The hills testimony exposed the frustration felt by many American officials and diplomats as President Trump encouraged all those to build relationships with the Ukrainian government Dr Hill said the u.s. Ambassador to the e.u. Gordon someone's told her that Mr Trump had expanded his portfolio to include Ukraine and that was with the express intention of getting the country to launch an investigation into his potential presidential rival Joe Biden the British foreign secretary Dominic rubbers announced that a number of orphaned children whose British parents died in Syria are being returned to the u.k. No more details have been given but it's understood that the children were living in areas which used to be controlled by the Islamic state group Mr Rubb said this was the right thing to do this is even where the process of returning back to the u.k. a Number of often British children from the conflict in Syria we look at the cases individually very carefully and in these circumstances it's the right thing to do these children should be safe and sound here in the u.k. At home but caught up in that vicious conflict I hope and now be given the time the space and the support to return to some kind of normal life world news from the b.b.c. Riot police in Bolivia have fired tear gas to disperse supporters of the former president Evo Morales who resigned nearly 2 weeks ago the protesters were taking part in a funeral procession for 5 of the 8 people killed in clashes outside the gas plant on Tuesday. The United States has said it's concerned about the condition of anti-government protesters in Nicaragua who've been holed up in a church for more than a week 14 people there are holding a hunger strike Leonardo Russia reports the group has been surrounded by police inside the church in the city of Messiah they have no access to clean water or electricity they gather there to demand the release of relatives arrested by Nicaraguan police for political reasons the church's priest or lawyer or not the people who gave them support over the past 8 days have also been detained police have encircled the church present the near lot there says the protesters were planning terrorist attacks the u.s. Says it will use all economic and diplomatic means available to restore democracy in a caracal an investigation into an Italian road bridge collapse last year has discovered that sensors to monitor structural stability had long been out of action Italian media say the devices led engineers to conclude in 2014 that the bridge in Genoa was at risk of giving way but the sensors were damaged during roadworks falling the following year and they were never replaced 2 metal detector tests in Britain have been found guilty of stealing a hoard of Viking treasure worth nearly $4000000.00 The bear had dug up the coins and jewelry in a field they were required by law to declare everything they'd found to the earth origins but instead they began selling it on to dealers many of the items still haven't been recovered experts say they provide fresh information about the unification of England in Saxon times the 2 men were convicted of theft and concealing their discovery b.b.c. News. Hello and welcome to the enquiry with me Celia Hatton Each week one question for expert witnesses and an answer. In July China's all powerful state media trumpeted the findings of a major medical study stroke is now the leading cause of death the headlines read going on to warn about the dangers of eating too much salt it was the kind of health story you might read in any newspaper anywhere but in online chat groups Chinese people focused on something else that had crept into the death statistics. For the 1st time depressive disorders had jumped on to China's top 10 list of killers. Depression ranks 10th wrote one person scoring more than 11000 likes tens of thousands of people then seized the rare chance to voice their true feelings online ignoring the threat of China's censors. Over half those who are depressed haven't even been diagnosed they're being ignored read one popular comment people don't seek treatment because society is prejudiced said another the discussion grew eventually racking up more than 50000 comments and more than 4000000 views in just over a day a huge number even for China. That's just one snapshot from one country but it points to a nagging concern for many of us so this week we're asking what can we do about the world's mental health problem. Part one every country is a developing country. If I'm asked the question how many people are affected by meant her problems globally I would really respond by asking the question how many people are affected by physical health problems globally and I think if you look at the last question across the lifetime the answer would be 100 percent. The crim Patel is a big name in the world of global mental health He's a Harvard psychiatrist and co-founder of the Center for Global mental health in London u.k. And he's devoted his career to studying the issue across the world finding similarities in countries from his native India to Zimbabwe and the u.s. His conclusion everyone's vulnerable every single human being on this planet will at some point in their eyes be affected by a physical problem my speculation is this is also equally true of a mental health problem actually is one in 3 of all people will experience the clinically significant mental health condition at some point in their lives. So 30 percent of us will cross that admitted Li blurry line between experiencing normal negative emotions like anger and sadness to feeling like we can't manage mental health is much more than the absence of mental illness it is a state of wellbeing in which the individual realizes his or her own abilities can cope with the normal stresses of everyday life how do we measure mental health where's that line between feeling mentally well and feeling like something's wrong . Finding the line between feeling well and something being wrong has been one of the greatest challenges in psychiatry and psychology the honest truth right now is that we do not have a clear way of being able to distinguish those individuals who have a mental health problem from those who are otherwise well are the numbers rising the numbers of people affected by mental health problems are rising globally in large part driven by the increase in the global population in absolute numbers of people who are entering the risk periods for developing mental health problems that is adolescents and young adults or are also increasing dramatically particularly in regions which witnessed a baby boom