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The growing mental health care deficit in Europe – POLITICO

This article is the product of a POLITICO working group, presented by Janssen.

Europe has some catching up to do when it comes to addressing unmet mental health needs.

In many places, the surge in demand for mental health care is eclipsing available services, with the coronavirus pandemic revealing and exacerbating a critical – and growing – gap in care.

It’s a costly affair.

Worldwide, around 12 billion working days are lost each year due to depression and anxiety, costing nearly $1 trillion, according to a report released last month by the World Health Organization. health and the International Labor Organization.

In European countries, the economic costs of poor mental health can exceed 4% of gross domestic product (GDP), according to the Organization for Economic Co-operation and Development. These are driven by reduced productivity and participation in the labor market, as well as direct costs outside the health system, such as social security programs.

But for many in Europe, access to mental health care services is a challenge, which is on the radar of the European Commission.

Last month, Commission President Ursula von der Leyen announced that the Commission was working on a new initiative on mental health, stressing the importance of having “appropriate, accessible…and affordable support”.

For many Europeans with mental health issues, it’s a plan that can’t come soon enough.

big needs

The coronavirus pandemic continues to have a substantial impact on people’s mental health.

The estimated prevalence of anxiety and depression in France, for example, almost doubled at the start of 2020, according to Doron Wijker, policy researcher at the Employment, Labor and Social Affairs Directorate of the Institute. OECD.

More recent figures suggest the situation has not yet returned to pre-pandemic levels either. According to data from a May 2022 survey, although self-reported symptoms of depression have decreased at the general population level, 15% of the French population still show signs of depression, compared to 10% before the pandemic, said Wijker. . And when it comes to anxiety, one in four people in France show signs of anxiety, up from 14% before the pandemic.

“While estimates of the prevalence of anxiety and depression provide an incomplete window into a population’s mental health and well-being, these numbers demonstrate the scale of the challenge,” Wijker told a recent POLITICO working group on mental health in France.

The mental health of young people in many European countries has been particularly affected; in many cases, young people reported symptoms of depression at rates almost double those of the general population, she said.

The impact of the pandemic on mental health services has been a double whammy: it has simultaneously increased the need for services, while eroding an already understaffed and exhausted health workforce.

Many healthcare workers leave the field due to their own poor mental health, said Natasha Azzopardi Muscat, director of the country health policy and systems division at WHO/Europe, at the European Health Forum of Gastein this year.

According to WHO/Europe, countries in the WHO European Region are already facing insufficient recruitment of health workers into mental health services.

All of this could further complicate patients’ access to care.

Long waits

Backlogs and long wait times for mental health services were already a significant problem long before the pandemic.

Across the OECD, even before the crisis, two in three people seeking mental health care said they had difficulty accessing it, Wijker said.

And within the bloc, mental health care is among the most unmet health needs, according to an April 2021 report by Eurofound.

Today, the waiting time in France to see a child psychiatrist, for example, is between six months and two years, according to Bruno Falissard, psychiatrist and former president of the International Association of Child and Child Psychiatry. adolescent and related professions.

Although children and adolescents make up about 20% of France’s population, there are only about 500 psychiatrists caring for this group, compared to about 10,000 adult psychiatrists, Falissard told the task force.

The gap in mental health care delivery did not happen overnight.

“We have a historic situation of underinvestment, and it’s not a French problem – it’s a global problem, and the needs are increasing and the supply is decreasing,” said Frank Bellivier, ministerial delegate for mental health. and psychiatry at the French Ministry of Health. Health and Prevention.

find ways

The coronavirus pandemic has caused countries to urgently look for ways to try to alleviate gaps in health care, and some of them may be here to stay.

On the one hand, there has been an increase in the use of telemedicine and digital health services, including for mental health.

A key lesson from the COVID crisis, Bellivier said, is that telepsychiatry works.

“We have seen a huge development of telemedicine in psychiatry and I think it is a positive experience, both from the point of view of healthcare professionals and from the point of view of patients and families,” he said. .

But the experience also raised significant concerns and challenges, including around the issue of access and the need to educate healthcare professionals and users of these technologies on what can reasonably be expected from telemedicine. and digital tools, he said.

Digital technologies have the potential to reduce high unmet care needs. But in order to ensure their positive growth is sustained, they need to be integrated into the broader mental health system, said the OECD’s Wijker.

And with the proliferation of digital tools and apps available for free, quality assurance is a key issue, she said.

“A number of countries are taking a more proactive role in this space, for example by assessing which digital therapies can be covered by existing psychological therapy programs,” she said.

This article is part of POLITICO’s Evolution of Healthcare series presented by Janssen. He is the product of a working group and was produced with complete editorial independence by POLITICO reporters and editors. Learn more about editorial content presented by external advertisers.

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