每七人就有一人：一項全球性研究告訴我們，我們的心理健康究竟出了什麼問題

他走進來時，穿著一件曲棍球球衣，背著一個後背包。十七歲，榮譽榜上的名字，球隊隊長。是他媽媽幫他掛的號。他一坐下來，就讓我很清楚地知道，他覺得這一切完全沒有必要。

「我很好，」A先生對我說。「是她太擔心了。」

我問他睡眠怎麼樣。他聳聳肩。「還好。」

食慾呢？又是一聳肩。「沒問題。」

這個賽季打曲棍球還開心嗎？就在這一刻，有什麼東西閃過他的眼神。他望向窗外。「不太有感覺，」他說。然後，聲音更輕了：「最近什麼事都提不起勁。」

那是一道門縫。我們又聊了四十分鐘。談到最後，A先生描述了將近兩年，整整快兩年的時間，他每天早上醒來，都感覺胸口有一塊說不清楚、也甩不掉的重量。他從來沒有告訴過任何人。不是教練，不是最好的朋友，也不是那個他「因為沒有力氣」而分手的女朋友。他靠著一股倔強撐住了成績，其他的一切都藏起來了。媽媽注意到他變了。他告訴自己那只是壓力。

他是一個沒有得到治療的憂鬱症患者，十七歲。從外表看，他是一個什麼都順風順水的孩子。

每次讀到心理健康的統計數字，我都會想起A先生，因為數字有一種讓痛苦變得遙遠、變得抽象的力量。A先生的痛苦，一點都不遙遠，一點都不抽象。而正如這個月發表在《刺胳針》（The Lancet）上的一項重磅新研究所揭示的，現在正有數量龐大的人在我們身邊走動，從外表看，他們完全沒事。

數字說了什麼

先說結論：2023年，全球將近十二億人正在與某種精神疾患共存。大約是地球上每七個人裡就有一個。而這個數字比1990年增加了95.5%，也就是說，在短短一代人的時間裡，全球精神疾病的負擔幾乎翻了一倍。

研究人員追蹤了204個國家和地區的12種不同心理健康狀況，每一種都上升了。首席研究員、昆士蘭大學的達米安·桑托毛羅（Damian Santomauro）博士說，他對「這個規模感到真的很震驚」。考量到這位研究者的整個職業生涯都在研究這個課題，這句話絕不是隨口說說。

增幅最大的兩種狀況，恰好是我在診間最常見到的：焦慮症，自1990年以來上升了158%；憂鬱症，上升了131%。當然，部分增幅反映了我們在辨識和診斷精神疾病方面做得比以前更好。汙名化減少了，篩檢改善了，走進診間的人多了。這些都是真正值得高興的消息。

但有一件事讓我夜裡睡不著：憂鬱症在新冠疫情期間急劇攀升，之後從未回到疫情前的水準。焦慮在那幾年達到高峰，從此居高不下。這不是統計上的雜訊。在全球規模上，人類正在經歷一些真實的事情，而我們有責任認真看待它。

這是每一個人的故事

當大多數人聽到這樣的統計數字，會有一種自然的衝動，想把它們歸入「別人的事」。生活更艱難的人。其他國家的人。原本就已經脆弱的人。我能理解這種衝動，但我也必須告訴你：它是錯的。

精神疾病不在乎你住在哪裡、賺多少錢、是什麼種族、信什麼宗教，或者你的履歷有多亮眼。它出現在頂層辦公室，也出現在擁擠的小公寓。它找上那些看起來有一千個理由可以快樂的人。它悄悄住進那些身穿球衣、成績優異的青少年的生命裡。它找到那些花了四十年當別人依靠的退休工程師。它安頓在那些覺得自己根本不應該這麼掙扎的新手媽媽身上。它不會敲門通知你。它不是性格缺陷。而且它比大多數人意識到的要普遍得多。

