Making mental health count
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Making Mental Health Count THE SOCIAL AND ECONOMIC COSTS OF NEGLECTING MENTAL HEALTH CARE Mark Pearson, Deputy Director for Employment, Labour and Social Affairs
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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.
Transcript of Making mental health count
Making Mental Health CountTHE SOCIAL AND ECONOMIC COSTS OF NEGLECTING MENTAL HEALTH CARE
Mark Pearson, Deputy Director for Employment, Labour and Social Affairs
One in five have a mental disorder
One in two experience a mental disorder in their lifetime
People with severe mental disorders die up to 20 years earlier
Since 1990 OECD suicide rates have fallen more than 20%...
… but increased 100% in Korea
In Korea 40 people die from suicide every day
The costs of mental ill-health can amount to more than 4% of GDP
Mental health spending doesn’t match the burden of
mental disorders
People with a mental disorder are…
…less effective at work…
… more likely to be absent from work…
… more likely to be out of work.
No d
isord
er
Mil
d-t
o-m
od
era
ted
isord
er
Seve
re d
isord
er
People with mild-to-moderate illness are 2-3 times more likely to be unemployed
People with severe mental illness are 6-7 more likely to be unemployed
THE POOR STATE OF MENTAL HEALTH CARE
How mental health care should be delivered: community based, well coordinated
Specialist community care
Inpatient care
Primary Care + Workplaces + Schools + Community
The state of mental health care now: fragmented, not enough of the right services
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
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Finland France Ireland Italy Korea Sweden OECD
Psy
chia
tric
car
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eds
per
100
000
po
pu
lati
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• Inpatient psychiatric beds falling across OECD; rose in Korea
• Average stay in psychiatric beds falling across OECD; rose in Korea
Hospital beds falling, but some countries still rely on inpatient care
• Multi-professional teams delivering care in the community for severe mental illness
• Hospitals used for short acute stays and emergency care
• Coordination across care settings is very important and often weak
Care has been shifting to community settings
Irelan
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United
King
dom
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Rep
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Austri
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Portu
gal
Belgium
Franc
e
Denm
ark
Hunga
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Czech
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OECD
Gre
ece
Italy
Eston
iaSpa
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Poland
Sloven
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Luxe
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Nethe
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10092 92 90
81 8178 76 75 75 73 73 71 71 71 71
67 67 6764
6157
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1411 12 13
17
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14
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12 128
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1714
11
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General practitioner Psychiatrist Psychologist%
Type of provider(s) consulted for mental health problems, selected EU countries, 2010
There is an important role for primary care
Note: The question asked during the interview was: “In the last 12 months, did you seek help from a professional because of a psychological or emotional problem? If yes, indicate who in the provided list (multiple answers possible)”.Source: OECD (2011), Health at a Glance 2011 – OECD Indicators, OECD Publishing, Paris, http://dx.doi.org/10.1787/health_glance-2011-en.
• Primary care is first port of call for mental health concerns• Key provider of care for mild and moderate illness• Coordinating role for severe mental illness
• For good mental wellbeing, good support from workplaces and schools is needed
• Involvement of occupational health services
• Need good integration of health and workplace services
• Good support in schools can have positive impact on educational attainment
• Need good teacher competence and awareness
Support can come from schools and workplaces
WHAT NEEDS TO BE DONE?
OECD countries need to make mental health count
Measure mental health
Increase evidence-based services for mild and moderate disorders
Better outcomes for severe mental illness
Make the link between work and mental health
• Identify people who need care • Better understand the cost of mental
illness• Improve reporting on quality and
outcomes
Measure mental health
• For mild-to-moderate disorders, scale-up evidence-based services
• Improve the competency and capacity of primary care practitioners
• Provide good support in workplaces and schools
Increase evidence-based services for mild and moderate disorders
• Focus on outcomes• Better coordination between care
settings• Pay attention to physical health
needs• Keep building high quality
community services
Better outcomes for severe mental illness
• Better competence among and support for key actors – e.g. employers, teachers
• Early intervention to prevent long-term costs
• Better integrated health and employment services
Make the link between work and mental health
Contact: [email protected]
Read more about our work Follow us on Twitter: @OECD_Social
Website: www.oecd.org/healthNewsletter: http://www.oecd.org/els/health-systems/oecd-health-update.htm
Thank you
