The World Health Organization’s Europe division (WHO/Europe) has released a new policy paper aimed at improving access to mental health care through primary health services. The paper, titled Scaling up mental health services within the primary care approach: lessons from the WHO European Region, highlights ways to enhance mental health services while reducing stigma and ensuring better health outcomes.
The paper is part of a series that draws from current research and offers practical steps to improve mental health services by increasing investment in primary care, as outlined in the Astana Declaration.
Mental Health as a Primary Care Priority
Between one-third and half of all people seeking help from primary care services do so for mental health issues. This makes primary care a vital point of contact for building trust in health systems. However, in many countries, mental health issues often go undetected or are only addressed by referring patients to specialized mental health services. This leads to long waiting times and can worsen conditions. Moreover, the stigma associated with seeking specialist help can discourage people from pursuing necessary care.
WHO/Europe’s policy paper presents strategies for integrating mental health services into primary care, making it more accessible and less stigmatizing.
Addressing the Mental Health Care Gap
In the WHO European Region, over 125 million people are affected by mental health conditions, yet many do not receive the care they need. The shortage of trained professionals, underfunded facilities, and persistent stigma are major barriers to care. Furthermore, social factors like income, housing, and employment also contribute to mental health problems, making it essential to address these issues within a primary care framework.
Primary care is uniquely positioned to help bridge the gap in mental health care. It is often the first point of contact for individuals seeking help and provides long-term, trusted relationships with providers. This continuity allows primary care providers to have more in-depth conversations about mental health and can detect early signs of illness or distress, offering support before conditions escalate.
A Holistic Public Health Approach
Many obstacles hinder the delivery of effective mental health care in primary care settings. These include financial constraints, a lack of trained staff, and insufficient communication between primary care professionals and mental health specialists. WHO/Europe’s policy paper offers solutions to overcome these challenges, drawn from successful examples across the region.
“Primary health care is not just a frontline service; it is the foundation of a resilient, equitable, and people-centered response to mental health,” says Natasha Azzopardi-Muscat, Director of WHO/Europe’s Division of Country Health Policies and Systems. “This paper is essential in emphasizing the importance of mental health promotion and prevention in building a recovery-oriented mental health care system.”
Four Key Strategies for Scaling Up Mental Health Services
The policy paper outlines four essential strategies to enhance mental health care within primary care:
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Training Primary Care Workers: Equip primary care workers with the skills to identify early signs of mental illness and offer support, referring to specialists only when necessary.
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Expanding Primary Care Teams: Integrate mental health professionals, such as clinical psychologists, into primary care teams to provide more comprehensive care.
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Strengthening Links with Specialist Services: Build stronger connections between primary and specialized mental health services to provide better care options and smoother transitions for patients.
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Partnerships with Other Sectors: Create partnerships with sectors such as housing, education, and employment to address the social determinants of mental health and provide long-term recovery support.
These strategies, when implemented together, can significantly improve mental health care in primary care settings, supported by better training, funding, and policy development.
The Economic and Social Value of Primary Care
Investing in mental health care within primary care not only improves access but also offers a high return on investment. WHO/Europe experts emphasize that primary care can provide person-centered care that addresses all aspects of health, including mental, social, and physical needs.
Ledia Lazëri, WHO/Europe’s Regional Adviser for Mental Health, states, “Primary care is where we can address all health determinants, making it the best place for sensitive, holistic care.”
By investing in primary care, countries can offer a wider range of mental health services, reduce reliance on expensive specialist care, and ultimately improve population health, well-being, and economic productivity.
In conclusion, scaling up mental health services within primary care is a key strategy for creating a more inclusive and effective mental health care system that meets the needs of all individuals, especially those facing the greatest challenges.
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