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Population level of unmet need for mental healthcare in Europe^*

Health Services Research Unit, Institut Municipal d’Investigació Mèdica (IMIM–Hospital del Mar), Barcelona, Spain

VIVIANE KOVESS, MD

Fondation MGEN pour la santé publique, Université Paris 5, Paris, France

MATTHIAS C. ANGERMEYER, MD, PhD

Department of Psychiatry, University of Leipzig, Germany

STEVEN J. KATZ, MD, MPH

Division of General Medicine, University of Michigan, Ann Arbor, Michigan, USA

JOSEP M. HARO, MD, MPH, PhD

Research and Development Unit, Hospital Sant Joan de Deu – Serveis de Salut Mental, Barcelona, Spain

GIOVANNI DE GIROLAMO, MD

University of Bologna, Italy

RON DE GRAAF, PhD

Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, The Netherlands

KOEN DEMYTTENAERE, MD

Department of Psychiatry, University Hospital, Gasthuisberg, Leuven, Belgium

GEMMA VILAGUT, Stat and JOSUÉ ALMANSA, Stat

Health Services Research Unit, Institut Municipal d’Investigació Mèdica (IMIM – Hospital del Mar), Barcelona, Spain

JEAN PIERRE LÉPINE, MD

Assistance Publique Hopitaux de Paris, France

TRAOLACH S. BRUGHA, MD, FRCPsych

Department of Health Sciences, University of Leicester, UK

the ESEMeD/MHEDEA 2000 investigators

Correspondence: Jordi Alonso, Health Services Research Unit, Institut Municipal d’Investigació Mèdica (IMIM – Hospital del Mar), Carrer del Doctor Aiguader, 88 E-08003 Barcelona, Spain. Tel: + 34 93 316 0754; fax: + 34 93 316 0797; email: jalonso{at}imim.es

Declaration of interest Partial funding from GlaxoSmithKline (see Acknowledgements).

^* Freely available online through the British Journal of Psychiatry open access option.

Background The high prevalence of mental disorders has fuelled controversy about the need for mental health services.

Aims To estimate unmet need for mental healthcare at the population level in Europe.

Method As part of the European Study of Epidemiology of Mental Disorders (ESEMeD) project, a cross-sectional survey was conducted of representative samples of the adult general population of Belgium, France, Germany, Italy, The Netherlands and Spain (n=8796). Mental disorders were assessed with the Composite International Diagnostic Interview 3.0. Individuals with a 12-month mental disorder that was disabling or that had led to use of services in the previous 12 months were considered in need of care.

Results About six per cent of the sample was defined as being in need of mental healthcare. Nearly half (48%) of these participants reported no formal healthcare use. In contrast, only 8% of the people with diabetes had reported no use of services for their physical condition. In total, 3.1% of the adult population had an unmet need for mental healthcare. About 13% of visits to formal health services were made by individuals without any mental morbidity.

Conclusions There is a high unmet need for mental care in Europe, which may not be eliminated simply by reallocating existing healthcare resources.

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