The economic impact of mental disorders in Europe: the importance of prevention in workplaces and schools

AP23 G 1030 Impatti03

Analysis of the results published in the latest report Headway - A new roadmap in Mental Health (2022), an initiative created by Think Tank The European House - Ambrosetti in partnership with Angelini Pharma. 

By 2030, mental health disorders will account for more than half of the global economic burden due to non-communicable diseases. A huge cost to society in terms of healthcare expenditure, lost productivity and unemployment. These are all expenditure factors that have already increased significantly during the Covid-19 pandemic.  

According to the latest OECD figures, the total cost related to mental health in Europe exceeded 600 billion euro, accounting for 4% of the EU's total GDP. In particular: the direct costs of health expenditure amounted to 190 billion euro; 170 billion euro were invested in social security programmes; and the indirect costs on the job market, caused by lower employment rates and reduced productivity due to mental illness, amounted to 240 billion euro. However, these are underestimated costs that do not take into account a number of other factors starting with social expenditure.

According to the OECD, mental illness, particularly mild and moderate, affects up to 20% of the working age population at least at some point in their lives. Once again, the latest report Headway, A new roadmap in Mental Heath (2022), takes stock of the impact of mental disorders on the world of labour in Europe. According to the report, partly due to the negative impact of the crisis caused by COVID-19, the mental health and well-being of workers is increasingly recognised as a relevant issue for stakeholders in the workplace. It is estimated that in OECD countries, the unemployment rate was on average 7.7 percentage points higher for people with mental health problems. They also find it more difficult to find a job, or to remain active in the labour market for longer. On average, people with a mental issue are more likely to retire early as well as to have a lower salary than other workers. On average, in the EU countries for which data are available, there is a large gap in average gross earnings between workers with mental health issues and those without. In some countries, such as Portugal, this difference reaches over 30%, followed by 23.5% in the UK and 23.2% in Ireland. 

Furthermore, a key component of the social burden of mental health is reduced productivity in the form of lost working hours. Workers with mental health issues may lose motivation and the ability to work effectively. In recent years, there has been an increase in absenteeism and even early retirement due to mental disorders throughout Europe. The consequence is an increase in the burden of unemployed people who receive specific unemployment benefits, but these are often not sufficient to enable them to lead independent lives as autonomous individuals.  

According to the latest data made available by the WHO, among the 27 EU countries plus the UK, 45.8% of countries have implemented programmes for the prevention and promotion of work-related mental health. In most cases, these programmes are managed directly by governments and only in rarer cases by a public-private partnership or even by private individuals.  

Governments also provide support to the mentally ill through a range of social benefits, albeit with a number of differences from country to country. And differences also exist with respect to the human resources employed in social services. For example, in Denmark, Belgium and Sweden, there are more than 100 occupational therapists for every 100,000 inhabitants, whereas these are completely absent in countries such as Bulgaria or Romania. Of course, the presence of other professional profiles, such as rehabilitation specialists or social workers, varies from country to country depending on the health and social system model in a given country.  

Mental health problems often manifest themselves at a young age and may accompany a person throughout his or her life. At least 50% of mental disorders occur before the age of 15, and 80% before the age of 18. Childhood is also a sensitive time for the promotion of well-being and the development of skills that prepare students for their working lives. This is why the school system becomes crucial for the development of good mental health for both children and adolescents. Scientific research has shown that the onset of depression and anxiety are often linked to a decline in school performance. Mental illness can cause poor performance or even dropping out of school. On average, in Europe, students who indicate mental distress are 24% more likely to repeat a year. And even then, not all countries behave in the same way. There are countries, such as Denmark or Finland, that make extensive use of awareness programmes in schools, while others use them little and ineffectively. Educational settings should also be well connected with other facilities, such as day care centres. But even here there are major differences from country to country. Compared to the European average of 0.947 every 100,000 inhabitants, the Netherlands has 5.630 compared to Spain with 0.004.  

According to the WHO, 68% of countries in the EU area, including the UK, have implemented at least one programme dedicated to mental health promotion and prevention for children and adolescents. Continuing to strengthen this approach of mental health awareness and support in schools, integrating health facilities and social services, will be crucial to improve the mental well-being of new generations and therefore of future populations.