Data and resources
Prevalence of mental disorders
According to a systematic review of data and statistics from community studies in European Union (EU) countries, Iceland, Norway and Switzerland: 27% of the adult population (here defined as aged 18–65) had experienced at least one of a series of mental disorders in the past year (this included problems arising from substance use, psychoses, depression, anxiety, and eating disorders).
These figures represent an enormous human toll of ill health, with an estimated 83 million people being affected. Yet even these figures are likely to underestimate the scale of the problem, as only a limited number of disorders were included and it did not collect data on those aged over 65, a group that is at particular risk.
Rates for women are significantly higher as compared to those for men, except for substance use disorders (men: 5.6%, women 1.3%), and psychotic disorders (almost identical estimates). Overall rates are 33.2 versus 21.7.
These figures also fail to capture the complexity of the problems many people face. 32% of those affected had one additional mental disorder, while 18% had two and 14% three or more.
Disability-adjusted life-years (DALYs)
Neuropsychiatric disorders are the third leading cause of disability-adjusted life years (DALYs) in Europe and account for 15.2%, following cardiovascular diseases accounting for 26.6% and malignant neoplasms (cancers) accounting for 15.4%.
All conditions listed above are noncommunicable diseases which comprise 81.3% of the disease burden in the European Region followed by injuries which account for 10.2%.
Three of the top 15 diseases responsible for disability-adjusted life years are mental health disorders:
- Unipolar depressive disorders are the third cause of DALYs (3.8% of all DALYs);
- Alcohol use disorders are the sixth leading cause of DALYs (2.9% of all DALYs);
- Alzheimer’s disease and other dementia are the 15th leading cause of DALYs (1.9% of all DALYs).
Disclaimer: Please note that changes in DALYs estimates from 2004 to 2012 should not be interpreted as time trends and comparisons to previous years should not be made. Differences may be the result of changes in methodology and data used (2012 estimates use updated disability weights and a different standard for calculating YLLs. Also, methods of age weighting and 3% discounting were removed).
Years lived with disability (YLDs)
Mental disorders are by far the largest contributor to chronic conditions afflicting the population of Europe. According to the most recent available data (2012), neuropsychiatric disorders rank as the first cause of years lived with disability (YLD) in Europe, accounting for 36.1% of those attributable to all causes.
- Unipolar depressive disorder alone led to 11% of all YLD, making it the leading chronic condition in Europe.
- Alcohol-related disorders rank third in Europe, accounting for 6.4% of all YLD.
- Anxiety disorders rank sixth, accounting for 4% of all YLD.
- Alzheimer’s disease and other dementias rank ninth, accounting for 3% of the total.
- Migraines rank 11th with 2.7%, schizophrenia ranks 15th with 1.8% and bipolar disorder ranks 17th with 1.6% of the total.
Source: Global Health Estimates 2014 Summary Tables: YLD by cause, age and sex, by WHO Region, 2000-2012.
An estimated 804,000 suicide deaths occurred worldwide in 2012, representing an annual global age-standardized suicide rate of 11.4 per 100,000 population, according to the most recent data available from the 2014 WHO report “Preventing Suicide: A Global Imperative”.
In the European Region six European countries fall within the top 20 countries with the highest estimated suicide rates globally. Lithuania has the fifth highest suicide rate globally at 28.2 per 100,000, Kazakhstan has the 10th highest at 23.8 per 100,000 and Turkmenistan has the 14th highest with 19.6 per 100,000 population.
In high-income countries, 3.5 males commit suicide for every female. Yet in low and middle-income countries in Europe the suicide rate is as high as 4.1 males for every female.
Suicide accounts for 17.6% of all deaths among young adults aged 15-29 in high-income countries. It is ranked the second leading cause of death globally and in Europe among this age group, following road traffic accidents.
Moreover, 90% of suicides can be attributed to mental illness in high-income countries and 22% of all suicides are linked to alcohol use. It is essential to address these risk factors through actions such as curbing alcohol abuse and integrating services in connection with addiction and mental illness.
Despite these data, only 13 European countries are however known to have a national suicide strategy.
Mental health services
The combined rate of psychiatric beds per 100 000 population in community psychiatric inpatient units, units in district general hospitals and mental hospitals ranges from 185 in Malta to 8 in Italy, with a median rate of 72.
Rates of admissions to inpatient units per 100 000 population vary from 1301 in Romania and 1240 in Germany to 87 in Albania. The median rate of admissions is 568 per 100 000 population.
The rate of visits to all outpatient facilities per 100 000 population (varies from 28 200 in Slovakia and 26 077 in Finland to 1083 in Albania and 1066 in the United Kingdom (Scotland). The median rate is 6596.
Mental health workforce
The number of psychiatrists per 100 000 population ranges vary widely: from 30 per 100 000 in Switzerland and 26 in Finland to 3 in Albania and 1 in Turkey. The median rate of psychiatrists per 100 000 in the 41 countries that provided information is 9.
The median rates of psychiatrists per 100 000 population in the different parts of the WHO European Region are:
- EU15 – 12.9
- countries joining the EU since 2004 – 8.9
- countries in south-eastern Europe – 8
- CIS countries – 5.6.
The rate of nurses working in mental health care varies from 163 in Finland to 4 per 100 000 population in Bosnia and Herzegovina (Republika Srpska) and 3 in Greece. The median rate of nurses per 100 000 population is 21.7, more than twice the median rate of psychiatrists.
Mental health in primary care
Most countries report that general practitioners (GPs) deal with common mental health problems:
- identifying and referring people with problems (95% of countries);
- diagnosing problems (86%);
- regularly treating people with common disorders (86%).
GPs play a major role in identification, diagnosis and referral for severe mental disorders, but in most countries specialists are expected to give treatment, with GPs playing a supportive role.
- 74% of countries report that GPs identify and refer people with severe and enduring mental health problems.
- 52% report that GPs diagnose such disorders: 11 of the 15 countries belonging to the European Union (EU) before May 2004 (73%) and 5 of the 12 countries that joined the EU afterwards (42%).
- 40% report GPs give treatment; this includes no countries in south-eastern Europe or newly independent states.