Improving mental health care in depression: A call for action

Abstract

Depressive disorders have one of the highest disability-adjusted life years (DALYs) of all medical conditions, which led the European Psychiatric Association to propose a policy paper, pinpointing their unmet health care and research needs. The first part focuses on what can be currently done to improve the care of patients with depression, and then discuss future trends for research and healthcare. Through the narration of clinical cases, the different points are illustrated. The necessary political framework is formulated, to implement such changes to fundamentally improve psychiatric care. The group of European Psychiatrist Association (EPA) experts insist on the need for (1) increased awareness of mental illness in primary care settings, (2) the development of novel (biological) markers, (3) the rapid implementation of machine learning (supporting diagnostics, prognostics, and therapeutics), ( 4) the generalized use of electronic devices and apps into everyday treatment, (5) the development of the new generation of treatment options, such as plasticity-promoting agents, and (6) the importance of comprehensive recovery approach. At a political level, the group also proposed four priorities, the need to (1) increase the use of open science, (2) implement reasonable data protection laws, (3) establish ethical electronic health records, and (4) enable better healthcare research and saving resources. Treatment of depression today The reality of diagnosing and treating depressionIn Europe, almost one citizen in five is diagnosed with depression. The 12-month prevalence of depression varies between different regions but is approximately 6% across all countries. The first depressive episode typically occurs in a period between adolescence and the mid-40s [1]. The European Study of the Epidemiology of Mental Disorders showed that only 36.8% of participants with an affective disorder and 20.6% with an anxiety disorder reached out to health services for help. Of the participants who sought help, 20.7% received no therapy to alleviate their mental health problems [2]. Depressive disorders have a peak prevalence between the ages of 25 to 35. They are referred to as complex disorders because their etiology involves an interaction of genetic and environmental risk factors. Despite the availability of evidence-based treatments, only 45% of patients with depression recover permanently [3]; According to the World Health Organization, unipolar depression and other mental disorders on average lead to a significant functional impairment more debilitating than chronic diseases like diabetes [2]. Compared with the general population, people with mental illnesses such as depression are in poorer health and their life expectancy is lower [3], showing a need for improvement of diagnostic capabilities, as well as expansion of care for the affected.The associated reasons are outlined in the first part of this policy paper below and are used as the basis for European Psychiatric Association (EPA) action points which aim to ensure that pr...

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