在美國，大約每五個成年人中就有一個，每年會經歷某種心理健康狀況。但這絕對不是美國獨有的問題。在巴西，重度憂鬱症是排名靠前的失能原因之一。在英國，心理健康問題是造成失能的最大單一來源。在澳洲，每年有五分之一的人符合精神疾患的診斷標準，而青少年自殺率一直在攀升。在奈及利亞，由於心理健康基礎設施嚴重不足，數十萬患有嚴重精神疾患的人在傳統或宗教療癒場所之間輾轉，只因為臨床照護根本無從取得。在世界的每一個角落，在每一種社群裡，都有人揹著從未告訴任何人的重擔。

《刺胳針》的研究跨越204個國家。其中沒有一個國家，精神疾病不是重大的公共衛生負擔。這是一個關於人的故事，而不是某個族群的故事。

亞洲正在發生什麼

這是整個討論中，尤其在西方媒體裡，遠遠沒有得到足夠關注的一部分。亞洲住著超過全球半數的人口，而那裡的心理健康危機既深重，又被嚴重低估。

先從中國說起。估計顯示，中國精神疾患的終身盛行率約為17%，涉及數億人。然而，根據《人口與發展評論》（Population and Development Review）期刊發表的研究，中國有超過90%有心理健康症狀的人從未接受過任何治療。更令人震驚的是，研究發現，中國有憂鬱症狀的人中，甚至有不到5%的人意識到自己的感受是一種有名字、有治療方法的疾病。他們不知道自己生病了。他們只知道有什麼地方不對勁，然後繼續撐下去。

在中國青少年中，一項全國性的綜合研究發現，17.5%的兒童和青少年有精神科狀況，其中以憂鬱和焦慮最為常見。2025年一項來自重慶的研究發現了一件格外令人心疼的事：許多曾經主動尋求心理健康照護的年輕人，事後反而感受到更深的汙名化，再也沒有回來。也就是說，在某些環境下，伸出手求助這個動作本身，非但沒有減輕他們的羞恥感，反而加深了它。這是一個在最關鍵的時刻讓人失望的系統。

南韓的情況格外觸目驚心。從2011年到2023年，自殺持續是南韓9至24歲人口死亡的頭號原因。不是意外，不是疾病，是自殺。南韓整體自殺率仍是已開發國家中最高的之一。研究持續將此與憂鬱症連結，也與一種文化氛圍有關——正如朝鮮大學一位心理學家兼教授所說，在南韓，「公開談論情緒問題依然是禁忌」。只有一小部分患有憂鬱症的南韓人尋求或獲得治療。大多數人默默受苦，因為開口求助感覺像是一種他們負擔不起的軟弱承認。

日本面臨著類似的矛盾。它是地球上身體最健康的國家之一，擁有全球數一數二的長壽紀錄。然而，它的自殺率長期偏高，尤其是老年人，這背後是根深蒂固的堅忍期待、對過勞的文化崇尚、老齡化社區的社會孤立，以及一個相對需求規模而言長期資金不足的心理健康體系。研究人員指出，日本和南韓都存在一個令人痛心的悖論：在體能健康和長壽方面創下非凡成就的國家，同時也是全球老年人自殺率最高的國家之一。

在香港，一項近期的區域研究發現，59%的受訪者處於心理健康的高風險狀態。這個數字折射出多年的政治動盪、社會不安、經濟焦慮，以及在長期不確定性中生活所帶來的特殊疲憊感。

放眼整個東亞，專家一再提醒，紙面上記錄的精神疾患率看起來往往低於西方國家，並不是因為痛苦比較少，而是因為汙名化的力量足夠強大，足以把痛苦藏起來。紙面上的數字幾乎可以肯定是嚴重低估了。真正的代價，被埋在沉默之下。

