How-to-Make-Societies-Thrive-Report-Highlights.pdf
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The document discusses how coordinated policy approaches can promote population mental health and well-being. It notes that mental health plays a central role in people's lives and was severely impacted by the COVID-19 pandemic, with rises in mental distress across OECD countries. The document advocates applying a well-being lens to mental health policies and provides several policy examples for integrating mental health considerations across sectors like health, employment, education, and social policies.
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How-to-Make-Societies-Thrive-Report-Highlights.pdf
- 1. How to Make Societies Thrive? Coordinated approaches to promote mental health and well-being WISE – the OECD Centre on Well-Being, Inclusion, Sustainability and Equal Opportunity Key Findings CENTRE ON WELL-BEING, INCLUSION, SUSTAINABILITY AND EQUAL OPPORTUNITY (WISE)
- 2. Why look at mental health? 27% 0% 10% 20% 30% 40% Share of people at risk of depression 2021 2020 2014 Source: OECD (2021), COVID-19 and Well-being: Life in the Pandemic, OECD Publishing, Paris, https://doi.org/10.1787/1e1ecb53-en In all countries with comparable baseline data, the share of the population at risk for depression rose sharply in 2020 Coalition building across sectors is limited, intersectoral task forces are given little authority, lack of M&E, general resource constraints Mental health plays a central role in people’s lives Rise of mental distress across OECD countries during COVID-19 Impact of mental health conditions pre-dates the pandemic Positive mental health as explicit policy target We see renewed calls for (mental) health in all policies approaches, but challenges remain:
- 3. This project – and two accompanying reports – applies a “well-being lens” to population mental health BETTER DATA FOR PREVENTION & PROMOTION How can we improve the quality and availability of comparable data on population-wide mental health status? WELL-BEING & MENTAL HEALTH NEXUS How do life experiences shape mental health? And, conversely, how does mental health shape outcomes in life? INTEGRATED APPROACHES IN PRACTICE What are lessons learned about systemic barriers and incentives to collaborate, from selected mental health initiatives across OECD countries?
- 4. OECD (2020) How’s Life? 2020: Measuring Well-being, OECD Publishing, Paris https://doi.org/10.1787/23089679 www.oecd.org/howslife • The analysis is grounded in the OECD Well-being Framework • The report tries to understand how mental health relates to each dimension of well-being, and the causal mechanisms that underpin these relationships • It identifies examples of “win-win” policies that involve agencies outside the health sector and that tackle both mental health and its upstream determinants
- 5. People with mental distress fare worse in every dimension of life Poor life outcomes, measured through the OECD Well-being Framework
- 6. Income and Wealth Two-way relationship Poor mental health is associated with a higher likelihood of poverty. Debt, as well as the financial strain and long-term stress of poverty can negatively affect mental health and its risk and resilience factors. Broader macroeconomic conditions (income inequality, general economic uncertainty, interest rate rises) also shape mental health. Cross-lag panel model showing psychological flourishing and difficulty making ends meet, GBR, 2009-20 Source: OECD calculations based on University of Essex (2022), Understanding Society: Waves 1- 11, 2009-2020 and Harmonised BHPS: Waves 1-18, 1991-2009. [data collection]., 5th Edition. UK Data Service., https://www.understandingsociety.ac.uk/.
