OPINION: Mental Health is the New Economic Imperative

By Chaneil Imhoff

Each October, the world pauses to acknowledge Mental Health Awareness Month, yet too often, the conversation remains confined to awareness rather than action.

In truth, mental well-being is not just a health issue but an economic necessity. A country’s ability to grow, innovate, and sustain development depends on the mental wellness of its people. Without it, no policy, investment, or technology can deliver the future we aspire to.

According to the World Health Organization (WHO), more than one billion people are living with mental health conditions globally, with depression and anxiety disorders costing the world economy an estimated US $1 trillion annually in lost productivity.

The International Labour Organization (ILO) further reports that roughly 12 billion working days are lost every year due to mental distress, through absenteeism, burnout, and presenteeism, quietly eroding productivity and economic stability across every region.

For small island developing states like ours, the impact is even more pronounced. Our economies rely heavily on human capital and the creativity, empathy, and resilience of people who power the tourism, education, and service industries. When those people are unwell, economies stall. The Organisation for Economic Co-operation and Development (OECD) estimates that in some nations, the cost of mental ill-health exceeds 4 percent of GDP, surpassing many countries’ education budgets. This means that the mental health crisis is not simply a moral issue but an economic emergency.

Here in Antigua and Barbuda, we stand at a turning point. For the first time in nearly seventy years, the government is on the verge of introducing a new Mental Health Bill, crafted with technical support from the Pan American Health Organization (PAHO). This long-overdue reform will replace the outdated Mental Treatment Act of 1957, which reflects an era when mental illness was treated with confinement and stigma, rather than compassion and science. The new legislation will bring our national laws in line with international human rights standards thus ensuring voluntary care wherever possible, protecting against discrimination, and expanding access to mental health services across communities.

In September 2025, a PAHO mission to Antigua and Barbuda engaged government officials, healthcare professionals, and civil society in finalizing the bill. The consultations emphasized a shift from institutional care to community-based, rights-oriented models, aligning with WHO’s call for integrating mental health into all areas of health and social policy. The mission also assessed facilities for potential expansion of mental wellness services and held public awareness activities to ensure citizens’ voices were heard in the reform process.
(PAHO, “PAHO advances mental health reform in Antigua and Barbuda,” 2025)

This goes beyond health reform and into the realm of economic strategy. When people receive timely and dignified mental health care, they are better able to work, create, and contribute to the nation’s growth. When stigma is reduced, workplaces become more inclusive and productive. And when care is accessible in every community, families are strengthened, social systems become more cohesive, and national resilience improves.

Antigua and Barbuda’s collaboration with PAHO through the Multi-Country Cooperation Strategy (MCCS) which is a five-year regional plan prioritizing mental health, equity, and primary-care integration — marks a critical shift in how our nation approaches well-being. Earlier this year, Antigua and Barbuda also co-hosted the hemispheric event “Uniting the Americas for Mental Health: From Commitment to Action” during the OAS General Assembly, helping to set a regional agenda that positions mental wellness as central to sustainable development.
(PAHO Event, June 2025)

The Caribbean’s development realities make this issue especially urgent. Economic uncertainty, high living costs, climate-related disasters, and the lingering effects of colonial trauma all contribute to rising stress, anxiety, and depression. The ILO warns that precarious work, job insecurity, and informal employment are among the leading psychosocial risk factors for poor mental health. And Unfortunately, nearly half of Caribbean workers experience one or more of these conditions. When workers are anxious, overextended, and unsupported, productivity and innovation decline. But the evidence shows that investment yields remarkable returns: for every US $1 invested in mental health, the WHO finds an average return of US $2 or more in better health and increased productivity.

Antigua and Barbuda’s reform therefore represents a model for small island states seeking to integrate compassion into economic policy. The proposed law aims not only to modernize care but also to deinstitutionalize treatment, strengthen community services, and introduce oversight mechanisms that protect the rights of individuals living with mental health conditions. These measures, when implemented effectively, can enhance workforce participation, reduce dependency ratios, and foster innovation across sectors. These outcomes directly support national development goals and the Sustainable Development Agenda.

Of course, the law alone will not suffice. To translate reform into reality, we must invest in human resources, data systems, and public education. We need to train more community health professionals, equip primary care centers to provide mental health services, and establish programs in schools that teach emotional literacy and resilience. Financing must reflect this priority: currently, mental health spending in many low- and middle-income countries accounts for less than 2 percent of total health budgets, according to PAHO. Antigua and Barbuda can — and should — do better, setting a benchmark for the Eastern Caribbean.

Equally important is culture. We must normalize conversations around mental wellness and move away from the outdated notion that seeking help is a sign of weakness. When we create environments at home, in schools, and in workplaces, that prioritize psychological safety, we create conditions for growth. A population that is emotionally resilient is better equipped to respond to shocks, recover from crises, and build sustainable livelihoods. That is the essence of development.

Antigua and Barbuda’s steps toward mental health reform are timely as they are transformative. They show that our nation understands a truth that global health economists have long articulated: mental health is not a cost to be minimized, but a catalyst for progress. The wellbeing of our citizens is our greatest economic resource.

As we prepare to adopt this new Mental Health Bill, we have a chance to lead by example and to build a society where dignity, inclusion, and care are seen not as social luxuries, but as economic strategies. Because in the final analysis, there can be no real development without well-being, and no lasting prosperity without peace of mind.

About the Author
Chaneil Imhoff is a communications specialist, mental health advocate, and founder of the Wadadli Initiative for Self-care and Healing (WISH) — a platform dedicated to breaking silence and shattering stigma around mental health in Antigua and Barbuda. She is also a correspondent for The Guardian UK and an award-winning creative entrepreneur.

Follow her on all platforms: @chaneilcimhoff

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Sources

1. World Health Organization (WHO). “Over a billion people living with mental health conditions require urgent service scale-up.” (2025). https://www.who.int/news/item/02-09-2025-over-a-billion-people-living-with-mental-health-conditions
2. International Labour Organization (ILO). Mental Health at Work: Policy Brief. (2024). https://www.ilo.org/global/topics/safework/publications/WCMS_856976
3. Organisation for Economic Co-operation and Development (OECD). Mental Health and Work: The Economic Impact. (2023). https://www.oecd.org/health/mental-health-promotion-and-prevention
4. Pan American Health Organization (PAHO). “PAHO advances mental health reform in Antigua and Barbuda.” (September 18, 2025). https://www.paho.org/en/news/18-9-2025-paho-advances-mental-health-reform-antigua-and-barbuda
5. PAHO & Government of Antigua and Barbuda. Multi-Country Cooperation Strategy (MCCS) 2023–2028. https://www.paho.org/en
6. PAHO. “Uniting the Americas for Mental Health: From Commitment to Action.” (June 2025). https://www.paho.org/en/events/event-uniting-americas-mental-health-commitment-action
7. PAHO. Policy for Improving Mental Health in the Americas. (2024). https://www.paho.org/en/documents/policy-improving-mental-health

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