最沉的擔子，壓在最年輕的肩上

讓我來說說L女士的故事，因為她在我診間的經歷，是A先生故事的另一面，兩者加在一起，告訴你這場危機正在觸及的是哪些人。

L女士第一次來找我時34歲，由她的家庭醫師轉介，起因是常規篩檢顯示她有較高的焦慮症狀。她來赴我們第一次門診時，帶著一份分好類別的打字清單，列出她想涵蓋的主題，因為她擔心浪費我的時間。在談話開始後不到二十分鐘，我就清楚看出，她在大半輩子裡一直生活在一種近乎持續的、低度的焦慮狀態裡。她有兩個研究所學位，婚姻她形容為幸福，工作上也頗有成就。但她從來沒有把這一切和任何臨床狀況聯繫起來。她以為自己只是「容易擔心的人」。她以為躺著睡不著、腦子裡反覆演練各種假想災難是正常的。她以為全世界的人都是這樣感覺的，只是其他人比她更會應對。

「我不知道這是可以做些什麼的，」她告訴我。

L女士本可以在十年前就得到治療。她應該早就得到的。這讓我說到《刺胳針》新研究中或許最令人震驚的發現：自這項研究於1990年代初期開展以來，精神疾病失能負擔的高峰，有史以來第一次移到了15至19歲的年輕人身上。這從未發生過。過去，最重的擔子落在中年人身上。現在，它落在青少年身上。

這件事非同小可，因為青春期不只是人生的另一個階段。這是大腦正在完成最關鍵發展的時期，是身份認同、情緒調節以及真實人際連結能力的基礎正在奠定的時期。當精神疾病在這幾年降臨，影響不會整齊地待在青少年的那個章節裡。它們會向前蔓延，滲入之後的一切。

那麼，是什麼在驅動年輕人的這個趨勢？沒有單一答案。社群媒體是其中一部分：德州西南醫學中心2025年的一項研究發現，40%接受憂鬱症或自殺危機治療的年輕人有問題性社群媒體使用行為，而重度使用社群平台的青少年，出現心理健康不良狀況的可能性幾乎是輕度使用者的兩倍。但研究人員也警告，單純沒收手機並非解決之道。多項研究發現，單獨執行社群媒體禁令所產生的效果微弱且不一致。年輕人真正需要的，是真實的人際連結、懂得如何問出真心問題的成年人，以及能在事情悄悄惡化兩年之前就觸及他們的心理健康支持。

這一切為什麼會發生？

沒有整齊的答案。推動全球心理疾病上升的力量，是層層疊疊、相互交織的。經濟不穩定。創傷。貧窮。武裝衝突。糧食不安全。氣候焦慮。歧視。穩定社群的緩慢瓦解，以及孤獨作為一種生活方式的興起。世界衛生組織估計，全球超過六分之一的人正在經歷顯著的孤獨感，而這如今被認為是憂鬱、焦慮，乃至早死最強的風險因子之一。

這些壓力對每個人的影響並不平等。女性承擔著全球心理健康負擔中不成比例的份額。生活在貧困中的人更脆弱，卻也更難以獲得幫助。2025年發表於《JAMA Network Open》的一項研究發現，即使在控制了社會經濟因素之後，中國少數民族個體的憂鬱、焦慮和自殺意念比例，仍顯著高於漢族。在全世界，種族和族裔少數群體、難民、原住民社群，以及LGBTQ+群體，都面臨著複合的壓力，以及複合的照護障礙。

精神疾病本身沒有偏見。但那些讓人無法獲得幫助的系統，絕對是有偏見的。而這是我們真正可以改變的事。

需求與照護之間的鴻溝

《刺胳針》的作者直白說出了一件我認為值得大聲疾呼的事：精神疾病的上升「並未伴隨著心理健康服務的相應擴展」。換句話說，問題的成長速度，遠遠快過我們的回應速度。

在美國，在許多地區，等待看精神科醫師可能要等上好幾個月。住院精神科床位長期短缺。很多人即便名義上有保險，也負擔不起治療費用。在收入較低的國家，這個差距更為嚴峻。而在全球各地，患有嚴重精神疾病的人，平均比沒有精神疾病的人早死十到二十年，主要原因就是那些本可治療、卻從未得到治療的病症。

