Mental ill-health can have devastating effects on individuals, families and communities, with one in every two people experiencing a mental illness in their lifetime. Symptoms of anxiety and depression as much as doubled at the height of COVID-19 pandemic, and a confluence ofmultiple emerging and enduring crises – such as the cost-of-living and climate crises – continue to heighten the risk factors for poor mental health.
Mental ill-health also weighs heavily on societies and economies. The economic burden of mental ill-health can rise to up to 4% of GDP. Individuals experiencing mental-ill health have poorer educational, employment, and physical health outcomes than those in good mental health. Yet, historically, as much as two thirds of people seeking mental health support reported difficulties getting it.
OECD work on mental health looks at deepening understanding of the population burden of mental ill-health, improving mental health promotion and ill-health prevention, measuring the performance of mental health systems, recommending best practices across health, employment, education and social welfare policies, and promoting a more integrated approach to mental health policy.
Available data suggest that in some countries, depression symptoms were lower in 2022 than during the peak observed in 2021, despite higher than before the pandemic. In the first half of 2022, the mental health and well-being of many adults in EU countries remained below pre-pandemic levels.
Share of adults with a risk of depression, 2020-2022
Note: A risk of depression is defined as people with a WHO-5 score of 50 or below on a scale from 0-100.
Source: Eurofound’s Living, Working and COVID-19 e-survey.
In Adult mental health, Fig. 3.13, Health at a Glance: Europe 2022 : State of Health in the EU Cycle.
STRENGTHENING MENTAL HEALTH SYSTEMS
A good mental health system helps people stay in good mental health, and connects those in need to appropriate support to manage their mental health condition or even fully recover from it. The OECD’s Mental Health Systems Performance Benchmark is a framework for understanding and strengthening mental health performance by identifying priority policy priorities for mental health systems, which are underpinned by internationally comparable indicators to track performance. This approach is set to grow stronger still in the coming years as more data become available, and the Benchmark is updated.
This report provides an in-depth analysis of how well countries are delivering the policies and services that matter for mental health system performance, and highlights recent reforms countries have taken to strengthen mental health performance.
The OECD’s mental health Benchmark revealed significant gaps in mental health system performance. Although available data point to some recovery in population mental health as the pandemic situation improved, it also shows that levels of mental distress remain elevated, and well above 2019 levels. Vulnerable population groups, who often struggle to get access to the mental health support they need, may be particularly exposed. Other significant challenges lie ahead: already, there are rising levels of climate change anxiety, especially amongst youth; rapid demographic change will transform to the impact of aging societies on the mental health system demand, with at least one in four older adults experience some mental disorder; and understanding of the impact and opportunities of increased digital connectivity and tools on mental health status and care delivery remains poor. New OECD work is exploring these four global megatrends – inequalities, climate change, aging and digitalization – to understand the new challenges and opportunities they will bring to both mental health status and mental health systems.
In addition, new OECD work is identifying best practice public health policies to promote good mental health, and prevent mental ill-health in European countries. In a second phase this work will leverage the OECDs Strategic Public Health Planning model to assess best practices identified in OECD countries as well as a range of mental health interventions implemented at-scale.
MEASURING MENTAL HEALTH
OECD work helps countries improve their understanding of population mental health needs, and the quality, outcomes and experiences of people using mental health services.
The OECD Patient-Reported Indicator Surveys (PaRIS) initiative aims to develop international benchmarks of health system performance as reported by patients themselves, and includes a focus on collecting the experiences and outcomes of users of mental healthcare services.
This new international survey focuses on patients with one or more chronic conditions, including mental health conditions such as depression or anxiety, who are living in the community and who are largely treated in primary care or other ambulatory care settings.
Integrated Mental Health, Skills and Work Policy
The Recommendation of the OECD Council on Integrated Mental Health, Skills and Work Policy (2016) marked the recognition by OECD countries that the obstacles to ensuring good mental health for all individuals cannot be overcome within the health system alone, and that it requires a “mental-health-in-all-policies” whole-government approach. Five years later, the OECD assessed progress achieved in the policy areas covered by the Recommendation (health policy, youth policy, workplace policy, and welfare policy), and found that in most OECD countries much more will have to be done to implement the principles and fulfil the promises of the Recommendation.
TACKLING THE MENTAL HEALTH IMPACT OF THE COVID-19 CRISIS
The COVID‑19 crisis has heightened the risk factors generally associated with poor mental health – financial insecurity, unemployment, fear – while protective factors – social connection, employment and educational engagement, access to physical exercise, daily routine, access to health services – fell dramatically. This led to a significant and unprecedented worsening of population mental health, especially for young people.
Explore OECD work on mental health during the COVID-19 crisis, and strengthening mental health system resilience:
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