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.
Launched in January 2011, this project has run along two main activity streams: (1) conducting reviews of evidence, best practices, value-for-money and performance in key policy areas; and (2) compilation of comprehensive descriptive profiles of the mental health systems of a selection of OECD countries, following a common template.
The project will result in a publication on what makes a high-performing mental health system based on the evidence available, due early 2014. The publication will include the following:
- an exploration of tools to measure health system performance, addressing data availability, outcome measures, and outcome and quality of care indicators;
- a review of mental health expenditures for selected countries and recommendations on the minimum data set needed for mental health policy development, monitoring and resource allocation;
- an evaluation of care provision for mild-to-moderate mental illnesses, and recommendations around efforts to secure better care for these highly prevalent disorders;
- a review of innovative and effective payment systems, organisation and delivery of care for severe mental illnesses, as countries struggle with deinstitutionalisation and its aftermath, working to assure appropriate care in the community;
- an assessment of how recent trends in and mix of mental health professionals as well as changing skillsets and work configurations contribute to producing better quality and better value-for-money for mental health systems;
- an appraisal of the tools that can be used to secure good governance drive positive change in mental health systems, and to apply effective practices for cross-sectoral working.
Alongside will be a volume of descriptive health profiles, designed to complement the analysis provided in the principal publication. The profiles provide a comprehensive picture of the variety 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 nine OECD countries’ mental health systems – Australia, England, Finland, France, Italy, Korea, The Netherlands, Scotland, and Sweden – 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.
Permanent URL: http://www.oecd.org/health/mentalhealth
The OECD Mental Health and Work Project