那些是可以預防的死亡。值得讓這句話在心裡停留一下。

仍然有理由抱持希望

我不想帶著這一堆沉重的數字離開你，因為數字不是故事的全部。

A先生回來了。他開始接受心理治療，過了一段時間又加了藥物治療。他告訴了他的教練。結果，他的教練多年前自己也曾和憂鬱症搏鬥，卻從來沒有告訴過任何人。A先生讀完了高中最後一年，進了大學，後來給我寄了一張簡短的便條，說他過得很好，想讓我知道。

L女士在接受治療後，多年來第一次整晚睡到天亮。她說那感覺「不真實」。她開始能分辨，什麼時候是焦慮症在說話，而不是現實。她說她感覺找回了一些自己，一些她不知道自己已經失去的部分。

這樣的故事並不罕見。在我的經驗裡，這就是當人們得到適當照護時會發生的事。憂鬱症對治療有反應。焦慮可以被管理、被減輕。即使是最嚴重的精神疾患，在得到妥善支持的情況下，也能讓人穩定下來，過上有意義的、有連結的生活。我們現在擁有的工具，比人類歷史上任何時刻都要好——從有充分實證的心理治療，到新型藥物，再到能夠在臨床醫師無法抵達的地方和時刻觸及人們的數位心理健康資源。

在汙名化方面，也有真實的、切實的進展。維吉尼亞理工卡里利恩醫學院的羅伯特·翠斯曼（Robert Trestman）博士說得很好：如今的人們「比過去更願意主動求助，而不是默默受苦」。美國心理學會執行長亞瑟·埃文斯（Arthur Evans）博士也指出，疾病的偵測和診斷已經有了實質性的改善。走進門的人更多了。這很重要。

那麼，我們能做什麼？

如果你正在掙扎，請告訴某個人。醫生、心理治療師、你信任的朋友、危機專線都可以。你不必等到全面崩潰才值得得到支持。你不必確定有什麼問題，才能開口求助。求助的意義，本來就是去弄清楚。

如果你是父母，請繼續問。不只是「今天學校怎麼樣」，而是「你最近真的還好嗎」。不只問一次，而是固定問，以一種讓孩子清楚知道答案不會讓你驚慌的方式問。A先生的媽媽注意到他不一樣了，在他覺得根本沒必要的情況下幫他掛了號。那次門診，改變了很多事。

如果你是老師、雇主、教練、社區領導者：不管你是否自願站上了第一線，你已經在那裡了。讓人們真正感到安全、可以說出「我不太好」的環境，不是軟弱的表現。它是有效的，而且它能救命。

如果你是政策制定者：數據是清楚的，已經清楚很久了，而且只會越來越清楚。精神疾病是全球失能最主要的原因之一。它在每個地方都在上升。而幾乎在每一個國家，應對它的基礎設施都跟不上。《刺胳針》的研究者說得直接：回應全球人口的心理健康需求「是一種義務，而不是一種選擇」。

十二億人。說著「我很好」、穿著球衣的孩子。坐在廚房地板上的退休工程師。帶著打字清單、從未有過一夜無憂的年輕媽媽。在東京和首爾撐著繼續往前走、因為沒有其他看起來可以接受的選擇的過勞上班族。他們全都是同一個人類故事的一部分。

我們有知識可以幫助他們。現在我們需要的，是去做的意志。

1 in 7: What a New Global Study Tells Us About the State of Our Mental Health

Mr. A came in wearing a lacrosse jersey and carrying a backpack. Seventeen years old, honor roll, captain of his team. His mom had made the appointment. He made it very clear, the second he sat down, that he thought the whole thing was unnecessary.

“I’m fine,” he told me. “She worries too much.”

I asked him how he was sleeping. He shrugged. “Okay.”

How was his appetite? Another shrug. “Fine.”

Was he enjoying lacrosse this season? And here, for just a moment, something flickered. He looked out the window. “Not really,” he said. Then, quieter: “Not really anything, lately.”

That was the crack in the door. We talked for another forty minutes. By the end, Mr. A was describing two years, nearly two full years, of waking up every morning feeling like there was a weight on his chest that he couldn’t explain and couldn’t shake. He had never told anyone. Not his coach, not his best friend, not the girlfriend he had broken up with because he “didn’t have the energy.” He had kept his grades up through sheer stubbornness and hidden everything else. His mother had noticed he seemed different. He had written it off as stress.

