The ‘’White January’’ health campaign is a Brazilian initiative that aims to promote awareness about people’s mental and emotional health. With the motto ‘’Who takes care of the mind, takes care of life!’’, the campaign disseminates information to combat the stigma of mental health and promote emotional well-being. The choice of this month, represented by the color white, is symbolic, suggesting a new beginning, encouraging people to establish new goals and care for their mental health. Furthermore, the campaign also emphasizes that mental health is as important as physical health.
Physical and mental health problems commonly occur simultaneously. Multimorbidity, that is, the existence of two or more chronic disease conditions, can include both physical health problems and mental disorders as well as problematic alcohol use. Research shows that there is an increased prevalence of physical health problems in people with mental health problems. This could be explained by worse health behaviors (e.g., alcohol use) in combination with the side effects of long-term use of psychotropic medications and the impact of stress on the hypothalamic-pituitary-adrenal axis and inflammatory systems (1).
A relevant study investigated the association between physical health in individuals with mental health problems and harmful alcohol consumption when compared with a group that did not present any of these problems (2). Evaluating more than 7,500 people, it was found that 61.7% of individuals did not present diagnostic criteria for psychiatric disorders or harmful use of alcohol. Among the remaining participants, 31.4% had psychiatric disorders or harmful use of alcohol and 6.9% had both. The physical conditions assessed were: hypertension, diabetes, stroke, cancer, epilepsy, asthma, bronchitis, emphysema, digestive problems, urinary and liver conditions and arthritis.
It was also noted that non-communicable physical diseases were more prevalent in people with psychiatric disorders or in individuals with psychiatric disorders and harmful use of alcohol, especially with clinical diseases related to the liver. All chronic non-communicable diseases evaluated, except cancer, were significantly associated with mental health problems, with approximately 1.5 times greater risk for diabetes, hypertension and asthma, and 2 to 3 times greater risk for heart attack/angina, ulcer stomach/digestive problems, arthritis, epilepsy, stroke, bronchitis/emphysema, intestinal/colon problems and liver problems. Harmful alcohol use alone has only been associated with hypertension. The authors explain that this low association between harmful alcohol use and physical illnesses may be due to the sample not only containing people with dependence, but rather any people who had a pattern of harmful use at the time of the research. Additionally, individuals with co-occurring mental health and alcohol use problems had an approximately 2-fold increased risk of hypertension, bronchitis/emphysema, ulcers/digestive problems, heart attack/angina, and colon problems and a 6-fold increase in chances of liver disease.
Finally, this study highlights the importance of integration in health care, covering both physical and mental aspects. The White January campaign plays a crucial role in raising society's awareness of the importance of mental health care, promoting the breaking of the stigma surrounding mental disorders. Through this awareness, we seek more inclusive care in health services.
