Emily Hewlett, OECD Health Division
Winston Churchill famously called it the ‘black dog’. “It is that absence of being able to envisage that you will ever be cheerful again. The absence of hope. That very deadened feeling, which is so very different from feeling sad,” said JK Rowling. “I don’t want to see anyone. I lie in the bedroom with the curtains drawn and nothingness washing over me like a sluggish wave… I am inadequate and stupid, without worth. I might as well be dead” wrote Margaret Atwood, in Cat’s Eye.
They were talking all about depression.
Across the world, millions of people are struggling with their own black dog. The OECD estimates that one in two people experience a mental illness in their lifetime, and some 20% of the working-age population is experiencing mental ill-health at any given time[i]. According to the WHO, depression is now the leading cause of ill-health and disability worldwide; globally, more than 300 million people are living with depression[ii]. While some people experience depression only briefly, others find themselves battling the black dog for long periods, or find it returning again and again. And when people are suffering from a mental disorder, it has big consequences across their lives: when people are living with mental ill-health they have poorer educational outcomes and a higher risk of dropping out of school[iii]; they are more likely to be dismissed from work and 2-3 times more likely to be unemployed[iv]; and in serious cases depression can lead to people harming themselves, or even dying from suicide[v].
The good news is that there are some very effective ways to help prevent mental illness and promote mental wellbeing, to treat depression and other disorders, and to support people who are living with mental ill-health. For instance, actions to prevent depression and anxiety can bring life-long economic benefits to mothers and children, while certain workplace interventions could reduce the cost of lost productivity – notably sickness absence and presenteeism – by up to a third[vi]. We know, too, that evidence-based services – like psychological therapies, early intervention approaches, or pharmacological therapies – can facilitate and speed-up recovery from depression. And we know that if employers and workplaces can provide a supportive environment, and thoughtfully facilitate return to work after a sickness absence for depression, then this can be good for the individual’s mental health and good for workplace productivity.
However, places where these effective, evidence-based policies have been rolled out are the exception, not the norm. People with depression too often face unsupportive or disengaged schools or workplaces, find inadequate treatment provision or long-waits to get help, and are still weighed down by a heavy burden of stigma. Today, on World Health Day, policy makers across the world must commit to putting care for depression and mental illness at the centre of their health systems, and their health policy priorities. More needs to be done.
We need better information, to understand what works, and where countries are falling short; at OECD, we are particularly keen to further improve, international benchmarking of data and policies so as to drive improvements across countries. We need innovation to find the effective, novel, adaptable and affordable policies that work, for depression and for all mental disorders. And we need implementation, so that better policies for depression can already start transforming peoples’ lives.
More needs to be done, and we should start today.
[i] OECD (2015), Fit Mind, Fit Job: From Evidence to Practice in Mental Health and Work, Mental Health and
Work, OECD Publishing, Paris. http://dx.doi.org/10.1787/9789264228283-en
[v] OECD (2015), Health at a Glance 2015: OECD Indicators, OECD Publishing, Paris. http://dx.doi.org/10.1787/health_glance-2015-en
[vi] OECD (Forthcoming, 2017), Understanding Effective Approaches to Promoting Mental Health and Preventing Mental Illness.
In October 1929, with storm clouds gathering, economist Irving Fisher warned against blind panic. “There may be a recession in stock prices, but not… a crash” since “Stocks have reached what looks like a permanently high plateau.”
A bit earlier, President Hoover could claim with pride that: “Given a chance to go forward with the policies of the last eight years, we shall soon with the help of God be in sight of the day when poverty will be banished from this nation.”
The working man would be the first to profit, with the US Department of Labor’s New Year’s Forecast promising that “1930 will be a splendid employment year.”
Entrepreneurs were buying their rose-tinted glasses from the same shop as politicians and academics. Thomas Watson, founder of IBM looked forward “with confidence to the progress of business in 1929“.
Then came Black Thursday, October 24th 1929, with the New York Stock Exchange down 11% on opening. Things improved temporarily in later trading, but a whole series of Blackdays lay in store and the stock market crash would soon provoke the worst depression the world had ever known.
It seems astonishing in retrospect that the optimism mentioned above seems to have been crash proof. The Chairman of the Continental Illinois Bank of Chicago stated that “This crash is not going to have much effect on business“. Away from the grubby world of wheeling and dealing, the Harvard Economic Society’s Weekly Letter dated January 18, 1930, agreed. “With the underlying conditions sound, we believe that the recession in general business will be checked shortly and that improvement will set in during the spring months.” The Letter went bankrupt shortly afterwards.
And today? You may remember the bemused question about the latest crisis Queen Elizabeth asked at the London School of Economics in November 2008: “Why did nobody notice it?”
For Professor John Kay of the London Business School and Oxford (and visiting Professor at LSE) one of the reasons is the dominant approach of the profession itself. “If much of the modern research agenda of the economics profession is thus unconnected to the everyday world of business and finance, this is also largely true of what is taught to students [who] could import data on GDP and consumer prices into a statistical package … but would be little better equipped than the person in the street to answer questions such as ‘why were nationalised industries more efficient in France than in Britain?’”
The Institute for New Economic Thinking asked a number of economists to respond to Kay. You can find their replies here.
What do you think? Have the economists and analysts got any better since the Great Depression, or is their main preoccupation explaining why their last forecast was wrong, but we should trust the new one?