New Headway Report highlights environmental determinants of mental health

AP22 Site 1030X302 Headway B
  • Published: 28 Sep 2022

Key findings of the Headway Report presented today include:

  • An estimated 22.1% of people experience a mental disorder in conflict settings – 1/3 of Ukrainian refugees might develop depression, anxiety disorders or PTSD as a result of fleeing the war or being internally displaced
  • The direct and indirect effects climate change has on mental health hit those most vulnerable hardest and can include psychological distress, higher mortality and increased suicide rates
  • In Europe, the overall cost related to mental illness amounts to more than 600 billion Euro (4% of total EU GDP)
  • Mental health disorders are expected to account for more than half of the global economic burden due to non-communicable diseases by 2030
  • Continuing a trend already evident in results from 2021, Northern European countries generally score better on the Index, while Romania, Bulgaria and Slovakia are among those with the lowest overall scores

Brussels, September 28, 2022 – The conflict in the Ukraine and the impact of climate change will be among key factors behind a tidal wave of increasing mental health disorders in Europe according to findings from the latest Headway report titled A new roadmap in Mental Health. The report was presented today by The European House – Ambrosetti, an Italian Think Tank, together with Angelini Pharma, an international pharmaceutical company which is part of the privately‑owned Angelini Industries.

The Report compares mental health across 28 European countries using 55 key performance indicators (KPIs), highlights stark differences regarding the status of mental health and how countries are set up to address issues and support their people. Continuing a trend already evident in results from 2021, Northern European countries generally score better on the Index, while Romania, Bulgaria and Slovakia are among those with the lowest overall scores.

For the first time since the Headway initiative was launched in 2017, the Mental Health Index specifically reviews environmental determinants of mental health, and therefore highlights the disastrous impact of issues such as climate change or conflicts and migration. Environmental determinants are a recently framed category in mental health that incorporates all external conditions affecting the life, development and survival of a person. Looking at these environmental factors of mental health shows that Denmark, Finland, Sweden, Estonia, and Ireland are set up comparatively well in this regard, while Eastern & Southern European countries still have work to do in addressing these determinants of health, with Romania, Bulgaria and Greece having the least favorable environmental factors.

“This report refocuses international attention on the importance of environmental influences on mental health, such as climate change, economic recession or geopolitical crises like the war in the Ukraine,” said Pierluigi Antonelli, Chief Executive Officer, Angelini Pharma. “Mental disorders continue to impose an enormous social and economic burden on communities. Insights from the Mental Health Index 2.0 show that by 2030 mental health disorders will account for more than half of the global economic burden due to non-communicable diseases, which is why we need to act now!”

Environmental determinants impact individuals differently

While climate change has been documented to impact mental health outcomes similarly across different populations, the Index argues it will impact individuals differently. Young and indigenous people as well as those living with pre-existing vulnerabilities, cognitive/mobility impairments or those living in poverty are expected to be most affected. The Index describes impacts to include increased mortality, impulsive and aggressive behaviors, and higher suicide rates. It further reveals that previously little-discussed factors such as an average monthly temperature increase of one degree are associated with a 0.48% increase in mental health emergency department visits and a 0.35% increase in suicides.

Looking at the impact of conflicts and migration, the Index reveals an estimated 22.1% of people experience a mental disorder in conflict settings (13% mild forms of depression, anxiety and PTSD; 4% more moderate forms; 5.1% severe depression and anxiety, schizophrenia, and bipolar disorder). Post-conflict, approximately one in five people continue to struggle with depression, anxiety disorders, PTSD, bipolar disorders and schizophrenia. With 27 ongoing conflicts around the world and 68.6 million people displaced worldwide according to the United Nations, addressing the mental health needs of people affected by conflict and migration is an urgent priority.

Additional findings from the report show continued effect of the pandemic

The COVID-19 pandemic led to an unprecedented worsening of mental health, with conditions such as anxiety disorder and major depressive disorder increasing by over 25% globally. As described in the report, this comes as 19% of patients were unable to access mental health services and 52% experienced a worsening of their condition during the pandemic. The pandemic also had a profound impact on those working in healthcare: a higher risk of infection, longer working hours and high patient loads have contributed to healthcare professionals experiencing much higher levels of anxiety (13% vs. 8.5%) and depression (12.2% vs. 9.5%) than people in other professions.

There remains much to be done to support the mental health of patients and healthcare professionals in the wake of the COVID-19 pandemic,” said Hilkka Kärkkäinen, President GAMIAN Europe. “Mental health and physical health are inextricably linked and with COVID-19 having changed the way we view and access healthcare, it has become a priority for mental health support to be equal to physical healthcare.”

Huge differences in how countries are prepared to improve or maintain mental health

The Index further outlines key capabilities of healthcare systems to improve or maintain mental health outcomes in the future. Although data still reveals a significant difference in mental healthcare strategies, policies and legislation and there are steep variations in healthcare expenditure across European countries (e.g., France 14.5% vs Luxembourg 1%), strides are being made with an increase in mental health outpatient facilities from 3.9 to 9.1 per 1000,000 inhabitants.

The Headway Mental Health Index monitors different aspects of mental health providing a comprehensive and dynamic tool for the monitoring and planning of healthcare, welfare, education and environmental policies in Mental Health across European Countries,” said Daniela Bianco, Partner and Head of the Healthcare Practice of The European House – Ambrosetti, “It can be considered as a compass for policymakers to meet and tackle today’s and tomorrow’s challenges, improving mental health support for individuals and their families in order to guarantee well-being, inclusion, social cohesion, sustainability, and growth of our societies.”

Improved support in workplaces, schools and society at large

A final aspect of the Index covers the responsiveness of member states to the needs of people with mental health disorders in workplaces, schools and society. Mental health disorders affect approximately 20% of the working-age population with the unemployment rate for people affected by a mental health condition 7.7% higher than for those without such a condition. The overall cost related to mental illness in Europe amounts to 4% of the total European GDP (more than 600 billion Euro), which may have further increased since the COVID-19 outbreak. On a positive note, over 45% of the European countries have already implemented work-related mental health prevention and promotion programs and 68% of European countries have implemented a national strategy or program focusing on mental health promotion and prevention for children and adolescents.

In the age of uncertainty in which we live, young people are increasingly exposed to fears and worries, often with negative consequences on their mental health. Suffice it to say that a person born in the early 2000s has already gone through a great recession and its subsequent austerity measures, a global pandemic, geopolitical conflicts, a cost-of-living crisis and a world coming to terms with the magnitude of climate change and environmental degradation. To ensure a healthy future for the youngest part of the European population, an EU Mental Health Strategy must involve and engage all relevant actors and sectors. This multi-faceted approach would not only be more effective, but it would also be more inclusive and reach out to those more vulnerable or marginalized groups of young people.”, said MEP Brando Benifei, Member of the MEP Mental Health Alliance.

To learn more about Headway: A new roadmap in Mental Health or to download the full report, please visit: