ABSTRACT
One in four: an oft-repeated statistic representing the number of people globally who will suffer from mental illness at some time in their lives. The alarmingly high figure has been stated so frequently that it has, perhaps, lost its sting. Yet, more recently the true figure has been recognised as being probably even higher. 1 In a 2014 survey in England, for example, 37% of adults between the ages of 16 and 74 (one in three) were in receipt of treatment for their mental health. 2 Given the growing elderly population worldwide, it is plain that the mental health burden is set to increase yet further, with approximately 9.9 million new cases of dementia globally each year. 3 To this must be added the widespread comorbidity of mental illness with substance use worldwide, 4particularly amongst men. In 2010, 10% of the total global burden of disease was held attributable to mental, neurological, and substance use disorders. 4 However, globally, the mental health burden is almost certainly underestimated too, perhaps by more than a third. 5
