By Sir Ronald Sanders
Across the nations of the Americas, a silent emergency is suffocating hope, stealing futures, and exacting an unbearable toll in lives lost and potential squandered. That “silent emergency” is a mental health crisis which is growing, unrelenting, and still, tragically, hidden in plain sight.
More than 160 million people in the Americas – from Canada to Argentina with the Caribbean in between – live with a mental disorder. In 2021 alone, over 652,000 souls were lost to mental illness, substance abuse, Alzheimer’s disease, and suicide. Two of our nations rank among the ten with the highest suicide rates in the world. Each year, over 100,000 people die by suicide. Yet only one in five receives treatment.
But this is not just a health crisis. It is a crisis of conscience and commitment. It affects children, teenagers, and adults—crippling productivity, corroding public trust, and fracturing families. The stigma surrounding mental health acts like a shroud, keeping this problem out of sight and out of political reach. Silence is no longer an option.
Even the wealthiest nations in our hemisphere are under siege. In the United States, suicide remains the 11th leading cause of death. In 2023 alone, more than 49,300 Americans died by suicide—nearly 135 every day. Among high school students, nearly 40% experienced persistent sadness and hopelessness, while one in five seriously considered suicide. The wealth of the nation offers no immunity from the affliction of the mind.
In Canada, the picture is no less grim. In 2022, over 4,850 Canadians died by suicide—an increase of nearly 9% from the year before. In 2023, 34 percent of youth in Canada met the criteria for a mental health or substance use disorder. Among 2SLGBTQ+ youth, one in four experienced suicidal ideation within a single year.
If the most resource-rich countries are reeling from such devastation, how much more vulnerable are the smaller and less wealthy states of Latin America and the Caribbean? This crisis does not discriminate, but its consequences are heaviest where capacity is weakest.
The situation in the Caribbean is equally alarming. Guyana and Suriname report the highest and second-highest suicide rates in the Americas—40.8 and 25.9 per 100,000 population, respectively. Trinidad and Tobago ranks ninth in the Americas. Youth are particularly affected. Between 20 percent and 25 percent of adolescents in the English-speaking Caribbean experience symptoms of mental health problems.
The COVID-19 pandemic triggered a sharp rise in mental health conditions across the Americas. The isolation of lockdowns, the sudden loss of human connection—even among family members—and the cruel denial of final farewells to loved ones who died alone from the virus, inflicted emotional wounds that have not healed. These experiences unleashed waves of depression, anxiety, and trauma that continue to ripple through societies.
Worryingly, the Lancet Commission on Global Mental Health and Sustainable Development found that mental health disorders were already on the rise globally even before the COVID-19 pandemic struck. The Commission issued a stark warning: if left unaddressed, mental health conditions could drain an estimated US$16 trillion from the global economy by 2030. Since that report, the Institute for Health Metrics and Evaluation (IHME) has tracked an alarming acceleration of mental health challenges in multiple regions, underscoring the scale and urgency of the crisis.
It is against this sobering backdrop that Antigua and Barbuda has taken the lead in crafting a resolution at the Organization of American States (OAS) to confront the escalating mental health crisis across the Americas. Work is already underway in the OAS General Committee in preparation for the Organization’s General Assembly, which Antigua will host this June. This initiative aims to put real political weight behind an issue that, for far too long, has languished on the margins of regional political policy.
We hope this resolution will serve as a call to arms, placing mental health where it belongs: at the centre of public policy and sustainable development. It builds on the foundation laid by the Pan American Health Organization’s 2022 Policy for Improving Mental Health and the 2023 Strategy for Improving Mental Health and Suicide Prevention, seeking to transform intention into action and frameworks into results.
But political will is the necessary catalyst. This resolution sets out to do four critical things: establish a Regional Mental Health Partnership to coordinate efforts; create a multi-agency Working Group to guide implementation; build a robust monitoring mechanism to ensure accountability; and launch a Regional Mental Health Fund to mobilize resources.
All our countries, including governments and the private sector, know what must be done. Community-based care must replace outdated, often inhumane institutional models. Mental health spending, currently just 3 percent of national health budgets, must increase. And mental health must be woven into the fabric of education, labour, finance, and justice systems. According to the World Health Organization, every $1 invested in scaled-up treatment for common mental disorders yields a $4 return in improved health and productivity. The economics are clear. The ethics, even clearer.
At the OAS, I have been proud to lead Antigua and Barbuda’s effort to forge consensus among the nations of the Americas in support of this resolution. If we succeed, it will not be the first time that the smallest of voices has spoken the loudest to rally nations to do the right thing for all humanity. We are determined to make the OAS General Assembly in June a turning point – a moment when the countries of the Americas declare that the well-being of every mind is the bedrock of a just and prosperous future.
We want this Assembly to be remembered as one that did not turn away from uncomfortable truths, but chose to confront them with courage, compassion, and resolve. In the context of mental health, let it be said: the OAS did not flinch; it acted.
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