Stepping Up to Tackle Mental Ill-Health
“Mental health issues exact a high price on individuals, their families, employers and the economy,” said OECD Secretary-General Angel Gurría, “Policymakers have been too slow to act. Strong political leadership is needed to drive reform and tackle this issue.”
Winston Churchill, Virginia Woolf and millions of others have suffered in the past or still live with mental illness. As many as half of all people in OECD countries can be expected to suffer from mild to moderate mental ill-health at some point during their lives. And yet despite the scale of the problem, mental illness is still too often a second thought for health systems, and a forgotten issue for policy makers. For too long the widespread worldwide burden of mental illness has done little to galvanise a policy response: those suffering from mental ill-health often experience prejudice and fear, struggle to get the treatment they need, and are more likely to experience unemployment, inactivity and physical ill-health than the rest of the population.
The OECD has long been shedding light on the unacceptably high personal, societal and economic burden of mental ill-health. For several years, we have recommended policies countries need to introduce to tackle mental illness, to give those affected the care and services they deserve. In OECD’s Making Mental Health Count we show that there are unacceptable treatment gaps for mental illness, even in the most advanced countries. Too many people go without treatment or wait too long for treatment and are unable to access the most appropriate treatment. Evidence-based treatment for mild and moderate mental illness is often unavailable, patients have to wait a long time, or face high costs. For severe illnesses, comprehensive treatment plans tailored to patients’ needs are few and far between. The outcomes tend to be, as one could expect, poor. OECD data show that in Denmark, New Zealand, Norway, Sweden and Korea, individuals with bipolar disorder or schizophrenia have a mortality rate some 4 to 6 times higher than the general population.
Mental illness does not just reduce the wellbeing of affected people and their entourage. The economic costs of mental-ill health are high, too, as they can exceed 4% of GDP. The OECD report Fit Mind, Fit Job suggests that people with poor mental health are much less likely to be in work, and, when employed are more likely to be absent from work. Depending on the severity of the mental illness, the employment gap can be 15 to 30 percentage points relative to the rest of the population. Not surprisingly, people suffering from mental ill-heath face a risk of poverty that is 30% to double that of the total population.
There are better ways to tackle mental ill-health. Evidence-based services – like psychological therapies, early intervention approaches, or pharmacological therapies – should be made more easily and quickly accessible. We need front-line public servants – GPs, nurses, teachers, social workers – to understand how to spot the signs of mental illness, and to know where to direct people to get help. Employment and health care services ought to act fast – and work together – when mental health problems are recognised or diagnosed. We need better policies to allow those affected by mental ill-health to find jobs, to be fully productive at work and avoid protracted periods on sick leave when they would do better on the job.. Public policy, while essential, is not enough: we need to involve employers and social partners in the required actions to make the labour market inclusive for people with mental ill-health. And we need to act early because the onset of mental health problems is typically during youth and adolescence. Young people seek help even less than others but their education success suffers significantly thereby further impacting on their labour market chances later in life.
It is encouraging to see that policy makers are finally grappling with these challenges. Besides its analyses and striking statistics, the OECD Recommendation of the Council on Integrated Mental Health, Skills and Work Policy provides a set of policy principles that help countries address, through an integrated approach, the impact of mental health problems on health, education, employment and social outcomes. This Recommendation, to which all OECD members countries have adhered, sends a very clear message: that mental health must be at the heart of health, employment, education and social policy making, giving countries the impetus to make this commitment a reality. Mental health is finally moving to the top of the global agenda, too. Political leaders, international leaders, thought leaders, and policy makers worldwide are slowly waking up to decades-old cries of campaigners, patients, families, and sufferers, and looking for ways to bring mental health care out of the shadows.
The status quo on mental health is no longer acceptable. The message is clear: we must all step up, together, to tackle mental ill-health. Now, it is the time to do it.