The number of people living with mental health conditions has surged to 1.2 billion worldwide, nearly doubling since 1990, according to a new analysis published in The Lancet as part of the Global Burden of Disease Study 2023. The sharpest increases were recorded for major depressive disorder and anxiety disorders, which rose by 131% and 158% respectively, making them the two most common mental health conditions globally.
“Responding to the mental health needs of our global population, especially those most vulnerable, is an obligation, not a choice,” the authors wrote. The report describes mental disorders as widespread illnesses that cause major human suffering and long-term health loss, affecting not only individuals but also families, workplaces, and governments through reduced productivity, lower workforce participation, and growing pressure on welfare and healthcare systems.
Uneven burden across genders and ages
The burden is not distributed evenly. Researchers estimated 620 million cases among females and 552 million among males, though they noted limited research into the drivers of this sex difference. “Compared with males, females experience lower self-esteem, greater tendency towards body-related shame, and higher rates of domestic violence and sexual abuse,” the report said. Biological changes, particularly during the peripartum period, increased career responsibilities, and structural inequalities such as gender discrimination were also cited as contributing factors.
Among women, depression and anxiety were the most common conditions, while persistent depressive disorder, bipolar disorder, anorexia nervosa, and bulimia nervosa were also more prevalent. In contrast, neurodevelopmental and behavioural conditions—including ADHD, conduct disorder, and autism—were more common among men. The highest mental health burden globally was found among teenagers aged 15 to 19, underscoring the need for earlier prevention and targeted support for young people.
Risk factors and complex causes
The study identified several major risk factors linked to mental illness, including childhood sexual violence, intimate partner violence, and bullying. These were associated with conditions such as schizophrenia, depression, bipolar disorder, anxiety disorders, conduct disorder, and bulimia nervosa. However, researchers cautioned that these factors alone do not explain the surge. Exposure rates remained relatively stable over time and accounted for only 18% of mental disorder Disability-Adjusted Life Years (DALYs) in 2023—a measure of years of healthy life lost due to illness or disability.
The authors argue that mental health outcomes are likely shaped by a more complex mix of influences, including genetics, biology, poverty, rising inequality, and major global crises such as war, pandemics, natural disasters, and climate change. Although mental disorders have long been one of the leading causes of disability worldwide, the report warns that the global burden is continuing to worsen. At the same time, the expansion of mental health services has failed to keep pace with growing demand. “Concerningly, this increase in burden has not been accompanied by proportional expansion of mental health services globally,” the authors wrote.
For Europe, the findings carry particular weight. The continent’s health systems, already strained by ageing populations and recent crises, face mounting pressure to address mental health. Countries like Germany, France, and the UK have seen rising demand for psychological services, with waiting times for therapy often stretching months. The study’s emphasis on adolescent mental health also resonates in European cities such as Berlin, Paris, and Stockholm, where youth mental health services are increasingly seen as underfunded. As the EU debates its next health budget, these data may strengthen calls for a dedicated mental health strategy, similar to the bloc’s recent efforts on cancer and pandemic preparedness.
