Psychiatric services not meeting demand – reform needed across the WHO European Region
Across the WHO European Region, about 30% of years lived with disability can be attributed to mental disorders, but fewer than 50% of people with a mental disorder have ever received any kind of treatment and even fewer (10%) receive adequate care. This massive unmet need for treatment – the treatment gap – is the result of a combination of the stigma of mental health and mental health services, lack of accessibility and, when services are available, poor quality. Many people are reluctant to go for help owing to the fear associated with mental disorders and a lack of trust in the quality and effectiveness of treatment and care offered by mental health services.
Proper prevention and treatment offer the potential for enormous health improvement, especially in vulnerable groups. People from the most deprived population groups are the most exposed to risk factors. They also have a much higher prevalence of most mental disorders, yet they have poorer access to mental health interventions. Half of all mental disorders have their onset by age 14 and, in several countries, the number one cause of death in adolescents is suicide. Only very minimal budgets are provided for prevention, typically less than 1% of the mental health budget, which itself is often a small fraction of the overall health budget.
“Countries need to close their large and isolated mental hospitals, which are branded by stigma and fear. Instead, we need to design mental health services that are trusted, offer respectful, safe and effective interventions and are accessible to all. The European Mental Health Action Plan offers a platform to develop such empowering services across the Region,” said Zsuzsanna Jakab, WHO Regional Director for Europe.
Strong evidence shows that prevention initiatives, particularly those targeting people at risk of developing mental disorders, are effective. They reduce suffering, increase productivity and prevent suicides through a number of proven interventions:
- training of family doctors to detect and treat depression;
- closure of large hospitals, establishment of community centres and the offer of occupational opportunities;
- training of home nurses to screen for depression;
- training in parenting to improve bonding and prevent abuse; and
- provision of pre-school placements and school education programmes.
European Member States endorse plan to improve mental health in the Region
The comprehensive European Mental Health Action Plan outlines specific interventions for the European Region based on proven effective treatments and care. The Plan was endorsed by 53 European Member States on 18 September 2013, and presses governments to ensure that mental health services are accessible, competent and affordable, and available in the community