He was a seventeen-year-old with untreated depression. He looked, from the outside, like a kid who had everything going for him.

I think about Mr. A a lot when I read statistics about mental health, because statistics have a way of making suffering feel distant and abstract. Mr. A was neither. And as a sweeping new study published this month in The Lancet makes clear, there are a staggering number of people walking around right now who look, from the outside, completely fine.

The Numbers

Here is the headline: nearly 1.2 billion people worldwide were living with a mental disorder in 2023. That is about one in every seven people on the planet. And it represents a 95.5% increase since 1990, meaning the global burden of mental illness has roughly doubled in a single generation.

The researchers tracked 12 different mental health conditions across 204 countries and territories. Every single one went up. The lead author, Dr. Damian Santomauro of the University of Queensland, said he was “honestly shocked at the magnitude.” Given that this man has spent his career studying exactly this topic, that is not a throwaway comment.

The two biggest increases are in the conditions I see most often in my own practice: anxiety, up 158% since 1990, and depression, up 131%. Now, some of that increase reflects the fact that we are better at identifying and diagnosing mental illness than we used to be. Stigma has come down. Screening has improved. More people are walking through the door. All of that is genuinely good news.

But here is the thing that keeps me up at night: depression spiked sharply during the Covid-19 pandemic and has never come back down to where it was before. Anxiety peaked during those years and has stayed elevated ever since. These are not just statistical noise. Something real is happening to human beings on a global scale, and we owe it to ourselves to take that seriously.

This Is Everybody’s Story

When most people hear statistics like these, there is a natural impulse to mentally file them under “other people.” People with harder lives. People in other countries. People who were already vulnerable. I understand that impulse, but I also need you to know it is wrong.

Mental illness does not care about your zip code, your income, your race, your religion, or your resume. It shows up in corner offices and in cramped apartments. It visits people who seem to have every reason to be happy. It sits quietly in the lives of high-achieving teenagers in lacrosse jerseys. It finds retired engineers who spent forty years being the strong one. It settles in on new mothers who believe they simply should not be struggling this much. It does not announce itself. It is not a character flaw. And it is far more common than most people realize.

In the United States, roughly one in five adults experiences a mental health condition in any given year. But this is nowhere near a uniquely American problem. In Brazil, major depression ranks among the leading causes of disability. In the United Kingdom, mental health conditions are the single largest source of disability overall. In Australia, one in five people meets criteria for a mental disorder each year, and youth suicide rates have been climbing. In Nigeria, where mental health infrastructure is severely limited, hundreds of thousands of people cycle in and out of traditional or religious healing settings simply because clinical care is not accessible. In every corner of the world, in every kind of community, people are carrying things they have not told anyone about.

The Lancet study spans 204 countries. There is not one of them where mental illness is not a significant public health burden. This is a human story, not a demographic one.

What Is Happening in Asia

This is a part of the conversation that does not get nearly enough attention, especially in Western media. Asia is home to more than half the world’s population, and the mental health crisis there is both profound and profoundly undercounted.

Start with China. Estimates suggest that the lifetime prevalence of mental disorders in China is around 17%, which represents hundreds of millions of people. And yet, according to research published in the journal Population and Development Review, over 90% of people in China with mental health symptoms never receive any treatment. Even more striking, studies have found that fewer than 5% of people in China with depressive symptoms are even aware that what they’re experiencing is a recognized condition with a name and a treatment. They don’t know they’re sick. They just know something feels wrong, and they push through.

Among Chinese adolescents, a comprehensive national study found that 17.5% had psychiatric conditions, with depression and anxiety the most common. A 2025 study out of Chongqing found something especially heartbreaking: many young people who did seek mental health care once were actually more likely to feel stigmatized afterward, and never came back. So the very act of reaching out for help, in some settings, deepened their shame rather than relieving it. That is a system failing people at the most critical moment.

