Is "Black lives matter" a public health issue?

Is mental health a public health issue?

According to the World Health Organisation (WHO), public health seeks to promote health; prolong life and prevent diseases. It helps individuals, organisations and even communities to address issues of preventable disease, mortality and disability. 

While mental health, helps to improve the general well-being of an individual, their quality of life, it is protective against acute and chronic physical illnesses. Mental health goes beyond an absence of mental illness. It includes, promotion of mental health and general well being. Thereby, tackling preventable diseases, morbidity and mortality. This shows that mental health is a public health issue.

The challenges faced by people of colour (especially blacks) include:

Non-acceptance

Racial profiling/being unfairly stopped by the police and police brutality.

Unemployment and rejection from schools and platforms.

Institutional racism, blacks world wide still face institutional hurdles to get a good job than their white counterparts (Weller, 2019).

Stereotyping

Emotional and social abuse. People acting like they are not smart; being subject to slurs or tasteless jokes and false accusations.

Some are being subject to hate crimes.

Leaving symbols and statutes of slave trader even after a petition has been signed by thousands of people and also slow response to getting justice (Siddique, 2020). 

Can these challenges be a mental health issue?

According to the National Health Service, NHS (2015), Unemployment has been linked to an increased suicide risk through mechanisms like depression, anxiety disorders; reduced accessibility and affordability of mental health care as a result of financial strain. Many studies have implicated unemployment to have a strong association with suicide.

Also according to Faulkner (2019) who is a mental health research expert, interpersonal racism like aggression and micro-aggression, bullying and harassment can have a subtle but harmful effect on the victims of racism. This can be generational, affecting the mental health of children. The effect of structural and interpersonal racism could lead to psychosis, pessimism, trauma, depression, anger and in general post-traumatic stress disorder. Consequently, all forms of racism and the challenges highlighted above, impedes mental well-being and so is a public health issue. The diagram below, from WHO (2009) illustrates this relationship.

How are public health issues addressed?

• Identifying the key areas or problems.
• Identifying stakeholders.
• Continuous communication with stakeholders.
• Analysing strategies with stakeholders.
• Implementing the strategies.
• Evaluation

Is addressing racism, as a public health prevention strategy more cost-effective?

According to the WHO (2013), cost of treating disease continues to increase especially in Europe and it is unsustainable. Mental illness costs the United Kingdom economy up to 110 billion pounds per year which is about 10.8% of the health service budget. Cost effectiveness of mental health promotion and prevention of depression was seen to be less than 20,000 per QALY (Quality adjusted Life years) when compared to treating the disease. Some of the mental health prevention strategies that are directly linked to racism and offer both quick wins and long term wins  include:

• Bullying prevention
• Mental health promotion in workplace.
• Social and emotional learning.
• Violence prevention policies.
• Family support
• Prevention of depression.
• Parenting programmes

Also the table below gives us a rough idea of the costs of not acting timely on issues relating to mental health.

Cost of not acting: health outcomes (table below is from WHO, 2013)

QALY: is a unit of measurement that shows life-years gains as a result of implementing a health intervention, in this case mental health promotion and disease prevention, with a judgement about the quality of life.

Why is it not being treated as a global health issue? 

With all the cost benefits of addressing racism as a potential mental health issue, why is racism not been addressed and discussed openly?

What are your thoughts?

REFERENCES

Faulkner, A. (2019). The impact of racism on mental health. 

https://www.nationalelfservice.net/populations-and-settings/black-and-minority-ethnic/racism-mental-health/

National Health Service (2015). Unemployment and Job insecurity linked to increased risk of suicide.

https://www.nhs.uk/news/mental-health/unemployment-and-job-insecurity-linked-to-increased-risk-of-suicide/

Siddique, H. (2020). BLM protesters topple statue of Bristol slave trader, Edward Colston

https://www.theguardian.com/uk-news/2020/jun/07/blm-protesters-topple-statue-of-bristol-slave-trader-edward-colston

World Health Organization (2014) The case for investing in public health. 

http://www.euro.who.int/__data/assets/pdf_file/0009/278073/Case-Investing-Public-Health.pdf?ua=1

World Health Organization (2013) Olso Conference on health systeams and the economic crisis. http://www.euro.who.int/en/media-centre/events/events/2013/04/oslo-conference-on-health-systems-and-the-economic-crisis/documentation/working-documents/health-systems-in-times-of-global-economic-crisis-an-update-of-the-situation-in-the-who-european-region.

World Health Organization (2009) Mental health, policy and development.

://www.who.int/mental_health/policy/development/en/

Weller, C.E. (2019) African Americans face systematic obstacles to getting good jobs.

https://www.americanprogress.org/issues/economy/reports/2019/12/05/478150/african-americans-face-systematic-obstacles-getting-good-jobs/