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This annual report reflects the extraordinary year of 2020 with unprecedented challenges due to the COVID-19 outbreak. It is important to stress, that even before COVID-19, nearly 1 billion people lived with mental health conditions and more than 800,000 people died from suicide every year. The pandemic is not the cause of the large number of mental health conditions in the world, it is merely an amplifier and a distractor from the fact that even before the pandemic, more than 75 per cent of people living with mental health conditions did not receive treatment.