in the sixty's for example in South Asia and in the coming years in sub-Saharan Africa. Here's what the big global surveys tell us the percentage of people across the world grappling with schizophrenia or personality disorders is remarkably consistent so too are the numbers of older people experiencing dementia that's in line with what we'd expect from populations that are living longer but some who study mental health trends say we are seeing a rise in anxiety and depression one that's out of step with simple population growth so they come Patel agrees with the people speaking out about depression on China's social media platforms they were on to something I don't think the word epidemic is correct but if you'd asked me Are we facing a global crisis of unmet needs for people with mental health problems yes we are one this is true in every country of the world when it comes to mental health he says every country is a developing country so even if you live in a rich country that doesn't mean you won't face stigma or long waiting lists for help. All over the world issues that might be treatable if they're caught early or being left to fester and that's making things much worse. Our 1st expert witness leaves us staring at a health crisis that no country has been able to solve so it's time to ask why when it's usually so easy to talk about our physical health is it so difficult to open up about mental health problems. Part 2 we need to talk. When I was a tiny land my mother developed a severe depression she sent me to run to a neighbor to get help because at that point in her extreme distress she wanted to put her head in the gas oven our next expert witness knows the impact of mental illness firsthand she wanted to put her head in the gas oven and also the heads of me and my young sister in those days we had coal gas in Britain and that was a common way to take one's life and fortunately I was able to get to a neighbor help came my mother received treatment and she went back to work a year later now I asked to resign I said Mum when you unwell did you say to your boss that you'd been away from work sick the depression's of course not you're mad if I told my boss why I was off sick that I would have lost my job. Graeme Thorneycroft watched his mother turn her life around it's what inspired him to become a psychiatry he's now Sir Graham Thorneycroft in the u.k. He was knighted by the Queen for his work reducing the stigma surrounding mental health problems in many countries I'd say most countries very idea of mental illness overlaps with madness and craziness and bring shame and embarrassment and damages not just one's own reputation but reputation the family indeed in some countries especially in South and Southeast Asia it may damage not just your marital prospects if you have a mental illness but the prospects of your wider family because there's a sense of vision etic or a familial taint upon the whole clan if you like for centuries we haven't really spoken about mental health people often talk about it in hushed tones behind closed doors or not at all the stigma so strong that people who do receive treatment. Are only the tip of the iceberg we have a difficulty specifically with depression so let's take one end of the spectrum which is called Major Depressive Disorder this is jargon in severe depression so recently we asked the question in 21 countries how common is this an answer between 4 and 5 percent of the population this year don't just feel a little bit down today but actually have severe depression might well be feeling like hurt themselves or taking their life and then we asked the question of all of those people in different countries how many were actually getting help the best we found in the rich countries one in 5 many 80 percent were not getting help the worst we found in the low income countries as one in 274 percent meaning 96 percent of people severe depression not mind a severe depression are not getting help in low income countries of course 85 percent of people world live in lower middle income countries that's where most of us live and the supply of actual treatment of any sort is miserably low at the moment that's a challenge that challenge begins by encouraging those who are in pain to put their hands up and get help stigma is a type of polluting or corroding fog or mist sort of miasma that interferes with every aspect of mental health where it's individual who's at home and lonely or depressed or of its policy making a profit ising as well at the top level every level is negatively affected by stigma it's almost like a house on fire you need to clear away the smoke so you can actually get to the source of the fire and put it out there and that's what stigma is exactly Graham and his fellow researchers have discovered that campaigns to reduce stigma have to be tailored to each local audience from cheap and cheerful radio jingles in southern Nigeria to with theatre group that tours coastal villages in Southeast India it all comes down to who is delivering the message the strongest evidence we have about how to reduce sigma is rigged. Excuse the simple and it's called social contact What does that mean it means arranging ways for people who have experience of mental health problems to come into contact with people who did not have that experience but Graham says that social contact doesn't have to be face to face celebrity messages and even fictional characters from books or movies can work it's enough to hear stories of people who've encountered mental health problems and overcome them without losing the love of the people around them. It's certainly a good thing to remove stigma and to talk about mental health that will help us to see just how many are suffering but still it doesn't answer why so many are struggling to cope. Our next expert witness offers some answers. Part 3 a brave new world. As stigma slowly we can see there are growing numbers of people who are suffering some of that rise can be matched by population growth but what else is contributing to our enzymes in depression some experts including our next witness to fundamental changes in the world around us in all societies and all countries as rich and poor small and large people heading more insight into mission. Is the director of the Department of Mental Health and Substance Abuse of the World Health Organization his work explores the complex list of factors that could push us across the line and contending with normal thoughts and emotions towards ones that stop us from functioning that is published literature is now ready decently done to say that