# Responsiveness of European countries to the population mental health needs: A cross-national comparison study

## TL;DR

This study compares how European countries respond to mental health needs in healthcare, workplaces, schools, and society, finding significant differences between nations.

## Contribution

The study introduces a cross-national comparison of mental health responsiveness using standardized performance indicators across Europe.

## Key findings

- Sweden, Denmark, and Finland showed the highest healthcare responsiveness, while Romania, Slovakia, and Bulgaria had the lowest.
- Germany, France, and Denmark were most responsive in workplaces, schools, and society, whereas Greece and Slovakia were least responsive.
- Poorer mental health status correlated with higher responsiveness scores, suggesting countries with worse mental health may have higher responsiveness efforts.

## Abstract

This study aimed to cross-compare European countries’ responsiveness to their populations’ mental health (MH) needs.

For the EU-27 countries and the United Kingdom, the 2023 Headway Initiative collected data on 15 key performance indicators (KPIs) in responsiveness in healthcare, including workforce, facilities, quality of care, and MH expenditure, and 14 KPIs in responsiveness in workplaces, schools, and society. Bivariate correlations between Headway-transformed KPI scores, which were standardised in a 1–10 Likert Scale (1: worst performance; 10: best performance), tested for putative associations.

Responsiveness in healthcare: Sweden (10), Denmark (8.8), and Finland (8.3) showed the best performance, while Romania (1.0), Slovakia (1.1), and Latvia and Bulgaria (1.2) had the poorest performance. Responsiveness in workplaces: schools, and society, Germany (10.0), France (9.1), and Denmark (9.1) were the most responsive countries, while Greece and Slovakia (1.0) had the poorest responsiveness. MH status total scores negatively correlated with global scores on responsiveness in healthcare (r = −0.34, p = .075), workplaces (r = −0.46, p = .014), schools (r = −0.59, p = .003), and society (r = −0.53, p = .003) – poorer MH status, greater responsiveness.

European countries significantly differed in their responsiveness to the populations’ MH needs, although the real effectiveness of their MH policies remains to be elucidated. Whether more responsive countries, which achieved poorer MH outcomes, successfully met greater preexisting MH needs, they failed to do so, or the relationship is driven by other third variables (e.g., quality of MH assessment) requires future investigation.