Data and statistics
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 second cause of disability-adjusted life years (DALYs) in Europe and account for 19%, with only 4% after cardiovascular disorders.
Four of the top 15 diseases responsible for disability-adjusted years of life lost are mental health disorders:
- unipolar depressive disorders are the third cause of DALYs (5.6% of all DALYs);
- alcohol use disorders are the sixth leading cause of DALYs (3.3% of all DALYs);
- self-inflicted injuries are the 11th leading cause of DALYs (2% of all DALYs);
- Alzheimers and other dementias are the 14th leading cause of DALYs (2% of all DALYs).
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 (2004), neuropsychiatric disorders rank as the first cause of years lived with disability (YLD) in Europe, accounting for 39.7% of those attributable to all causes.
- Unipolar depressive disorder alone led to 12.4% of all YLD, making it the leading chronic condition in Europe.
- Alcohol-related disorders are on second place in Europe, and account for 6.8% of all YLD.
- Alzheimer and other dementias are in fifth place, accounting for 3.9% of the total.
- Schizophrenia and bipolar disorders rank 12, and are each responsible for 2.3% of all YLD.
According to the most recent available data 123 853 people commit suicide every year, out of which almost 80% are men.
The average suicide prevalence rates in Europe are 13.9 per 100000, with the highest rates in the Commonwealth of Independent States (CIS) (21.4 per 100000), followed by the new EU countries (13.8 per 100000).
Even within the European Union, where the overall average rate is 10.1 per 100 000 population, it rises as high as 30.7 per 100 000 population in Lithuania, 21.5 per 100 000 in Hungary, and 18.5 per 100 000 in Finland and 18.4 per 100 000 in Slovenia.
Men are almost 5 times more likely to commit suicides than women, in all countries of the European Region (average of 23.8 per 100 000 for men versus 5.2 per 100 000 for women), with the highest male/female ration in CIS countries and the new EU Member States (6 times and respectively 5.3 times more frequent in men).
The highest suicide rates are reported among people aged 65+ (21.9 per 100 000 population) and 45–59 (21.5 per 100 000 population), both rates are around 1.5 higher than the European average.
Among the age group 15–29, the highest rates are in CIS countries (21.9 per 100 000 population), 1.6 times higher than European average.
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.