Table 1.
Indicators of public mental health in OECD countries.
| # | Indicator | Reference example |
|---|---|---|
| 1. Mental Health Promotion and Prevention [n = 7 indicators] | ||
| 1 | Mental health promotion budget | (14) |
| 2 | Existence of mental health promotion programs | (15) |
| 3 | Presence of mental health promotion in schools | (14) |
| 4 | Presence of programs to support parenting skills | (16) |
| 5 | Presence of suicide prevention programs | (16) |
| 6 | Participation in selected or indicated preventive programs on mental health | (17) |
| 7 | Anti-stigma movement | (18) |
| 2. Mental Health Resources [n = 19 indicators] | ||
| 8 | Spirituality | (5) |
| 9 | Sleep | (19) |
| 10 | Healthy lifestyle [e.g., nutrition, physical activity, substance/alcohol consumption] | (20) |
| 11 | Self-efficacy | (21) |
| 12 | Resilience | (22) |
| 13 | Optimism | (7) |
| 14 | Personality | (19) |
| 15 | General trust | (20) |
| 16 | Emotional intelligence | (20) |
| 17* | Self-esteem | (23) |
| 18 | Emotion regulation | (22) |
| 19 | Life-domain/Work-life balance | (7) |
| 20 | Satisfaction with work environment | (7) |
| 21 | Neighborhood environment | (20) |
| 22 | Perceived neighbourhood security | (20) |
| 23 | Sense of community belonging | (19) |
| 24 | Community involvement | (20) |
| 25 | Political participation | (20) |
| 26 | Social support/Social network | (5) |
| 3. Mental Health Risks [n = 16 indicators] | ||
| 27 | Chronic physical diseases | (19) |
| 28 | Chronic pain | (19) |
| 29 | Family history of mental disorders | (19) |
| 30 | Family history of suicide-related behavior | (19) |
| 31 | Critical life events trauma | (24) |
| 32 | Adverse childhood experiences | (24) |
| 33 | Violence | (20) |
| 34 | Discrimination | (20) |
| 35 | Chronic stress | (25) |
| 36 | High job strain | (7) |
| 37* | Cognitive impairment | (26) |
| 38 | Housing conditions | (20) |
| 39 | Stressful neighborhood conditions | (20) |
| 40 | Income inequality in society | (27) |
| 41 | Homelessness | (28) |
| 42 | Loneliness | (29) |
| 4. Mental Health Literacy [n = 10 indicators] | ||
| 43 | Mental health-related knowledge | (28) |
| 44* | Mental health locus of control | (30) |
| 45 | Attitudes towards mental disorders | (28) |
| 46* | Attitude towards mental health services / Mental health care | (31) |
| 47 | Public attitudes toward people with a mental disorder | (32) |
| 48 | Social distance toward persons with mental disorders | (28) |
| 49* | Perceived legitimacy of discrimination of persons with mental disorders | (33) |
| 50* | Self-stigma | (31) |
| 51* | Help-seeking attitudes | (31) |
| 52 | Competence in mental health self-management | (34) |
| 5. Positive Mental Health [n = 5 indicators] | ||
| 53 | Happiness | (28) |
| 54 | Health-related quality of life | (35) |
| 55 | Life satisfaction | (20) |
| 56 | Well-being [e.g., emotional/subjective well-being; psychological, social, physical] | (5) |
| 57 | Meaning in life | (22) |
| 6. Psychopathology [n = 34 indicators] | ||
| 58 | Prevalence of psychological distress | (36) |
| 59* | Prevalence of burnout | (37) |
| 60* | Incidence of any mental disorder (all F-diagnoses) | (38) |
| 61 | Incidence of affective disorders | (16) |
| 62 | Incidence of anxiety disorders | (16) |
| 63* | Incidence of substance use disorders | (23) |
| 64* | Incidence of psychotic disorders | (39) |
| 65* | Incidence personality disorders | (38) |
| 66 | Prevalence of anxiety disorders | (36) |
| 67* | Prevalence of mood/Affective disorders | (40) |
| 68 | Prevalence of depression | (29) |
| 69 | Prevalence of postpartum depression | (36) |
| 70 | Prevalence of bipolar disorders | (36) |
| 71* | Prevalence manic episodes | (41) |
| 72 | Prevalence of alcohol use disorder | (42) |
| 73 | Prevalence of substance use disorder | (24) |
| 74 | Prevalence of attention deficit hyperactivity disorders | (43) |