- 7. Policy examples to support financial security and mental health outcomes Increase access to social assistance programs, while decreasing the cognitive burden of enrolment Universal schemes to improve quality of life and reduce stigma of social service use Intervention 3 Increase access to mental healthcare through new technology and expansion of community services Intervention 2 Intervention 1 Social policy and service provision, financial departments responsible for debt relief and targeted inflation support measures Social policy and service provision Health care and social policy For further details and concrete examples of existing policy practice, refer to Box 2.1 in the full report
- 8. Work and Job Quality Work, job quality and mental health are highly interrelated, showing the need for integrated approaches The quality of employment matters. Job instability and poor working conditions can lead to increased fatigue, risk of burnout or depression. Unemployment can worsen, or lead to the onset of mental health conditions, partly due to prolonged stress, low self-esteem and feelings of helplessness. Experiencing mental ill- health can also increase the likelihood of future unemployment, and is linked to challenges to productivity in the workplace. Long-standing OECD calls for integrated approaches to mental health policy in the 2015 OECD Recommendation of the Council on Integrated Mental Health, Skills and Work Policy and its follow-up work. A framework to integrate mental health considerations into: Health systems Youth support systems Social protection systems Workplace systems
- 9. Policy examples to support labour market and workplace as well as mental health outcomes Integrate mental health service provision into unemployment services through Individual Placement and Support (IPS) programmes Encourage employers to prioritise mental flourishing at work Intervention 3 Extend social protection schemes to platform workers Intervention 2 Intervention 1 Employment promotion, adult and continuing education, health care Employment and labour, corporate affairs Social policy, employment, and labour For further details and concrete examples of existing policy practice, refer to Box 2.2 in the full report
- 10. Housing 0% 10% 20% 30% Overcrowded accomodation Housing cost overburden Noise from neighbors or street No Internet at home Those with worse mental health are more likely to experience problems with housing conditions than the general population Share of people with deprivations in housing, by mental health outcome, OECD 26 Note: Risk of mental distress is defined using the Mental Health Index-5 (MHI-5) tool. Source: OECD calculations based on the 2013 and 2018 European Union Statistics on Income and Living Conditions (EU-SILC), https://ec.europa.eu/eurostat/web/microdata/european-union-statistics-on-income-and-living-conditions. Residential areas are important for mental health: neighbourhoods that are safe, facilitate social interactions, provide access to green space and areas to exercise, and are close to services are key. Mental health conditions can increase the likelihood of becoming homeless; homelessness increases the risk for developing a mental health condition. Housing unaffordability – especially housing debt – and instability in housing tenure can drive poor mental health.
- 11. Policy examples to support good housing, neighborhood as well as mental health outcomes Housing First as strategy to tackle homelessness and help alleviate mental distress Integrate mental health considerations into housing design guidelines Intervention 3 Create supportive and inclusive neighbourhoods to promote connectedness and psychological well-being Intervention 2 Intervention 1 Housing and social policy Housing, social policy, healthcare, environment and urban planning Housing, social policy, health care, sports and culture, environment and urban planning, law enforcement and safety For further details and concrete examples of existing policy practice, refer to Box 2.3 in the full report
- 12. Physical Health Poor physical and mental health often co-occur Physical activity and healthy eating habits positively influence mental health; exercising can lead to improved mood, higher self- esteem and lower levels of anxiety, worry and stress. Smoking can be a way to self-medicate, but tobacco use may actually worsen symptoms of anxiety or depression. Excessive alcohol consumption can occur alongside symptoms of depression and anxiety. Mental health conditions can make it harder to adhere to a treatment plan or manage symptoms; some psychiatric medications have side effects. Positive mental health may provide resilience against future health risks. Close association between poor mental health and many physical ailments, leading to increased morbidity and premature mortality. Some physical health conditions lead to social isolation; others to feelings of hopelessness or lack of control.
- 13. Policy examples to support physical health, healthy behaviours and mental health outcomes Better integrate physical and mental health care Encourage physical activity to promote good mental health Intervention 2 Intervention 1 Health care Health care, sports and culture, education, employment and labour, environment, urban planning, transport For further details and concrete examples of existing policy practice, refer to Box 3.1 in the full report
