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One in eight people worldwide lives with a mental health disorder — close to 1.2 billion people, according to the 2026 Lancet Global Burden of Disease Study. Cases have nearly doubled since 1990, and young people are hit hardest: some 293 million children and young adults under 25 live with a mental health condition. What is driving this surge? Is modern life really more stressful than the past? How does the picture differ between the Global North and the Global South? What role did COVID play, and is social media to blame? Vikram Patel — professor and chair of Global Health and Social Medicine at Harvard Medical School and co-founder of Sangath in India — unpacks the causes of the crisis and offers ideas for solutions. Then tell us what you think should be done.