“No Health Without Mental Health”: Why It Matters More Than Ever

Everyone knows that health is about physical well-being, such as disease prevention and living a healthy lifestyle by engaging in diets and various exercises.  But what does the common person think about mental health? Over 15 years ago, a seminal paper, “No Health without Mental Health” by Prince et al., (2007) was published in the Lancet. The paper was the first of a series of six papers that addressed global mental health and emphasised the disorders that significantly contributed to the global burden of disease.  However, even today global mental health might still be under-prioritised in low- and middle-income countries' health systems and too often remains separate from mainstream health care policies.

In this post, I shall review that mental health is just as vital as physical health and how the conversation has evolved from the Millennium Development Goals (MDGs) to today's Sustainable Development Goals (SDGs).  

The Missing Piece in Global Health.

According to the World Health Organisation (WHO) approximately 1 billion men and women suffer from a mental illness and 1 person dies from completed suicide every 40 second. This data indicates that 450,000 or 7 out of every 1,000 families has a mental disorder. Did you know that neuropsychiatric disorders such as depression, anxiety and schizophrenia account for about 14% of the global disease burden? In other words, these illnesses contribute to more disability worldwide than some physical illnesses such as heart disease or cancer. So, we know that these figures underscore the difficulties of mental illnesses on individuals and societies.  Despite these alarming figures, mental health has historically been excluded in global health discussions, and the focus of healthcare spending is usually focused on treating physical disease. It should be emphasised that many figures might be conservative due to the complex interactions between mental and physical health. The reality is that mental disorders do not just affect emotion! Mental illness can impact everything in an individual’s life and is a critical factor in well-being.

Mind and Body: An Inseparable Connection

One of the main themes that is highlighted in the paper is the interconnectedness of mental and physical health. The authors discuss the effects of mental illness such as an increased risk of both communicable and non-communicable diseases, unintentional and internal injuries with adverse outcomes of disability and even death. How does this happen? An example would be an individual suffering from chronic depression who might not be motivated to adhere to a treatment plan nor attend appointments for regular check-ups for any major illnesses. In the same way, anxiety or depression could be triggered in a person after they are given a diagnosis of a serious illness such as cancer or heart disease.

From MDGs to SDGs: A Shift in Priorities 

In 2007 when Price et al published their study, the world was navigating through the Millenium Development Goals (MDGs) which focused on reducing poverty, gender equality and improving health by 2015. Although the MDGs did not explicitly mention mental health the paper did highlight the relevance to key targets in maternal and child health. 

Fast forward to 2025, the world is now working towards the Sustainable Development Goals (SDGs) which were adopted in 2015. This is a more holistic global agenda where mental health is recognised as a priority under Goal 3: Good Health and Well-being. The target includes a reduction in premature deaths from non-communicable diseases and to promote mental well-being. 

This shift is highly significant as it means that governments around the world are investing in mental health services and integrating psychological care into general healthcare while also tackling stigma. It should be noted that although there is growing acknowledgment of global developmental priority, many socio-economic challenges which are highlighted in the paper such as poverty, gender-based violence and lack of access to healthcare continue to impact mental health outcomes……so, room for improvement. 

Why this matters.

Mental health is a growing concern across the globe without exception. Although increased awareness has been very useful, stigma remains a barrier when an individual needs help. Sadly, many societies continue to believe that mental health is a personal weakness and not necessarily a medical condition that requires professional intervention. Post covid most regions saw a rise in the number of cases related to stress disorder, anxiety and depression amongst young people and professionals as high-pressure environments became more common.

Prince et al., argue that effective mental health services/interventions should be integrated into existing health programmes and chronic disease management. Health care systems need to be strengthened to deliver integrated care, and the authors also advocate for training of primary health care workers into mental health identification and management.

Wu et al., in 2023 shared the same message. Using the annual percentage change (APC), the authors found that between 1990 and 2019, mental disorders had increased significantly. Their study indicated that the numbers increased significantly in men but decreased in women with the adult population having the highest incidence. Furthermore, orbidity traits might be higher due to increased stressors in modern society. Thus, the authors urged the creation of policies formulated to promote mental health with more attention to vulnerable or individuals at higher risk in society.

Moving Forward

Prince et al., (2007) conclude with a powerful message that there is “no health without mental health”. Communities with the support of government, and healthcare providers must work towards reducing stigma with more open conversations revolving around mental well-being. People need to be encouraged to seek help without fear of being labelled. Good mental health is an all-round win-win situation as it supports economic productivity, education and overall well-being. So the message is simpler than ever: Mental well-being is not a luxury, it is a necessity.

Nivs D (31st March 2025)

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Further reading:

Arensman, E., Scott, V., De Leo, D. and Pirkis, J. (2020). Suicide and Suicide Prevention From a Global Perspective. Crisis, 41(Supplement 1), pp.S3–S7. doi:https://doi.org/10.1027/0227-5910/a000664 

Prince, M. (2007). No Health without Mental Health. The Lancet, [online] 370(9590), pp.859–877. doi:https://doi.org/10.1016/S0140-6736(07)61238-0.

Wu, Y., Wang, L., Tao, M., Cao, H., Yuan, H., Ye, M., Chen, X., Wang, K. and Zhu, C. (2023). Changing trends in the global burden of mental disorders from 1990 to 2019 and predicted levels in 25 years. Epidemiology and Psychiatric Sciences, [online] 32(32), p.e63. doi:https://doi.org/10.1017/S2045796023000756 .