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Long waiting times, limited accessibility and fees are common obstacles faced by those seeking public psychological services in Europe. Shockingly, 56% of people diagnosed with depression in Europe receive no treatment at all (Purebl et al. 2015). This raises a crucial question: are European countries providing adequate psychological treatment through their public healthcare systems?
To explore this issue, the Spanish newsroom “Civio” collected data to identify shortcomings within the public healthcare systems of the European Union (EU).
Data collected
Due to the absence of official data on this issue, the Civio researchers, led by Bernardo et al. (2021), created their own database. They did this by sending out questionnaires to professional organizations, mental health non-profits, experts and data journalists from all EU countries. Their large data collection allowed them to analyze key metrics such as therapy fees, the number of sessions offered, the number of public psychologists per 100 000 people, and waiting times.
The study found that all EU countries (23 countries), except Bulgaria, Latvia and France, provide some form of psychological treatment through the public healthcare system. In Bulgaria, Latvia and France, only psychiatric treatment is covered, with psychologists accessible exclusively through private practices (Bernardo et al. 2021).
Fees for public psychological treatment
In one-third of the countries examined including Italy, users are required to pay fees for the public therapy sessions with fees ranging from as low as 3 euros per session in Greece to over 50 euros in Denmark (Bernardo et al. 2021).
Number of sessions provided
Bernardo et al. (2021) also highlighted that at least of 10 out of 23 countries impose limits on the number of sessions covered by the public healthcare system. These limits vary, from as few as 8 sessions in Belgium and Ireland to as many as 80 in Finland.
Shortage of resources
Limited resources were another critical issue. Civio’s researchers could only compare 14 countries due to insufficient data. Among these, nine countries had fewer than 20 public psychologists per 100 000 people – significantly below the minimum recommended by clinical psychology experts (Bernardo et al. 2021).
Long waiting times
Bernardo et al. (2021) found that waiting times for public psychological services ranged from 1 to 8 months, with longer waits reported in wealthier countries. Barbato et al. (2016) explored this issue further in an EU consensus paper, concluding that patients often had to wait over two months to receive psychotherapy. In contrast, the median time for psychotropic medication ranged between 7 and 30 days. Waiting times also varied based on the severity of the mental health disorder, as shown in Figure 1 (Barbato et al. 2016).
Long waiting times can cause significant suffering for patients needing psychological care. As a solution, some countries, such as the United Kingdom and Germany, have introduced “waiting maximums”. This policy allows patients to access private psychologists covered by public funds if waiting time exceeds a certain limit (Bernardo et al. 2021).
In conclusion, public healthcare systems in Europe are often insufficient in meeting the psychological needs of their populations, contributing to the alarming statistics that 56% of people with depression go untreated. Common challenges across countries include fees, long waiting times, session limits and recourse shortages. Addressing these gaps is crucial to improving access to mental health care in Europe.
Figure 1:
Source: Barbato, A., Vallarino, M., Rapisarda, F., Lora, A., Caldas de Almeida, J. M., (2016). Access to mental health in Europe – consensus paper. EU compass for action on mental health and well-being, 1-41. https://health.ec.europa.eu/system/files/2016-12/ev_20161006_co04_en_0.pdf
Vita Jamila Keil
keil.jamila@gmail.com
Bibliography
Barbato, A., Vallarino, M., Rapisarda, F., Lora, A., Caldas de Almeida, J. M., (2016). Access to mental health in Europe – consensus paper. EU compass for action on mental health and well-being, 1-41.
Bernardo, A., Álvarez Del Vayo, M., Torrecillas, C., Hernández, A. (2021). Pay up or put it off: how Europe treats depression and anxiety. Fundazión Civio.
Purebl, G., Petrea, I., Shields, L., Tóth, M. D., Székely, A., Kurimay, T., McDavid, D., Arensman, E., Granic, I., Abello, K. M. (2015). Depression, suicide prevention and e-health, Situation analysis and recommendations for action. Joint action on mental health and well-being.
Sitography
https://civio.es/medicamentalia/2021/03/09/access-to-mental-health-in-europe/
https://health.ec.europa.eu/document/download/ab5ab6a0-b8a5-47a7-9c81-91a0183c3a19_en
A.P.E. 
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