South Korea tells a particularly striking story. From 2011 through 2023, suicide was the leading cause of death among South Koreans between the ages of 9 and 24. Not accidents. Not illness. Suicide. The country’s overall suicide rate remains among the highest in the developed world. Research consistently links this to depression and to a cultural environment where, as one psychologist and professor at Chosun University put it, “talking openly about emotional problems is still taboo.” Only a small fraction of South Koreans with depression seek or receive treatment. Most people suffer quietly, because asking for help feels like an admission of weakness they cannot afford to make.

Japan faces a similar paradox. It is one of the physically healthiest nations on earth, with some of the longest lifespans anywhere. And yet it has persistently high suicide rates, particularly among older adults, driven by deep-rooted expectations of stoicism, the cultural glorification of overwork, social isolation in aging communities, and a mental health system that remains chronically underfunded relative to the scale of need. Researchers have noted a painful irony in both Japan and South Korea: countries that have achieved remarkable things in terms of physical health and longevity also have some of the highest rates of suicide among older adults in the world.

In Hong Kong, a recent regional study found that 59% of respondents were at high risk for mental health challenges, a number that reflects years of political turmoil, social unrest, economic anxiety, and the particular exhaustion of living through extended uncertainty.

Across East Asia broadly, experts caution that recorded mental disorder rates often look lower than those in Western nations, not because suffering is rarer, but because stigma is powerful enough to keep it hidden. The numbers on paper are almost certainly a significant undercount. The real toll is buried under silence.

Our Youngest People Are Carrying the Most

Let me tell you about Mrs. L, because her story is the counterpart to Mr. A’s in my practice, and together they tell you something important about who this crisis is touching.

Mrs. L was 34 when she first came to see me, referred by her primary care doctor after a routine screening flagged elevated anxiety. She arrived to our first appointment with a typed list of topics she wanted to cover, organized by category, because she was worried about wasting my time. Within the first twenty minutes of talking, it became clear she had been living in a state of nearly constant, low-grade anxiety for most of her adult life. She had two graduate degrees, a marriage she described as loving, a career she was good at. She had never connected any of this to a clinical condition. She thought she was “just a worrier.” She thought it was normal to lie awake running through hypothetical catastrophes. She thought the rest of the world felt this way too and was simply better at handling it.

“I didn’t know this was something you could actually do something about,” she told me.

Mrs. L could have been treated a decade earlier. She should have been. Which brings me to what may be the most alarming finding in the new Lancet study: for the first time in the history of this research, which dates back to the early 1990s, the peak burden of mental illness disability has shifted to young people between 15 and 19 years old. This has never happened before. Historically, the heaviest burden fell on middle-aged adults. Now it falls on teenagers.

This matters because adolescence is not just another life stage. It is the period when the brain is finishing some of its most critical development, when the foundations of identity, emotional regulation, and the capacity for real human connection are being built. When mental illness lands during these years, the effects don’t stay neatly contained in the teenage chapter. They ripple forward into everything that comes next.

So what is driving this in young people? There is no single answer. Social media is part of it: a 2025 study from UT Southwestern Medical Center found that 40% of depressed or suicidal young people reported problematic social media use, and teens who spend heavy amounts of time on these platforms are nearly twice as likely to report poor mental health compared to light users. But researchers also caution that simply taking phones away is not the solution. Multiple studies have found that social media bans alone produce weak or inconsistent results. What young people actually need is genuine human connection, trusted adults who know how to ask real questions, and mental health support that reaches them early, before things have quietly gone wrong for two years.

Why Is This Happening?

There is no tidy answer. The forces driving this global rise are layered and interconnected. Economic instability. Trauma. Poverty. Armed conflict. Food insecurity. Climate anxiety. Discrimination. The slow unraveling of stable communities and the rise of loneliness as a way of life. The World Health Organization estimates that more than one in six people globally experiences significant loneliness, which is now recognized as one of the strongest risk factors for depression, anxiety, and even early death.

