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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 overshadowing available services, with the coronavirus pandemic exposing and exacerbating a critical – and widening – care gap.
It’s a costly affair.
According to a report by the World Health Organization and the International Labor Organization, approximately 12 billion working days are lost worldwide each year due to depression and anxiety, costing nearly $1 trillion.
According to the Organization for Economic Co-operation and Development, the economic cost of mental health problems in European countries can exceed 4 percent of gross domestic product (GDP). These are driven by reduced productivity and participation in the labor market, as well as direct costs outside the health system, such as in social security programs.
But for many in Europe, access to mental health services is a challenge, one that 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 mental health initiative, highlighting the importance of “appropriate, accessible … and affordable support”.
For many Europeans with mental health problems, it is a plan that cannot come soon enough.
The coronavirus pandemic continues to have a substantial impact on people’s mental health.
For example, the estimated prevalence of anxiety and depression in France nearly doubled in early 2020, according to Doron Wijker, policy researcher at the OECD’s Directorate for Employment, Labor and Social Affairs.
More recent figures suggest that the situation has also not yet returned to pre-pandemic levels. According to May 2022 survey data, even though self-reported symptoms of depression have declined on a general level, 15 percent of the French population still show signs of depression, compared to 10 percent before the pandemic, Wijker said. And when it comes to anxiety, one in four people in France show signs of anxiety, compared to 14 percent before the pandemic.
“While estimates of the prevalence of anxiety and depression provide an incomplete picture of a population’s mental health and well-being, these numbers demonstrate the magnitude of the challenge,” Wijker told a recent POLITICO mental health working group in France.
The mental health of young people in many European countries has taken a particular blow; in a number of countries, young people reported symptoms of depression nearly double those of the general population, she said.
The impact of the pandemic on mental health care was a double whammy: it simultaneously increased the need for the services, while eroding an already understaffed, burnt-out health workforce.
Many healthcare workers leave the field because of their own poor mental health, Natasha Azzopardi Muscat, director of WHO/Europe’s Department of Health Policy and Systems, said at this year’s European Health Forum Gastein.
According to WHO/Europe, countries in the WHO European Region are already experiencing under-recruitment of mental health professionals.
All this could pose further problems for patients’ access to care.
Long waiting times
Backlogs and long wait times for mental health services have been a major problem long before the pandemic.
Across the OECD, even before the crisis, two out of three people seeking mental health care reported difficulty accessing it, Wijker said.
And within the bloc, mental health services rank as one of the most unmet health needs, according to an April 2021 report from Eurofound.
According to Bruno Falissard, psychiatrist and former president of the International Association for Child and Adolescent Psychiatry and Allied Professions, the wait time in France to see a child and adolescent psychiatrist, for example, is now six months to two years.
Although children and teens make up about 20 percent of the French population, there are only about 500 psychiatrists serving this group, compared to about 10,000 adult psychiatrists, Falissard told the task force.
The gap in mental health care did not arise overnight.
“We have a historic situation of underinvestment, and this is not a French problem – this is a global problem, and needs are increasing and supply is declining,” said Frank Bellivier, ministerial deputy for mental health and psychiatry at the French Ministry of Health. Health and Prevention.
The coronavirus pandemic has forced countries to urgently look for ways to close health care gaps, and some of them may persist.
First, there was an increase in the use of telemedicine and digital health services, including for mental health care.
An important lesson from the COVID crisis, Bellivier said, is that telepsychiatry works.
“We’ve seen a huge development of telemedicine in psychiatry and I think this is a positive experience both from a health professional’s point of view, but also from a patient’s and family’s point of view,” he said.
But the experience also raised significant concerns and challenges, including the issue of access and the need to train health professionals and users of such technologies on what can reasonably be expected from telemedicine and digital tools, he said.
Digital technologies have the potential to reduce the large number of unmet healthcare needs. But to ensure their positive growth continues, they need to be integrated into the wider mental health system, said Wijker of the OECD.
And with the proliferation of freely available digital tools and apps, quality assurance is an important issue, she said.
“A number of countries are taking a more proactive role in this area, for example assessing which digital therapies can be covered by existing psychological therapy programs,” she said.
This article is part of POLITICO’s Health Care Evolution series presented by Janssen. It 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 third-party advertisers.