Such issues cause immense suffering with staggering economic and social costs. People with mental disorders often face social isolation, poor quality of life and higher death rates.  The World Health Organisation has reported that mental health problems have increased and are set to increase further, largely due to the pace of modern life.  Statistics from the organisation show that in 2002, there were 154 million people in the world suffering from depression, just one form of mental illness.

Glenn Roberts, who has more than 30 years' experience in psychiatry and has been a consultant in rehabilitation and recovery at Wonford House Hospital, Exeter, since 2003, said many mental health problems were linked to urbanisation, even in third world countries.  "It's the demands, expectations and challenges put on people by others and themselves," said Dr Roberts.  "People want and expect more in terms of their material goods and lifestyles."  He said the credit crunch had brought additional concerns. "Secure accommodation and disposable income are compromised more, so for people in the lower income brackets there is an increased vulnerability to mental health problems," he said.

World Mental Health Day has been marked with local, regional and national events in more than 100 countries every year since 1992. It was established by the World Federation for Mental Health and promotes more open discussion about illnesses and investments in prevention and treatment services. The theme of this year's global campaign is "mental health in primary care: enhancing treatment and promoting mental health". It is highlighting the need for more attention to mental health services in primary healthcare.

"People regard stigma as a worse problem than the mental health problem they have got," said Dr Roberts, who spends at least half of his time working directly with people who use mental health services.  "There are a lot of myths about people with mental health problems and we need to change the attitudes of families and employers.  People with psychoses are among the least employed. It's about cultural change, not just structural change."

Historically, mental health services have been clearly focused on diagnosis then treatment. Now there is an emphasis on personal recovery, which goes beyond treatment.  "Recovery is not just about symptoms but about people's self-esteem, job, relationships, home and so on," said Dr Roberts. "Recovery is about building a meaningful and satisfying life, as defined by the person themselves, whether or not there are ongoing symptoms or problems. It's about understanding what people want as well as need, and interfering with their lives as little as possible," said Dr Roberts.

Devon is seen to be leading the way in the new approach to mental health services. Dr Roberts said everyone can make a constructive contribution towards building healthier communities and resilience in individuals.

"If people learn a bit about mental health they can respond appropriately to family, friends and colleagues with problems."