Health policies and data

Mental Health Systems in OECD Countries


Mental disorders account for one of the largest and fastest growing categories of the burden of disease with which health systems must cope, often accounting for a greater burden than cardiovascular disease and cancer. As reliance upon inpatient care reduces – psychiatric inpatient beds are falling across most OECD countries – countries are often struggling to provide appropriate care in the community. Many mild to moderate mental disorders are under diagnosed and untreated, meaning that a significant proportion of the population suffering from mental ill health remains hidden. The indirect costs of mental ill health, for example in lost productivity, are significant.

Mental disorders also account for a significant share of health spending, particularly public health spending. OECD estimates of expenditure on mental and behavioural disorders show a wide variation between countries. There is also significant variation in inputs, clinical outcomes and health care quality indicators.

Given the large burden of disease and the variations in financing, delivery and outcomes, there is considerable interest in how to strengthen mental health systems, and measure performance in an objective and standardised way. There is also vast potential for cross-country learning and sharing of best practices between OECD members. Much still remains to be done to assure high-quality evidence-based treatment, appropriate outcome measurement, and good value-for-money in mental health systems across OECD countries.



The health, social and economic consequences of poor mental health are substantial. More attention is focusing now on the development of actions to promote better mental health and wellbeing and prevent mental ill-health. If effective and well-implemented potentially such actions may help avoid some of these substantial adverse individual, social and economic impacts of poor mental health.

This new OECD paper, Understanding Effective Approaches to Promoting Mental Health and Preventing Mental Illness, provides an overview of the development of approaches to promoting mental wellbeing and preventing mental ill-health in OECD countries, together with an assessment of what is known on their effectiveness and cost effectiveness. The paper finds that there is a sound and quite extensive evidence base for effective and cost effective actions which can promote mental wellbeing and prevent mental ill-health. However, the existence of actions and programmes in mental health promotion and prevention is uneven both between countries, and across different points of the life course. Many countries could stand to scale-up their promotion and prevention efforts in the mental health field, and further efforts are particularly needed to introduce interventions targeted at unemployed and older populations.

October 10, 2017 - World Mental Health Day



Despite the enormous burden that mental ill-health imposes on individuals, their families, society, health systems and the economy, mental health care remains a neglected area of health policy in too many countries. Mental disorders represent a considerable disease burden, and have a significant impact on the lives of the OECD population, and account for considerable direct and indirect costs.

Making Mental Health Count argues that even in those OECD countries with a long history of deinstitutionalisation, there is still a long way to go to make community-based mental health care that achieves good outcomes for people with severe mental illness a reality. The high burden of mental ill health and the accompanying costs in terms of reduced quality of life, loss of productivity, and premature mortality, mean that making mental health count for all OECD countries is a priority.

October 30, 2014 - Official launch of the publication in Korea

Read the presentation by Mark Pearson on Making Mental Health Count. Also available for download at

Country profiles

Alongside Making Mental Health Count, the OECD will be releasing a series of mental health system profiles, designed to complement the analysis provided in the principal publication. The profiles provide a comprehensive picture of the various ways that systems have evolved, improved, assessed and responded to weaknesses, and work to tackle the different challenges that all OECD mental health systems continue to face. These descriptive accounts of OECD countries’ mental health systems present the diversity of approaches to mental health care provision, the peculiarities of the challenges faced by systems, the similarities and general trends between countries, and the potential for sharing of best practices between OECD members. Profiles of the mental health systems in Finland, Italy, the Netherlands and Scotland were released on July 10, with profiles of England and Sweden following later in 2014.

England England Netherlands Netherlands
Finland Finland Scotland Scotland
Italy Italy Sweden Sweden



On World Health Day, policy makers across the world must commit to putting care for depression and mental illness at the centre of their health systems, and their health policy priorities.


High-level event organised by the World Bank Group and the World Health Organization, 13-14 April 2016, Washington DC.

Francesca Colombo, Head of the OECD Health Division, participated in the plenary panel discussion on "Mental Health in the Global Development Agenda: Challenges and Option".


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