Data from the OECD-WHO Mental Health Questionnaire 2023 show that 94% of respondent countries have either expanded or introduced new measures on prevention and promotion since the COVID‑19 pandemic. In addition, around 96% of EU/EEA countries had a national mental health policy in 2023, with a vast majority also having a strategy or action plan to guide the implementation of the mental health policy (Figure 3). However, despite the large number of countries with national strategies and action plans on mental health, countries are at different stages of the implementation. Nearly 28% of surveyed countries have not addressed or have not yet started to implement a strategy or action plan on mental health in primary healthcare settings, while only 10% report having a fully implemented strategy or plan (Figure 3). The implementation of mental health policies in school-based settings has yet to be initiated in 21% of countries, while only 14% report that they have fully implemented a school-based mental health plan or policy. Finally, regarding workplace‑based interventions, which may provide support to young adults as they enter the workforce, 10% of countries have not addressed or implemented a strategy or action plan, while another 10% have fully implemented one.
Promoting good mental health in children and young adults
Notes: * Levels correspond, from lower to higher, to 1) No mental health policy, strategy or action plan, 2) Countries with a national mental health policy, and 3) Countries with a strategy or action plan to guide implementation of the mental health policy.
Source: OECD-WHO Mental Health Survey 2023.
Significant unmet needs for mental health care remain, and further action is needed to prevent mental disorders before they emerge. The levels of unmet needs for mental health care across all age groups are high in OECD countries. About two in three people who wanted to receive mental health care had difficulties accessing it for financial or geographical reasons, or because of long waiting lists (OECD, 2021[21]). In young people, rates of unmet needs for mental health care are similarly high. During the pandemic, an estimated half of Europeans aged 18‑29 had unmet needs for mental health care (OECD/European Union, 2022[5]).
Several factors contribute to low access to mental health services. Structural barriers within health systems (e.g. lack of services, long waiting time, cost) limit availability, while personal barriers (e.g. lack of mental health literacy and stigma around mental illness) may discourage individuals from seeking help. Critically, access to support for early, mild symptoms of mental ill-health is even more limited, despite evidence that early intervention is essential. Individuals with mild and moderate symptoms are significantly less likely to receive a mental health support compared to those with severe symptoms (Evans-Lacko et al., 2018[22]). Yet, milder symptoms, if left untreated, can deteriorate to more severe mental disorders. For instance, research indicates that there is a 10% to 20% risk that subclinical depression deteriorates to major depression (Teepe et al., 2023[23]). This risk is particularly concerning for children and adolescents as mental health disorders that develop in youth tend to persist into adulthood, affecting lifelong well-being. Approximately 75% of adult mental disorders have their onset during adolescence, and this early onset increases the risk of recurrence and disabling physical conditions in adulthood (Kessler et al., 2005[24]). Promoting good mental health and addressing early symptoms can reduce the long-term burden of mental illness, improve quality of life, and ease pressure on already strained healthcare systems.