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Abstract
We argue that the global burden of mental illness is underestimated and examine the
reasons for under-estimation to identify five main causes: overlap between psychiatric
and neurological disorders; the grouping of suicide and self-harm as a separate category;
conflation of all chronic pain syndromes with musculoskeletal disorders; exclusion
of personality disorders from disease burden calculations; and inadequate consideration
of the contribution of severe mental illness to mortality from associated causes.
Using published data, we estimate the disease burden for mental illness to show that
the global burden of mental illness accounts for 32·4% of years lived with disability
(YLDs) and 13·0% of disability-adjusted life-years (DALYs), instead of the earlier
estimates suggesting 21·2% of YLDs and 7·1% of DALYs. Currently used approaches underestimate
the burden of mental illness by more than a third. Our estimates place mental illness
a distant first in global burden of disease in terms of YLDs, and level with cardiovascular
and circulatory diseases in terms of DALYs. The unacceptable apathy of governments
and funders of global health must be overcome to mitigate the human, social, and economic
costs of mental illness.