they did that least a 3 to 4 times increase in the percentage of people who will have ngs ideo depression or even other mental disorders if they're affected by conflicts and wars and or some natural disasters but what if you haven't been directly affected by war or natural events like floods or forest fires what if you're living a supposedly normal life she Gaar sexiness believes that a host of new complexities tied to our modern world could also be causing problems I'm not talking about all the people in the world but for the very large number of people who live in urban environments who are doing what is going the knowledge based jobs the competition is very high and the stress has become unbearably high for many of these people together with the job uncertainty and also the economic issues reared expectations are much larger than what that he added is Shaker believes that. He makes the problems worse for those at the bottom end of the pyramid a large number of people have moved up in in life in terms of economic benefit the genes is an even and many people have become much much more powerful and ignore me capable and some others have moved just a little bit up and it's the inequality is the difference that people see for their reality versus the c.l.p. Which really affects them it's a mixture that's bound to create problems take a younger population that's contending with an urbanized world and in soaring inequality and then remove many of the traditional social networks that once offered support the usual earlier methods of social connection including in the extended family in the neighborhood in the community have decreased in many other revenues leg the social media having pleased and that really affects the way people react that resilience within the person is interacting with the sort of support they have or at least the perceived social support they have and danger action of that is affecting the chances of person having anxiety and depression and so humans are social beings they need to have social interactions in order to stay mentally healthy absolutely correct and that really is affecting the way we react to environment to people and to us the exactly one thing that certainly changed over the years is social media and many young people now play out their lives over the Internet how does that fit into all of this well it's difficult to analyze the various aspects of social media as they impact people's lives and there are certainly positive things that are happening because social media and people feel more connected people agree to converse with many more people than they are able to see face to face and so on but yes there is that other element that they become much more aware. About. The possibility for them. That remains out of did reach so the world has changed but the way in which we can take care of ourselves to cope with those changes hasn't really caught up yet. Because we find ourselves in a new word and hooping strategies and it was social support systems have no devil of Google but the debt kind of issues. Facing a global mental health Burton that's weighing on every country no exceptions and we're starting to understand what's fueling the crisis it's time for some solutions . Part for Grandmother time. In Sierra Leone for a very very long time there was only one psychiatrist working in the public sector for the entire country. Our next expert witness Grace Ryan is a researcher at London's global mental health center in the u.k. And then I think as part of the a bowler response they got a 2nd psychiatrist and I'm not sure that that 2nd psychiatrist is still even working in this is a country that had years of civil war Liberia I think had a very similar situation so there really is an extreme shortage of specialists to provide mental health care in the middle income country settings. This shortage comes with very real consequences. End Up With People living many years in psychiatric facilities that may be run by specialists but oftentimes the quality of care is pretty low so for example at the psychiatric hospital where I've been doing some research in Uganda it's called the because it's the country's biggest psychiatric facility it has about 500 beds but it regularly has more than 752000 patients so you have. 2 people sleeping to a bed if highly trained psychiatry aren't an option there's a growing realisation in some poor countries that the best solutions are right on their doorsteps Grace studies how those countries can address mental health and innovative ways by doing more with less so imagine a staircase and at the very top of that set of stairs is a specialist a psychiatric care from one of the very few psychiatry's or clinical psychologists or other specialists in the country Ideally you want to keep as few people as possible from having to climb the staircase up to that stairs that step is the most expensive the least efficient and not everybody needs it or can benefit from it so why don't we instead focus on catching people at the bottom of the stairs. On that bottom step some of the basic things that researchers are realizing are vital to good mental health programs that tackle poverty and give everyone access to good schools and stable jobs they help to decrease everyone's baseline stress levels then when people do become unwell community level services so that could be lay workers community health workers who live close to you maybe know you in your family and you feel that they're somebody who you can talk to governments around the world are just beginning to embrace the idea that it's a lot easier and cheaper to address mental health problems before they reach psychiatric hospital levels the top step is best avoided for everyone one of the really exciting examples that we're hearing a lot about right now is in Bob boys friendship bench program and essentially they train community grandmothers to sit on a bench outside of primary health care facilities and if somebody comes to primary care and is you know not feeling so hot emotionally they can go speak to one of these community grandmothers and they'll give what they call a problem solving therapy after. 6 months researchers discover that almost all the people who were able to sit down for a constructive chat with a grandmother felt better only 14 percent of them were still feeling depressed the ones who didn't get any grandmother time didn't fare so well half of them were still experiencing depression 6 months later the rich countries have picked up on this simple solution to friendship benches are now popping up in London and New York City. So here's t