OECD Health Policy Studies A New Benchmark for Mental Health Systems Tackling the Social and Economic Costs of Mental Ill-Health
Mental ill-health affects millions of people, and drives economic costs of more than 4% of GDP. 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.
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| Autor Corporativo: | |
| Formato: | Libro electrónico |
| Idioma: | Inglés |
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Paris :
OECD Publishing
2021.
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| Ver en Biblioteca Universitat Ramon Llull: | https://discovery.url.edu/permalink/34CSUC_URL/1im36ta/alma991009704615806719 |
Tabla de Contenidos:
- Intro
- Foreword
- Acknowledgements
- Executive summary
- A benchmark for understanding mental health system performance
- The state of mental health systems: Significant gaps in performance remain
- Some countries are leading the way with policies to tackle the social and economic costs of mental ill-health
- 1 Key findings and recommendations
- A framework for benchmarking mental health system performance
- High-performing mental health systems have high quality and accessible services, are person-centred, innovative, and multi-sectoral
- Measuring mental health performance
- No OECD mental health system delivers excellent performance across the board
- Principle 1. Person-centred approach: a policy priority that is not sufficiently implemented in routine care
- Person-centred mental health is a policy priority in many OECD countries, but proving harder to deliver in practice
- Moving from consultation to co-production is key for increasing person-centredness of mental health policy and services
- Principle 2. Accessible and high-quality care: service availability has been scaled-up, but still doesn't meet demand
- Unmet need for mental health care is an enduring concern across countries, despite efforts to scale up services
- Quality and outcomes of care remains a major challenge - both to measure, and to improve
- Scaling-up available to mental health services is critical for increasing access
- Principle 3. Integrated and multi-sectoral approach: in practice integration remains the exception, and not the norm
- The COVID-19 crisis calls for a re-doubling of efforts to integrate mental health, work, and education policy
- Some impressive efforts to improve mental health knowledge of key front-line actors but inconsistent implementation.
- Integration of mental health, skills, and work policy is uneven, and tools to make integrated care more systematic could be more widely used
- Principle 4. Promoting mental well-being and preventing mental ill-health: the COVID-19 crisis has highlighted the importance of good mental well-being, and gaps in support
- Mental health policies should focus on promoting positive mental health
- Countries are focusing on promoting good mental health in early life
- Steps to promote mental resilience in the face of the COVID-19 pandemic should be maintained
- Principle 5. Strong mental health leadership and governance: mental health has risen to the forefront of governments' agendas, and investment improvements is now needed
- Mental health is now a priority area for many governments, and has been prioritised in COVID-19 responses
- Overall mental health spending is increasing, but not significantly
- Decisive action to reduce stigma around mental illness is critical, but is infrequently measured
- Some population groups are significantly more vulnerable to mental illness and mental health services must be tailored to support their unique needs
- Principle 6. A future-focused and innovative approach: COVID-19 has accelerated mental health innovation, but workforce shortages are a limiting factors in improving mental health system performance
- Data availability makes workforce planning and international comparisons very challenging
- Use of digital tools increase access to services
- The way that mental health services are delivered is changing, accelerated by the COVID-19 outbreak
- The future of mental health performance measurement
- At present, OECD countries are not able to comprehensively measure mental health performance across the domains that they identify as priorities.
- More measures of quality and outcomes are warranted, even as important gaps in 'input' measures remain
- Patient-reported measures should be at the centre of policy making and service-monitoring
- References
- 2 People-centred mental health policies and services
- Introduction
- Individual-centred mental health care puts the individual at the centre
- People-centred care is a way forward to improve health care systems
- OECD countries are taking important steps towards a people-centred health system
- People-centred care is essential to build high-performing mental health systems
- How effectively are OECD countries delivering individual-centred mental health care?
- Do individuals have ownership of their own care?
- Elevating the service users' voice in mental health care
- Individual care plans are common in OECD countries, but not systematically used to their full potential
- Countries are reshaping involuntary care and putting in place frameworks to protect patient rights, including under involuntary admission
- Is mental health care respectful and inclusive of the individual, carer and family?
- Patient-reported measures show some signs of gaps between the widely held policy principle of person-centred mental health care, and the experience of mental health service users
- The significant economic role of carers and family members in mental health care must be recognised
- Are care and treatment tailored to individual needs and preferences?
- Offering service users choice is key to tailoring care to individual needs and preferences, but choice is not possible in most mental health service settings
- Deinstitutionalisation expands the range of choice for people in need of mental health care
- Can OECD countries deliver individual-centred mental health services which are culturally, age and gender appropriate?.
- Mental health services should be adapted to meet the needs of key population groups
- Many countries have strategies in place to support the mental health of key population groups
- Does the mental health system empower the individual to realise his or her own potential and contribute to society?
- Strengthening people-centred mental health care provision
- Moving from consultation to co-production is key for increasing person-centredness of mental health policy and services
- Peer-delivered services are of value for creating appropriate people-centred care
- More widespread use of patient-reported measures will be critical for driving more people-centred systems
- References
- 3 Accessible, high-quality mental health services
- Introduction
- Building high-performing mental health services
- What are accessible and high-quality mental health services?
- How accessible and high-quality are mental health services in OECD countries?
- Are services accessible and provided in a timely manner?
- Historically, rates of unmet need for mental health care have been high
- Coverage of mental health services varies across countries
- Average waiting times for mental health services decreased in countries tracking them
- Are services developed close to the community?
- Inpatient psychiatric beds are declining in almost all OECD countries
- The use of inpatient mental health services varies across countries
- Community-care capacity for mental health varies more than 30-fold between OECD countries
- Is continuity of care assured?
- Community-based mental health care demands good care co-ordination
- Emergency care visits and repeat admissions to inpatient care point to gaps in care co-ordination between inpatient and community care
- Services after discharge - suicide following discharge inpatient admissions.
- Do services deliver improvement of individual's condition?
- Are services safe?
- Inpatient suicides point to shortcoming in OECD countries
- Coercion in contemporary mental health care
- Do mental health services account for and respect the needs of vulnerable groups?
- Improving the accessibility and quality of mental health services
- Strengthening community services by developing early intervention approaches and accessible services such as talking therapies
- Early intervention techniques can effectively target adolescents or young adults
- Integrated continuous community care to improve mental health for people with severe mental health conditions
- Creating safe inpatient settings while reducing coercive measures
- When coercive measures are inevitable, care facilities should strive for using the least intrusive measures possible
- References
- 4 An integrated and multi-sectoral approach to mental health
- Introduction
- Why do mental health systems need to be integrated and multi-sectoral?
- Cross-sectoral mental health policies can support good mental health
- The economic costs of mental ill-health are distributed across multiple sectors
- The COVID-19 crisis calls for a re-doubling of efforts to integrate mental health, work, and education policy
- Are OECD mental health systems integrated and multi-sectoral?
- Do OECD countries take a 'mental health in all policies' approach?
- International mental health strategies recognise the importance of sectors beyond the health system for mental health policy
- OECD countries have made cross-sectoral mental health policy a priority in strategies, but implementation in practice is inconsistent
- Integration of mental health, skills, and work policy is uneven
- Do mental health systems ensure physical health needs are met?.
- People with severe mental health conditions have a lower life expectancy than the general population.