| 75 | Prevalence of obsessive-compulsive disorder | (43) |
| 76 | Prevalence of schizophrenia | (43) |
| 77* | Prevalence of psychotic disorder | (41) |
| 78* | Prevalence of adjustment disorder | (41) |
| 79 | Prevalence of posttraumatic stress disorder | (43) |
| 80 | Prevalence of eating disorders | (43) |
| 81* | Prevalence of impulse control disorders | (41) |
| 82* | Prevalence of somatoform and dissociative disorders | (44) |
| 83 | Prevalence of personality disorders | (43) |
| 84 | Prevalence of sleep disorders | (19) |
| 85 | Prevalence of any mental disorder (all F-Diagnoses) | (22) |
| 86 | Prevalence of severe mental disorders | (43) |
| 87 | Prevalence of common/high prevalent mental disorders | (22) |
| 88 | Prevalence of depression and/or anxiety disorders | (45) |
| 89 | Prevalence of chronic mental disorders | (28) |
| 90 | Comorbidity physical disease | (22) |
| 91 | Comorbidity mental disorder | (46) |
| 7. Self-Harm and Suicidality [n = 6 indicators] | ||
| 92 | Self-harm | (19) |
| 93 | Suicidality [e.g., ideations, plans] | (19) |
| 94 | Suicide attempts | (19) |
| 95 | Suicide rate of the general population | (47) |
| 96 | Suicide rate of mental health inpatients and recently after discharge | (48) |
| 97 | PYLL due to suicide | (29) |
| 8. Supply and Utilization of Mental Health Care [n = 34 indicators] | ||
| 98 | Capacity of outpatient mental health care: mental health workers | (15) |
| 99* | Capacity of outpatient mental health care: mental health specialists | (49) |
| 100 | Capacity of inpatient mental health care | (15) |
| 101 | Number of mental health hospitals | (15) |
| 102 | Number of psychiatric units in general hospitals | (15) |
| 103 | Number of forensic inpatient units | (15) |
| 104 | Number of mental health outpatient facilities attached to a hospital | (15) |
| 105 | Coverage of services for severe mental disorders | (50) |
| 106 | Treatment coverage for alcohol and drug dependence | (50) |
| 107 | Utilization of any health care of persons with diagnosed mental disorders** | (15) |
| 108 | Utilization of outpatient mental health care of persons with diagnosed mental disorders** | (15) |
| 109 | Utilization of primary health care of persons with diagnosed mental disorders for mental health reasons** | (29) |
| 110 | Utilization of primary health care of persons with diagnosed mental disorders for physical health reasons** | (51) |
| 111* | Utilization of primary health care and somatic specialist care only of persons with diagnosed mental disorders** | (52) |
| 112* | Proportion of psychotherapy in outpatient mental health care** | (53) |
| 113* | Proportion of pharmacotherapy in outpatient mental health care [e.g., depression]** | (53) |
| 114* | Treatment with psycho- and pharmacotherapy in outpatient care** | (54) |
| 115 | Utilization of inpatient care of persons with diagnosed mental disorders** | (34) |
| 116* | Number of inpatient cases** | (55) |
| 117 | Number of days of inpatient stay** | (48) |
| 118 | Hospital discharges for mental disorders | (36) |
| 119 | Number of long stay patients | (17) |
| 120 | Inpatient readmissions by mental health diagnoses | (6) |
| 121 | Out-patient aftercare | (17) |
| 122* | Utilization of psychiatric day care** | (56) |
| 123 | Utilization of home treatment** | (51) |
| 124 | Pre-admission community care | (6) |
| 125 | Emergency room visits | (19) |
| 126 | Self-help intervention utilization | (17) |
| 127 | Assisted housing for persons with mental disorders | (29) |
| 128* | Utilization of rehabilitation measures due to mental disorders | (57) |
| 129* | Number of days of rehabilitation measures due to mental disorders | (58) |
| 130 | Treatment with psychotropic drugs [e.g., antidepressants, antipsychotics, narcotic, sedative and anxiolytic substances] | (59) |
| 131 | Opioid substitution treatment | (60) |
| 9. Needs, Unmet Needs and Barriers in Mental Health Care | ||
