Mental health gap: Why we need prevention, not just treatment

This article is authored by Dr Vikram Vora, medical director and chief health officer, International SOS.

Waiting for a heart attack to begin discussing cardiovascular health is not only foolish but can also be fatal. Even so, conversations about mental health and wellbeing often begin only when someone is no longer able to cope and reaches breaking point. And till that point is reached, the individual may have spent months or even years struggling quietly, while those around mistook exhaustion for commitment, withdrawal for disinterest, or distress for a temporary phase.

Mental health ((PIC FOR REPRESENTATION))

Mental health belongs in everyday discussions about how we live and work and not in hushed conversations hidden from the world. And they must receive the same legitimacy as that accorded to physical health.

Prevention cannot eliminate every mental health condition, and treatment is of course, essential. But being unwell is not evidence of personal failure. Timely care must accompany a sustained collective effort to reduce avoidable harm and create conditions for people to thrive in. Ever so often, prevention gets reduced to advice about individual resilience. Individual strategies like sleep, movement, meaningful relationships and time to recover do support wellbeing but asking someone to meditate while exposing them to relentless workloads, bullying or financial insecurity is unfair and overlooks the pressures surrounding them.

For employers, this makes prevention a leadership responsibility. A robust wellbeing strategy should influence staffing, deadlines, job design and how managers behave. Counselling services are valuable, but their availability does not excuse a culture that routinely exhausts people.

The practical questions to ask in every organisation are straightforward. Are workloads achievable within working hours? Can employees raise concerns without damaging their future prospects? Do leaders and managers respect leave and recovery time? When team members repeatedly report stress, does anything change?

Managers must be trained and equipped with the confidence to start a supportive conversation, listen without judgement and guide someone towards appropriate help. They should not be expected to diagnose colleagues. Employees should be able to retain control over what they disclose, with clear confidentiality safeguards and support that is accessible across roles, locations and shifts.

At an individual level, prevention starts by making room for honest reflection and routine conversation. “How have you been sleeping?” or “What is putting you under pressure?” may open a more useful exchange than a hurried “Are you okay?”

Persistent changes in mood, sleep or day-to-day functioning deserve attention and, where needed, professional advice. We must normalize seeking help before difficulties become overwhelming. Equally, importantly, we should avoid treating every difficult emotion as an illness. People need space to experience grief, frustration and uncertainty without being labelled.

Communities can help make this possible. Schools, neighborhood groups, health care services and community organisations must create opportunities for connection, strengthen understanding of mental health and make support easier to navigate. Conversations must also make sense across different languages, cultures and life circumstances.

Physicians in the community have a role to play--routine health care appointments offer an opportunity to ask about emotional wellbeing alongside physical symptoms.

We should judge corporate wellbeing initiatives by what they change in people’s daily lives. Meaningful questions must be asked about manageable demands, trust, access to support and whether employees feel safe asking for help.

The mental health gap begins well before a crisis or a clinical appointment. It grows whenever distress is dismissed, harmful conditions are accepted or help feels out of reach. Closing it requires everyday attention, shared responsibility and leaders willing to act on what they hear. Mental health conversations should be entered into early so that the outcome is positive and resilience (both individual and organisational) can be sustainable.

(The views expressed are personal)

This article is authored by Dr Vikram Vora, medical director and chief health officer, International SOS.