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.
HAPPY DANES
Photo: EPA/Bas Czerwinski
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.
Photo: AFP/Aref Karimi
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.
Eating disorders such as anorexia nervosa and bulimia are much more prevalent among females (3 percent) than males (0.2 percent). Boys, however, show higher rates than girls of problems in early childhood such as autism (0.9 percent, 0.2 percent) and learning disabilities (1.8 percent, 1.2 percent).
THE BIRTH OF ILLNESS
The Danish study also gives us a very clear sense of when mental health problems tend to arise. For both sexes and for most conditions, it usually manifests during adolescence and early adulthood. The statistics show a substantial increase in cases from ages 10 to 20, a peak in the early 20s, and then a steady decrease with age. Mood disorders such as depression, however, become more prevalent again after the age of 65, and another obvious exception to this pattern are organic problems such as dementia, for which rates rise dramatically from the age of about 70 (the lifetime risk of organic mental health problems in Denmark was 12 percent for women and 9 percent for men).
There is no reason to believe that the Danish statistics are anomalous. Well-run, scientifically credible epidemiological surveys suggest that each year 38 percent of those living in the EU experience mental illness, with anxiety disorders the most commonly experienced problem. That equates to 165 million people. Yet fewer than a third of these individuals receive any form of treatment, with even fewer given the most effective forms of intervention. The scale of distress to which these figures attest is reason enough for action. But policymakers might also take on board the fact that psychological problems are estimated to cost the EU EUR800bn annually.
Right now the UK is marking Mental Health Awareness Week. In the light of this timely reminder of how common mental illness is — even in the happiest countries — the stigma still attached to these conditions is remarkable. Pretty much everyone can expect either to experience a problem themselves or to know someone who has, and yet nine out of 10 people using mental health services in England report experiencing discrimination as a consequence, with much of that hostility coming from family and friends.
As a society, it is high time we faced up to the fact that mental illness is just as routine as physical illness (and assuredly no more shameful), and provided the high-quality, timely care that these conditions require.
A few weeks ago I found myself at a Family Mart talking with the morning shift worker there, who has become my coffee guy. Both of us were in a funk over the “unseasonable” warm weather, a state of mind known as “solastalgia” — distress produced by environmental change. In fact, the weather was not that out of the ordinary in boiling Central Taiwan, and likely cooler than the temperatures we will experience in the near-future. According to the Taiwan Adaptation Platform, between 1957 and 2006, summer lengthened by 27.8 days, while winter shrunk by 29.7 days. Winter is not
Taiwan’s post-World War II architecture, “practical, cheap and temporary,” not to mention “rather forgettable.” This was a characterization recently given by Taiwan-based historian John Ross on his Formosa Files podcast. Yet the 1960s and 1970s were, in fact, the period of Taiwan’s foundational building boom, which, to a great extent, defined the look of Taiwan’s cities, determining the way denizens live today. During this period, functionalist concrete blocks and Chinese nostalgia gave way to new interpretations of modernism, large planned communities and high-rise skyscrapers. It is currently the subject of a new exhibition at the Taipei Fine Arts Museum, Modern
March 25 to March 31 A 56-year-old Wu Li Yu-ke (吳李玉哥) was straightening out her artist son’s piles of drawings when she inadvertently flipped one over, revealing the blank backside of the paper. Absent-mindedly, she picked up a pencil and recalled how she used to sketch embroidery designs for her clothing business. Without clients and budget or labor constraints to worry about, Wu Li drew freely whatever image came to her mind. With much more free time now that her son had found a job, she found herself missing her home village in China, where she
In recent years, Slovakia has been seen as a highly democratic and Western-oriented Central European country. This image was reinforced by the election of the country’s first female president in 2019, efforts to provide extensive assistance to Ukraine and the strengthening of relations with Taiwan, all of which strengthened Slovakia’s position within the European Union. However, the latest developments in the country suggest that the situation is changing rapidly. As such, the presidential elections to be held on March 23 will be an indicator of whether Slovakia remains in the Western sphere of influence or moves eastward, notably towards Russia and