Epidemiology and public mental health — structured clinical viva

Table reading. Twelve-month prevalence 20% means one in five adults met criteria in the past year — not rare. Severity band 4% is the smaller group driving much specialist demand, but mild/moderate cases still generate primary care and population disability. Treatment among cases 35% implies a large treatment gap (about two-thirds untreated if "any treatment" is the coverage metric — confirm definition of treatment).[3][4]

GBD slide. High YLD ranking means mental disorders are priority disability conditions for health systems; do not conclude low importance because direct YLLs are lower than for ischaemic heart disease. Mention suicide and physical comorbidity as mortality pathways; note debates that true burden may be underestimated depending on coding boundaries.[1][2][9]

Prevention follow-up. High-risk clinic expansion helps the tail; Rose reminds that many cases arise from average-risk groups, so universal/selective measures (schools, social determinants, ACE-informed family supports) are required for population impact.[5][6]

Suicide follow-up. Population rates and WMH ideation/attempt data justify means restriction and system aftercare; individual prediction from risk factors has limited PPV at community base rates — avoid fatalism and avoid false certainty.[7]

STROBE follow-up. Ask sampling frame, response rate, instrument (CIDI version), diagnostic system, handling of missing data, and limitations before accepting the 20% figure for policy.[8]