The Pursuit of Happiness: paying greater attention to Mental Health

18 March 2016
By Natalia Linou and Jon Hall are policy specialists in, respectively, UNDP’s HIV, Health and Development team and the Human Development Report Office.

Sunday marks the United Nations’ 5th International Day of Happiness. Few people are against the pursuit of happiness, but many argue that governments – and international organisations for that matter – have no business in setting happiness as a public policy goal. And yet leaders around the world, from France to Japan, Italy to Qatar, are increasingly paying attention to it. Bhutan has long advocated for the use of a Gross National Happiness Index to provide a fuller assessment of national development progress than what is captured by Gross Domestic Product (GDP), while the US Surgeon General sees happiness as a part of the country’s public health agenda.

Economists and statisticians recognise that measuring happiness – or subjective wellbeing as it’s more accurately called - is a key step towards new policies. In a note to the General Assembly in 2013, the UN Secretary-General remarked: ”the pursuit of happiness is a stated objective in many national constitutions, and the creation of an enabling environment for improving people’s well-being is a development goal in itself. Overall, there is no doubt that Governments need to revisit their priorities. In the face of persistent, extreme poverty and global warming generated by current production systems, focusing on other measures of well-being beyond rising incomes can only be worthwhile”. Surveys of subjective wellbeing capture people’s day to day mood, as well as self-evaluations of satisfaction with one’s life or aspects of it (such as trust in institutions, health, community cohesion). And as the amount and analysis of data grows, experts are becoming convinced that the information provided by these indicators have valuable uses.

So if countries are able to measure happiness, how might the measures affect policy making? Subjective wellbeing offers another lens through which to look at policy. Around the world, a happiness perspective is influencing the way governments think about things as varied as Singapore’s prison system, cooperation between UK government departments to tackle climate change, or Korea’s response to the 2009 global financial crisis (1). Moreover, the media interest in life satisfaction measures can trigger richer, facts-based national conversations about many of the things that matter in life – vibrant communities, quality schools, fair institutions and more (because just about everything that is important, influences happiness).

Greater attention to measures of happiness, can also uncover under-resourced or under-recognized areas for action. Indeed, the UK’s Commission on Wellbeing and Policy found that mental health is the most important driver of wellbeing, more important than physical illness, income, employment, or family status. Yet, mental health, until recently, rarely featured in international development conversations. Professor Richard Layard, a co-editor of the World Happiness Reports, has argued that if any government was truly determined to improve happiness it would need very quickly to pay far greater attention to the population’s mental health and emotional wellbeing.

Health data support this view. A recent study, which pooled findings across surveys in a mix of high, middle and low income countries, reported that on average 18% (almost one in five) adults experienced a mental disorder within the last year. And the metric of Disability-adjusted life years (DALYs) which captures both what makes us sick and what kills us, suggests that the global burden of disease from mental and behavioral disorders is rising. Depression alone is now the second leading cause of years lived with disability worldwide.

If untreated, mental disorders can be an enormous source of misery, not only for individuals, but also for friends, families, and communities. Yet in many parts of the world, shame, stigma, and the absence of enough mental health care and diagnostics, means there are few options for millions of people in need. And sadly, many individuals living with severe mental illness are marginalized, mistreated, discriminated against, and denied basic human rights. It is time for the development community to acknowledge the need to do more.

The good news is that policy-makers are beginning to pay attention worldwide. Just months ago, New York City’s Mayor Bill de Blasio launched ThriveNYC, a comprehensive plan to improve mental health for all New Yorkers. And it isn’t only rich countries taking action. Ethiopia launched a National Mental Health Strategy, that addresses the human resource gap (there are only 40 psychiatrists in the country) by training primary health care workers, as well as extension workers (known in other places as community health workers), to provide mental health care. Community based approaches which empower lay people (members of civil society or faith-based organisations, neighbours, peers) to lead mental health interventions, can help reduce stigma while also expanding care. This April, the World Bank and the World Health Organization are co-hosting a high-level meeting on global mental health to share best practices and innovations, building on existing actions and commitments by the international community.

Reducing poverty and inequality, fighting discrimination and social exclusion, preventing environmental degradation, all matter greatly to the happiness of individuals, families, communities and nations. If, as development practitioners, we are able to help shatter the stigma around mental illness and ensure that policies are in place to promote the well-being and rights of those who live with it, our nations will be better off: happiness, mental health, and human development go hand in hand. Peoples' happiness, their emotional wellbeing and mental health, affect their ability to meet their full potential: to stay in school, hold a decent job, and contribute to family and community life. The reverse is also true: wellbeing is often the result of expanding opportunities for people to go to school, work a decent job, and be active in their communities. (2) The inclusion of targets on mental health and substance abuse in the Sustainable Development Goals was a much needed first step in including mental health in development discourse. Let this year’s World Happiness Day celebration reinforce that commitment to promote mental health and well-being, and help move us from words to analysis and action.

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Photo credit: UN Photo/Martine Perret

(1) “Using Wellbeing as a Guide to Policy”, Gus O’ Donnell: Chapter 6 of the World Happiness Report 2013, Helliwell, J., Layard, R. & Sachs, J. (Eds). (2013). New York: UN Sustainable Development Solutions Network.
(2) “From Capabilities to Contentment: Testing the Links Between Human Development and Life Satisfaction”, Jon Hall: Chapter 8 of the World Happiness Report 2013 Helliwell, J., Layard, R. & Sachs, J. (Eds). (2013). New York: UN Sustainable Development Solutions Network.