| [n = 12 indicators] | ||
| 132* | Perceived needs | (61) |
| 133* | Help-seeking behavior due to mental disorders | (62) |
| 134* | Treatment latency | (63) |
| 135 | Early intervention [e.g., in psychosis]** | (51) |
| 136* | Met mental health care needs for adults with mental disorders** | (64) |
| 137 | Unmet mental health care needs | (19) |
| 138* | Number of cases per registered psychiatrist /psychotherapist | (56) |
| 139 | Waiting times ambulatory mental health care | (35) |
| 140* | Waiting times inpatient mental health care | (65) |
| 141* | Waiting times psychiatric daycare | (65) |
| 142 | Waiting times in emergency rooms | (32) |
| 143* | Access barriers in mental health care | (66) |
| 10. Quality of Care [n = 13 indicators] | ||
| 144 | Patient satisfaction with mental health care system | (22) |
| 145 | Patient reported outcome measures | (51) |
| 146 | Treatment success | (17) |
| 147* | Drop-out from mental health care | (67) |
| 148 | Patient education and participation | (17) |
| 149* | Inclusion of family and social environment into treatment of mental disorders | (68) |
| 150 | Coercive measures: involuntary admission | (51) |
| 151 | Coercive measures: compulsory treatment | (60) |
| 152 | Coercive measures: seclusion | (22) |
| 153* | Detection of depression in primary care | (69) |
| 154* | Guideline adherence mental disorders with S3 health care guidelines | (53) |
| 155* | Transfer rate from primary to secondary care | (52) |
| 156* | Outpatient-sensitive hospital cases | (70) |
| 11. Costs due to Mental Disorders [n = 7 indicators] | ||
| 157 | Total expenditure on mental health services | (15) |
| 158 | Direct costs due to mental disorders | (71) |
| 159* | Direct costs due to mental disorders - outpatient care | (72) |
| 160* | Direct costs due to mental disorders - rehabilitation | (73) |
| 161* | Indirect costs due to mental disorders | (74) |
| 162 | Sickness compensation | (16) |
| 163 | Disability pension for mental health reasons | (75) |
| 12. Burden of Disease and Mortality [n = 9 indicators] | ||
| 164 | Work loss due to mental health reasons | (28) |
| 165 | Functional Impairment due to mental health reasons | (59) |
| 166 | Mentally unhealthy days | (36) |
| 167 | DALYs (disability-adjusted life years) | (15) |
| 168 | YLDs (years lived with disability) | (24) |
| 169 | Excess mortality of people with mental disorders | (48) |
| 170 | Mortality for persons with severe psychiatric disorders | (76) |
| 171 | Alcohol-related deaths | (77) |
| 172 | Drug-related deaths | (77) |
| 13. Participation [n = 9 indicators] | ||
| 173 | Proportion of people with mental illnesses in employment | (32) |
| 174 | Existence of employment programs for people with long-term mental problems | (14) |
| 175* | Poverty among persons with mental illnesses | (78) |
| 176 | Proportion of people in prison with mental illnesses | (22) |
| 177 | Social and political participation in people with mental illnesses | (22) |
| 178 | Housing situation of people with mental illness [e.g., homelessness] | (22) |
| 179 | Discrimination due to mental health problems | (22) |
| 180* | Stigma-related stress | (33) |
| 181* | Stigma coping | (33) |
| 14. Sociodemographic Variables with an impact on public mental | ||
| health [n = 11 indicators] | ||
| 182 | Age | (79) |
| 183 | Gender | (79) |
| 184 | Region | (79) |
| 185 | Income equality / Social deprivation of the district (GINI) | (79) |
| 186 | Urbanization /Region | (79) |
| 187 | Migration background/Ethnicity | (79) |
| 188 | Relationship status (such as marriage) | (79) |
| 189 | Unemployment | (79) |
| 190 | Level of education | (79) |
| 191 | Income/ Poverty | (79) |
| 192 | Socio-economic status | (79) |
Indicator in Italics = indicator found only once.
*
Indicator not included in an established surveillance system.
**
Applicable to “any diagnosis of mental disorder” or itemized by different diagnoses.