For the third time in six weeks, a 34-year-old woman sat in an emergency room, desperate for help, and for the third time, the system failed to see her. It saw her dehydration, severe enough to require IV fluids. It saw her malnutrition, with electrolyte imbalances that required correction. It saw her vision problems, concerning enough for an ophthalmologic consultation. It saw everything except the person suffering. Each time, the medical system declared her “stable” and sent her back into the circumstances that were slowly killing her, armed only with specialist referrals she was too depleted to follow. The depression, the actual crisis driving everything, remained invisible until her fourth visit, when she finally whispered the word “hopeless” to a nurse who had the presence of mind to pause and listen.
The violation we don’t name
When we talk about human rights violations, we picture dramatic acts: detention, torture, and overt discrimination. We rarely recognize the quiet violence of systematic neglect. Yet having a mental health condition increases the risk of experiencing human rights violations, not always through active harm, but through a medical system designed to look away. That 34-year-old woman experienced a violation at every encounter. When the gastroenterologist after several tests, found “nothing wrong,” and didn’t ask about her life. When the emergency room discharged her with referrals but no support system to help her follow through. When multiple specialists examined parts of her body but no one examined the whole person in front of them. The violation wasn’t in what they did. It was in what they refused to see. The triage system doesn’t just fail to identify these crises; it actively invalidates the suffering. It operates on a hierarchy of legitimacy: Blood tests are real, imaging is real. Depression manifesting as self-neglect is treated as less urgent, less medical, and less worthy of intervention. This is how human rights violations happen in health care, not through malice, but through a system that demands the “right” evidence. By the time depression creates the lab values the system trusts, the person has already endured months of preventable agony.
The mathematics of mortality
The stakes of this systematic blindness aren’t abstract. Left untreated or at its worst, depression can lead to suicide, which claims more than 700,000 lives every year. Seven hundred thousand people. More than the population of Seattle. Gone, every single year, because the world failed to see their suffering in time. These deaths don’t happen in a vacuum. They are the culmination of countless moments exactly like that woman’s emergency room visits, opportunities for intervention that a system designed for other purposes couldn’t recognize. Each of those 700,000 people likely encountered health care multiple times before they died. They sat in waiting rooms. They described vague symptoms. They answered “fine” when asked how they were doing, because they’d learned that saying anything else led nowhere. The 34-year-old woman’s journey was a near-miss in this epidemic. Her dehydration, her malnutrition, and her vision problems, these weren’t just medical complications. They were increasingly desperate signals from a person whose ability to care for herself was collapsing. They were a cry for help in the only language her failing body knew how to speak.
The architecture of indifference
The barrier isn’t just clinical; it’s structural. On average, countries dedicate just 2 percent of their health budgets to mental health. This isn’t an oversight. It’s a statement of priorities written in budget allocations. The numbers tell the story of institutional abandonment: Two-thirds of countries have just one psychiatrist for every 200,000 people. In low-income countries, there is just one mental health worker of any kind for every 100,000 people. We’ve built a health care system where mental health is permanently under-resourced, perpetually an afterthought, and consistently someone else’s problem. And then we act surprised when people in mental health crises slip through every crack in that system. Even for those unmoved by moral arguments, the economics should be sobering. That woman’s three unnecessary emergency room visits likely cost over $15,000. Had her depression been identified on day one, treatment might have cost $500. Mental health conditions cost the global economy $1 trillion annually, yet for every dollar invested in treatment, the return is $4 in improved health and productivity. We’re already paying for mental health care; we’re just paying in the most expensive, least effective way possible.
What dignity-centered care demands
The solution isn’t more efficient neglect or a better algorithm to cut costs; it’s a fundamental reimagining of triage itself. True, dignity-centered triage would have recognized that woman’s crisis on day one. Her malnutrition and dehydration weren’t a puzzle for specialists; they were a massive red flag demanding immediate, holistic assessment. This approach rejects the fiction that we can separate “mental” from “physical” health, her depression was a medical emergency, and the fact that it didn’t fit the right diagnostic code doesn’t make it less urgent. This new standard means that when a patient presents with clear signs of self-neglect, a mental health screening isn’t optional; it’s primary, immediate, and mandatory. It means that before she was discharged, she wouldn’t just get a referral slip she was too depleted to use; she would get a warm handoff. This is the crucial difference: an actual, human connection to a professional who could assess her state, connect her to support, and ensure follow-up before she ever walked out the door.
The choice at every bedside
The patient eventually got help, but her survival was a matter of luck; a luxury the 700,000 people we lose each year don’t have. She survived the system’s indifference long enough to finally be seen as a whole person, not just a collection of symptoms. This is the lethal choice we are actively making: to see the dehydration but not the depression, the malnutrition but not the despair. It’s a choice reflected in budgets that dedicate a mere 2 percent to mental health, and it’s a choice that is killing people. We are funding the downstream consequences instead of the upstream cause. The question facing health care, then, isn’t about cost or technology. It’s simpler and more profound: Will we finally choose to see the whole person, or will we continue treating symptoms while people die of the very causes we refuse to acknowledge? Seven hundred thousand lives hang in the balance of that answer every single year.
Ronke Lawal is the founder of Wolfe, a neuroadaptive AI platform engineering resilience at the synaptic level. From Bain & Company’s social impact and private equity practices to leading finance at tech startups, her three-year journey revealed a $20 billion blind spot in digital mental health: cultural incompetence at scale. Now both building and coding Wolfe’s AI architecture, Ronke combines her business acumen with self-taught engineering skills to tackle what she calls “algorithmic malpractice” in mental health care. Her work focuses on computational neuroscience applications that predict crises seventy-two hours before symptoms emerge and reverse trauma through precision-timed interventions. Currently an MBA candidate at the University of Notre Dame’s Mendoza College of Business, Ronke writes on AI, neuroscience, and health care equity. Her insights on cultural intelligence in digital health have been featured in KevinMD and discussed on major health care platforms. Connect with her on LinkedIn. Her most recent publication is “The End of the Unmeasured Mind: How AI-Driven Outcome Tracking is Eradicating the Data Desert in Mental Healthcare.”
