Tue, May 20, 2014 - Page 12 News List

Mental illness affects us all — even in the happiest country on Earth

It’s high time we faced up to the fact that mental illness is commonplace and no more shameful than physical illness

By Daniel Freeman and Jason Freeman  /  The Guardian

A plastinated human exhibit by German anatomist Gunther von Hagens is on display in ‘Body Worlds: The Happiness Project’ in Amsterdam, The Netherlands, in January.

Photo: EPA/Bas Czerwinski

Which is the happiest nation on the planet? Fans of The Killing may be surprised to learn that it is Denmark. Nordic noir offers us a claustrophobic country shrouded in fog and lashed by icy rain, stalked by serial killers and riddled with corruption: a land from which noble souls such as Sarah Lund are compelled to flee, never — sadly — to be seen again.

In stark contrast, the World Happiness Report 2013, written by leading academics, finds that levels of self-reported happiness are higher in Denmark than anywhere else, with fellow Scandinavian countries Norway and Sweden also in the top five. The UK is 22nd and the US 17th. The lowest ranked nations — out of 156 — are Rwanda, Burundi, the Central African Republic, Benin and last of all Togo.


Why are the Danish so happy? The World Happiness Report cites factors such as healthy life expectancy, GDP per capita, levels of social support, freedom to make life choices, perceptions of corruption and the degree of generosity shown by citizens. Other experts have highlighted Denmark’s high degree of income equality: this is a country, it seems, where people truly are “in it together.”

Given that levels of happiness are so high in Denmark, it is reasonable to assume that Danes also enjoy good mental health. But a study published this month by the American Medical Association tells a very different story — one that demonstrates just how common mental health problems are, regardless of where people happen to live.

One of the many positive aspects of life in Denmark is its universal health care system. As part of that system, treatment for mental illness is recorded in the Danish Psychiatric Research Register: a resource that provides scientists with a treasure trove of data. Since 1969, for every person living in Denmark the register has logged admissions to psychiatric hospitals, visits to outpatient psychiatric clinics, attendance at psychiatric emergency departments and all diagnoses. As such, it provides a comprehensive and uniquely detailed picture of treatment for psychological problems in the country.

On the basis of the register’s data, researchers estimated that 38 percent of Danish women and 32 percent of Danish men will receive treatment for a mental disorder at some point during their lifetime. Remember: these statistics only include cases serious enough for professional help to be required. Of course, there are likely to be many more people with mental health conditions who for one reason or another don’t seek treatment. This is why representative epidemiological surveys often produce even higher estimates for mental ill health than the Danish study. But for all those who criticize such surveys for including problems that are mild or transient, this latest research constitutes a forceful riposte. Mental illness is not a figment of over-eager clinicians’ imagination; the problem is real and widespread.

The Danish results contain fascinating details. As we have noted in a previous article, women are more likely than men to develop a mental health problem, and this pattern is certainly evident in Denmark. We also see the classic dichotomy in the types of mental health problem experienced by men and women. When it comes to so-called “internalizing” conditions, rates for Danish women are higher than for Danish men: for anxiety disorders 19 percent of women will receive treatment compared with 13 percent of men; for depression the figures are 16 percent and 9 percent respectively. Men, on the other hand, are more vulnerable to “externalizing” disorders: in Denmark 8 percent of men will receive treatment for alcohol or drug problems, twice the figure for women.

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