These pressures don’t affect everyone equally. Women carry a disproportionate share of the global mental health burden. People living in poverty are more vulnerable and far less likely to get help. A 2025 study published in JAMA Network Open found that ethnic minority individuals in China had significantly higher rates of depression, anxiety, and suicidal ideation than their Han counterparts, even after controlling for socioeconomic factors. Across the world, racial and ethnic minorities, refugees, indigenous communities, and LGBTQ+ individuals face compounding stressors and compounding barriers to care.

Mental illness itself is not biased. But the systems that leave people without help absolutely are, and that is something we can actually change.

The Gap Between Need and Care

The Lancet authors put something plainly that I think deserves to be said loudly: the rise in mental illness “has not been accompanied by proportional expansion of mental health services.” In other words, the problem is growing much faster than our response to it.

In the United States, the average wait to see a psychiatrist can stretch to months in many parts of the country. Inpatient psychiatric beds are chronically scarce. Many people can’t afford therapy even when they technically have insurance. In lower-income countries, the gap is even more severe. And across the world, people with severe mental illness die on average ten to twenty years earlier than those without, largely because of conditions that were treatable but went untreated.

Those are preventable deaths. It is worth sitting with that for a moment.

The Reason for Hope

I do not want to leave you here, with all these heavy numbers, because numbers are not the whole story.

Mr. A came back. He started therapy and, after a while, medication. He told his coach. His coach, it turned out, had struggled with depression himself years earlier and had never told anyone either. Mr. A finished his senior year, went to college, and sent me a brief note that just said he was doing well and wanted me to know.

Mrs. L, with treatment, started sleeping through the night for the first time in years. She called it “surreal.” She started recognizing when the anxiety was the condition talking, not reality. She said she felt like she got parts of herself back she hadn’t realized she had lost.

These stories are not rare. They are, in my experience, what happens when people get appropriate care. Depression responds to treatment. Anxiety can be managed. Even the most serious psychiatric conditions can be stabilized in ways that allow people to live meaningful, connected lives. We have better tools now than at any previous point in history, from well-studied therapies to newer classes of medication to digital mental health resources that can reach people in places and moments where a clinician cannot.

There is also genuine, real progress on stigma. Dr. Robert Trestman of the Virginia Tech Carilion School of Medicine put it well: people today are “much more comfortable coming forward, as opposed to suffering in silence.” Dr. Arthur Evans of the American Psychological Association has noted that detection and diagnosis have meaningfully improved. More people are walking through the door. That matters.

So, What Do We Do?

If you are struggling, please tell someone. A doctor, a therapist, a friend you trust, a crisis line. You do not have to be in a full-blown crisis to deserve support. You don’t have to be certain something is wrong before you reach out. The whole point of reaching out is to find out.

If you are a parent, keep asking. Not just “how was school” but “how are you actually doing.” Not just once, but regularly, in a way that makes it clear the answer won’t alarm you. Mr. A’s mom noticed something was off and made the appointment even when he thought it was unnecessary. That appointment changed things.

If you are a teacher, an employer, a coach, a community leader: you are on the front lines whether you signed up for it or not. Environments where people feel genuinely safe to say “I’m not okay” are not soft. They are effective, and they save lives.

And if you are a policymaker: the data is clear, it has been clear for a while, and it is getting clearer. Mental illness is among the leading causes of disability in the world. It is rising everywhere. And the infrastructure to address it, in almost every country, is not keeping up. The Lancet researchers said it plainly: meeting the mental health needs of the global population “is an obligation, not a choice.”

1.2 billion people. Kids in lacrosse jerseys who say they’re fine. Retired engineers sitting on kitchen floors. Young mothers with typed lists who have never known a night without worry. Overworked professionals in Tokyo and Seoul pushing through because there is no other option that feels acceptable. All of them part of the same human story.

We have the knowledge to help. What we need now is the will to do it.

作者：Dr. Bob Lee, DO, MS, MBA
Chief Resident Physician, Department of Psychiatry & Behavioral Sciences
Child and Adolescent Psychiatry Fellow
Nassau University Medical Center