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.
Release date: 8 July 2014
Making Mental Health Count
The Social and Economic Costs of Neglecting Mental Health Care
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. This report 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 disproportionate focus on severe mental illness has meant that mild-to-moderate mental illnesses, which makes up the largest burden of disease, have remained overwhelmingly neglected. This book addresses the high cost of mental illness, weaknesses and innovative developments in the organisation of care, changes and future directions for the mental health workforce, the need to develop better indicators for mental health care and quality, and tools for better governance of the mental health system. 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.
> Read the press release: Mental healthcare under-resourced in too many countries, says OECD
> Read the Focus on Health: Making Mental Health Count (PDF, 8 pages)
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Country press releases
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 Australia, England, Korea, and Sweden to follow later in 2014.
Ms. Emily Hewlett (firstname.lastname@example.org)