Mental health service coverage and gaps among adults in Europe: a systematic review

Ensuring the right to the highest attainable standard of mental healthcare requires a clear understanding of the current state of service coverage and gaps across Europe. Given the wide heterogeneity of health systems and resources, systematically assessing these gaps is crucial in order to identify...

ver descrição completa

Detalhes bibliográficos
Autores: Barbui, Corrado, Alonso Caballero, Jordi, Chisholm, Dan, Evans-Lacko, Sara, Keynejad, Roxanne C., Lazeri, Ledia, Miah, Numan, Valuckiene, Zivile, Gastaldon, Chiara
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Recursos:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/72624
Acesso em linha:https://hdl.handle.net/10230/72624
http://dx.doi.org/10.1016/j.lanepe.2025.101458
Access Level:acceso abierto
Palavra-chave:Coverage gap
Europe
Mental health
Treatment gap
id ES_4c822f2fce12743ede2012a1829dbbce
oai_identifier_str oai:repositori.upf.edu:10230/72624
network_acronym_str ES
network_name_str España
repository_id_str
spelling Mental health service coverage and gaps among adults in Europe: a systematic reviewBarbui, CorradoAlonso Caballero, JordiChisholm, DanEvans-Lacko, SaraKeynejad, Roxanne C.Lazeri, LediaMiah, NumanValuckiene, ZivileGastaldon, ChiaraCoverage gapEuropeMental healthTreatment gapEnsuring the right to the highest attainable standard of mental healthcare requires a clear understanding of the current state of service coverage and gaps across Europe. Given the wide heterogeneity of health systems and resources, systematically assessing these gaps is crucial in order to identify inequities, inform policy and guide efforts to strengthen care at regional and national levels. In this Series paper, we systematically reviewed 45 studies reporting 198 national or sub-national estimates of adult mental health service coverage and treatment gaps in the World Health Organization (WHO) European Region. Data were scarce for many countries and conditions, heterogeneous in definitions, and rarely longitudinal, limiting comparability and trend analysis. Coverage for psychotic disorders was generally higher, often exceeding 90% in some countries but varied widely. For major depressive disorder, minimally adequate treatment ranged from below 10% in Bulgaria, Tajikistan and Turkmenistan to over 35% in Germany and Czechia. Anxiety disorder coverage ranged from 7% in Bulgaria to 47% in Sweden; most substance use disorder estimates were under 15%, and adult ADHD coverage was typically below 10%, based on outdated data. Trend analyses indicated minimal increases in depression coverage over two decades and mixed patterns for psychosis. Marginalised groups, including refugees, homeless populations and sexual minorities, faced the largest gaps, sometimes exceeding 80%. The lack of standardised, repeated measures hampers tracking of progress toward WHO's 2030 goal of a 50% increase in coverage. We advocate that harmonised monitoring systems, with attention to treatment adequacy and equity, are urgently needed to close persistent mental health care gaps across Europe.Elsevier2026202620252026info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/10230/72624http://dx.doi.org/10.1016/j.lanepe.2025.101458reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésThe Lancet Regional Health - Europe. 2025;57:101458© 2025 World Health Organization; licensee Elsevier Ltd. This is an open access article under the CC BY IGO license (http://creativecommons.org/licenses/by/3.0/igo/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any use of this article, there should be no suggestion that WHO endorses any specific organisation, products or services. The use of the WHO logo is not permitted.http://creativecommons.org/licenses/by/3.0/igo/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/726242026-06-12T07:21:37Z
dc.title.none.fl_str_mv Mental health service coverage and gaps among adults in Europe: a systematic review
title Mental health service coverage and gaps among adults in Europe: a systematic review
spellingShingle Mental health service coverage and gaps among adults in Europe: a systematic review
Barbui, Corrado
Coverage gap
Europe
Mental health
Treatment gap
title_short Mental health service coverage and gaps among adults in Europe: a systematic review
title_full Mental health service coverage and gaps among adults in Europe: a systematic review
title_fullStr Mental health service coverage and gaps among adults in Europe: a systematic review
title_full_unstemmed Mental health service coverage and gaps among adults in Europe: a systematic review
title_sort Mental health service coverage and gaps among adults in Europe: a systematic review
dc.creator.none.fl_str_mv Barbui, Corrado
Alonso Caballero, Jordi
Chisholm, Dan
Evans-Lacko, Sara
Keynejad, Roxanne C.
Lazeri, Ledia
Miah, Numan
Valuckiene, Zivile
Gastaldon, Chiara
author Barbui, Corrado
author_facet Barbui, Corrado
Alonso Caballero, Jordi
Chisholm, Dan
Evans-Lacko, Sara
Keynejad, Roxanne C.
Lazeri, Ledia
Miah, Numan
Valuckiene, Zivile
Gastaldon, Chiara
author_role author
author2 Alonso Caballero, Jordi
Chisholm, Dan
Evans-Lacko, Sara
Keynejad, Roxanne C.
Lazeri, Ledia
Miah, Numan
Valuckiene, Zivile
Gastaldon, Chiara
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Coverage gap
Europe
Mental health
Treatment gap
topic Coverage gap
Europe
Mental health
Treatment gap
description Ensuring the right to the highest attainable standard of mental healthcare requires a clear understanding of the current state of service coverage and gaps across Europe. Given the wide heterogeneity of health systems and resources, systematically assessing these gaps is crucial in order to identify inequities, inform policy and guide efforts to strengthen care at regional and national levels. In this Series paper, we systematically reviewed 45 studies reporting 198 national or sub-national estimates of adult mental health service coverage and treatment gaps in the World Health Organization (WHO) European Region. Data were scarce for many countries and conditions, heterogeneous in definitions, and rarely longitudinal, limiting comparability and trend analysis. Coverage for psychotic disorders was generally higher, often exceeding 90% in some countries but varied widely. For major depressive disorder, minimally adequate treatment ranged from below 10% in Bulgaria, Tajikistan and Turkmenistan to over 35% in Germany and Czechia. Anxiety disorder coverage ranged from 7% in Bulgaria to 47% in Sweden; most substance use disorder estimates were under 15%, and adult ADHD coverage was typically below 10%, based on outdated data. Trend analyses indicated minimal increases in depression coverage over two decades and mixed patterns for psychosis. Marginalised groups, including refugees, homeless populations and sexual minorities, faced the largest gaps, sometimes exceeding 80%. The lack of standardised, repeated measures hampers tracking of progress toward WHO's 2030 goal of a 50% increase in coverage. We advocate that harmonised monitoring systems, with attention to treatment adequacy and equity, are urgently needed to close persistent mental health care gaps across Europe.
publishDate 2025
dc.date.none.fl_str_mv 2025
2026
2026
2026
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/10230/72624
http://dx.doi.org/10.1016/j.lanepe.2025.101458
url https://hdl.handle.net/10230/72624
http://dx.doi.org/10.1016/j.lanepe.2025.101458
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv The Lancet Regional Health - Europe. 2025;57:101458
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/3.0/igo/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/3.0/igo/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869407632152854528
score 15,812429

Registos relacionados