group.
The Mental Health Million team hopes it will give MHQ a better understanding of this important issue. Admittedly, it’s imperfect: the questionnaire is only available online, in just four languages (English, Spanish, French and Arabic), and would have mostly attracted participants who could see online advertisements. This population may not be representative in a number of ways; First, Internet users, especially in poorer countries, are probably the wealthiest and most educated segment of the population and differ from the average in other ways.
Even in countries with more ubiquitous internet access, young people who spend the most time on the internet and thus may be harder hit by the resulting negative effects on well-being are likely to be overrepresented; conversely, for the elderly, the internet connoisseur may be better connected and educated than the norm for that age group, which could contribute to the consistently high reported well-being in the over-65s. Cultural factors can also influence how people interpret survey questions, as well as how they relate to the concept of well-being and mental illness; this makes the patterns found at the country level with cultural indicators more difficult to analyze.
Wealth does not always equal happiness
Countries and cultures seemed to affect mental well-being in other, unexpected ways. Counterintuitively, a higher national GDP in the survey was correlated with a lower self-reported well-being. The English speaking countries – USA, UK, Ireland, Canada, Australia and New Zealand; all developed, rich countries — had the worst average scores. “We were very surprised to see that,” said Thiagarajan.
The report also looked at cultural factors at the country level, using indicators compiled by the Globe project and with Geert Hofstede at Maastricht University† Of the factors examined, performance orientation, which measures the extent to which rewards and recognition are based on job performance, had the strongest negative correlation with the average MHQ scores in a country – despite the fact that societies that score high on this dimension tend to be more economically successful, with higher levels of human development.
On the other hand, the factors are greater power distance (cultures that accept an unequal, hierarchical distribution of power), uncertainty avoidance (cultures that emphasize social norms and rules), and group or family collectivism (communities that express pride, loyalty) and cohesion within families. ) are all positively correlated with mental well-being. As the report puts it, “All of these relationships paint a surprising yet consistent picture: A culture in which we are each for ourselves and judged and sorted by performance can be good for economic growth, but harmful to our collective mental well-being.”
Mental Health Million recognizes that their research data and report are only a first step and further research is needed. Their details are: available for researchers on demand, and some 20 organizations are already working with it in hopes of finding ways to improve mental wellbeing worldwide. According to Denver Brown, a psychology professor at the University of Texas who studies the effects of physical activity and sleep on mental health, “these findings suggest that we cannot use a compartmentalized approach to understanding mental well-being.”
In the past, the effects of policies on mental health have been difficult to measure; when decisions were made about Covid-19 lockdowns, it was almost impossible to take population well-being into account in the cost-benefit analysis. But the costs to mental wellbeing are real, and the Mental Health Million project shows we can’t ignore it.
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