Collaboration is key to treatment and assessing outcome

At the moment, only a small number of countries in the Organisation for Economic Co-operation and Development (OECD) regularly collect data on patient-reported indicators of success or otherwise in the mental healthcare setting,¹ Katherine de Bienassis (OECD, Paris, France) said at the plenary session.

The encouragement and co-ordination of such efforts is the key to creating meaningful measures for national and international comparison, she believes.²

Voices of patients and carers vital in improving quality of care

Collaboration between professionals, patients and caregivers

• The closer individual patients are involved in treatment decisions, the better their adherence and the better the treatment outcomes, Raluca Nica (Vice-President, GAMIAN Europe) told the EPA. From the patient perspective, she also drew attention to the need for co-ordination between primary and secondary healthcare, for integration between mental health and social care and for continuity of care across an episode of disease and perhaps throughout the life cycle.
• The contribution of family members – who know patients well and are well placed to encourage them into treatment and in adherence – was emphasized by Urs Würsch, newly-elected president of EUFAMI, which represents 25 million families of those with mental health problems across 23 European countries.
• Stecy Yghemonos (Executive Director of the Eurocarers network) emphasized the need for informal caregivers also to be involved in treatment decisions. Though often overlooked in such conversations, caregivers are the main providers of support to people with chronic physical and mental health problems, are again well-placed to promote adherence and are themselves vulnerable to mental health problems.  For all these reasons, the interface between caregivers and healthcare professionals should be strengthened, he urged.

“Getting better” should be defined not by what psychiatrists think, but by what the patient thinks as well

A European Year for Mental Health?

The ethical imperative is to help patients get better, and “getting better” should be measured not by what we think, but by what the patient thinks, agreed Philip Gorwood (EPA President).

Given the importance of facilitating patients’ informed treatment preferences, he advised everyone to participate in the EPA Forum’s ongoing Ambassadors survey on shared decision style.

Earlier in the session, John Ryan (European Commission, Luxembourg) described an EU initiative to encourage the spread of best practice, including prevention of ill-health through client-centered community services, reducing the rate of suicide and a step-wise approach to the management of depression.

He argued that the principles of universality, equity and solidarity should underlie the provision of mental healthcare. Sadly, the COVID pandemic has done much to undermine progress in all of these areas, it was acknowledged.

Treatment for existing mental ill health has been interrupted, and new problems created

Existing inequalities in access to healthcare have been exacerbated, those with existing mental health problems have had their treatment interrupted and been among the most vulnerable to infection, and social isolation and fear have fuelled a rise in anxiety and depression. 

Never before has there been so much focus on the need for mental health services, and the encouragement of resilience and other means of prevention. One positive step being advocated is the designation of a European Year for Mental Health.³