Mental Health Systems in OECD Countries


Mental disorders account for one of the largest and fastest growing categories of the burden of disease worldwide. 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. As many as 80% of those with a common mental disorder, and up to 50% of those with a severe mental disorder, do not seek or receive treatment. 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, and those with mental illness have poorer educational and work outcomes than those in good mental health.


Given the significant burden of mental ill-health, for individuals, societies and economies, there is considerable interest in ways 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, and much still remains to be done to assure high-quality evidence-based treatment, appropriate outcome measurement, and good value-for-money in mental health care.

In 2018, the OECD began an ambitious new project to benchmark mental health performance. Working with international mental health experts and key stakeholders from across the world, this project will establish how ‘performance’ in mental health should be defined, measured, and improved. A final report, which ties together the performance benchmarking and the best-practice policies, is expected to be released in 2019. The report will use mental health performance measures, and mental health policy mapping, to benchmark how effective countries are at delivering mental health care. This report is expected to be a key tool to deepen understanding, drive improvement, and identify excellence in mental health practice in OECD countries.


The inaugural Global Mental Health Summit is being held in London on Tuesday 9 and Wednesday 10 October 2018. The Summit is co-hosted by the OECD and the Government of the United Kingdom, and supported by the World Health Organization (WHO). The Summit brings together political leaders with innovators, experts-by-experience, policy makers and civil society to share the most innovative and effective approaches to improving mental health. The overall theme for the Summit is Mental Health Equality in the 21st Century.

The key aims of the summit are to:

  • build momentum on global mental health issues such as tackling stigma and promoting access to evidence-based services;
  • agree to a global declaration demonstrating political leadership on mental health; and
  • create a legacy, with summits being held annually, driving global action.

The first day of the Summit, 9 October, is expert-focused with workshops and panel discussions. A series of six workshops will be held and will develop consensus statements for Ministers to hear on the second day. The OECD will host the ‘Children, young people and the now generation’ workshop which recognises the significant consequences mental ill health and psycho-social disability can have children and young people – impacting upon their development, contributing to poorer educational outcomes, higher rates of unemployment, and poorer physical health. 
The second day, 10 October, will include a message to ministers, and securing a global declaration committing to political leadership on mental health.


The Patient-Reported Indicators Survey (PaRIS) initiative

Health systems know very little about whether the health care delivered seeks to improve people’s well-being and their ability to play an active role in society. It is only when we measure outcomes reported by patients themselves – such as quality of life – that important differences in the outcomes of care emerge.

The Patient-Reported Indicators Survey (PaRIS) initiative addresses these critical information gaps and 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 health care services. In areas where patient-reported indicators already exist, the OECD supports countries to accelerate the adoption and reporting of validated, standardised, internationally-comparable patient-reported indicators. A working group on patient-reported indicators for mental health care is one of three international working groups that started in 2018, to discuss and coordinate instruments, definitions and data collection strategies across countries.

In addition, a new set of internationally comparable measures will be developed to help policy makers assess to what extent their policies are on track to make health systems more people-centred, under the OECD Patient-Reported Indicators Survey (PaRIS) initiative. 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.

PaRIS brochure image



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

Access country 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.

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






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