- 14. Knowledge and Skills Poor mental health can make it more difficult for students to perform well in school: completing assignments on time, focusing in class. Not doing well academically hurts self-esteem, which heightens risk for mental distress. Educational attainment and mental health are linked, but hard to disentangle from income and employment pathways. People at risk of mental distress have lower levels of educational attainment, compared to the general population Note: Risk of mental distress is defined using the Mental Health Index-5 (MHI-5) tool. Low education indicates the highest level of education is less than primary or lower secondary Source: OECD calculations based on the 2018 European Union Statistics on Income and Living Conditions (EU- SILC), https://ec.europa.eu/eurostat/web/microdata/european-union-statistics-on-income-and-living- conditions. 0% 10% 20% 30% 40% Low education (full pop) Low education (young people) Share of people with low levels of education, by mental health outcome, OECD 26, 2018
- 15. Policy examples to support knowledge, skills and educational attainment, as well as mental health outcomes Promote school-based interventions for mental health prevention and promotion Incorporate social and emotional learning into curricula Intervention 3 Promote life-long learning Intervention 2 Intervention 1 Education, health care Education, sports and culture Education, including adult and continuing education, sports and culture, employment For further details and concrete examples of existing policy practice, refer to Box 3.2 in the full report
- 16. Environmental Quality Younger people are more likely to be emotionally affected by climate change than are older people Climate change and its implications – biodiversity loss, increasing extreme weather events – harms mental health and has given rise to new forms of ill-health. The natural environment shapes our mental health. Clean air, access to green and blue spaces and more time spent in nature are all associated with better mental health outcomes. 0% 10% 20% 30% 40% Afraid Anxious Despair Ashamed Depressed Ages 18-24 Age 65+ Note: OECD 12 refers to Belgium, France, Germany, Ireland, Italy, Japan, Mexico, Spain, Switzerland, Turkey, the United Kingdom and the United States. Source: OECD calculations based on AXA (2023), Toward a New Understanding: How we strengthen mind health and wellbeing at home, at work and online, AXA Group, https://www.axa.com/en/about-us/mind-health-report. Reported feelings on climate change in OECD 12, share of respondents, 2022
- 17. Policy examples to support environmental and mental health outcomes Ecotherapy and green social prescribing Building green, connected cities to promote mental well-being Intervention 3 Strengthening government service systems, including mental health services, to better respond to climate disasters and foster resilience among the population Intervention 2 Intervention 4 Highlighting the hidden costs of climate change through innovative environmental accounting and well-being cost benefit analyses Health care, environment and conservation, urban planning Urban planning, environment, transport, sports and culture Emergency response, health care, social policy, environment, housing, urban planning Budgeting, health care, environment, urban planning, transport, housing, social policy Intervention 1 For further details and concrete examples of existing policy practice, refer to Box 3.3 in the full report
- 18. Safety Neighbourhood crime and feeling unsafe can worsen mental health directly and by influencing health protecting behaviours and social cohesion. Intimate partner violence is a gendered risk to safety with substantial mental health consequences. Experiencing the psychological stress and structural consequences of discrimination has been linked to depression and anxiety. Note: OECD 12 refers to Belgium, France, Germany, Ireland, Italy, Japan, Mexico, Spain, Switzerland, Turkey, the United Kingdom and the United States. Source: OECD calculations based on AXA (2023), Toward a New Understanding: How we strengthen mind health and wellbeing at home, at work and online, AXA Group, https://www.axa.com/en/about-us/mind- health-report. Experiencing discrimination has been linked to worse mental health (compared to those not experiencing it) Share of people with mental health deprivations, by self-reported experience of discrimination in the past year, OECD 12, 2022 0% 10% 20% 30% 40% Report depression Report anxiety Feel life is not worthwhile
- 19. Policy examples to support safety and mental health outcomes Improve neighborhood safety and resulting time-space inequalities (in the ability to use the neighborhood space fully, at all times, for mental health protecting activities such as sport and socialising) Address intimate partner violence and improve support for survivors Intervention 3 Tackle the roots of discrimination and racism Intervention 2 Intervention 1 Urban planning, transport law enforcement, social policy, healthcare, environment Law enforcement, justice, social policy, health care, statistics, education Justice, health care, education, employment and labour For further details and concrete examples of existing policy practice, refer to Box 4.1 in the full report
- 20. Work-Life Balance Time is a necessary resource for good mental health People with low levels of positive mental health are less satisfied with how they spend their time compared to the overall population 0% 10% 20% 30% 40% 50% Too tired after work for household chores No time to do things I enjoy Long hours in unpaid work Difficult to concentrate on work because of family responsibilities Share of people with deprivations in time use, by mental health outcome, OECD 24 Note: Positive mental health is calculated using the World Health Organization-5 (WHO-5) tool. OECD 24 includes: Austria, the Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Norway, Poland, Portugal, the Slovak Republic, Slovenia, Sweden and the United Kingdom. Source: OECD calculations based on the 2016 European Quality of Life Surveys(EQLS), https://www.eurofound.europa.eu/surveys/european-quality-of-life-surveys.
- 21. Policy examples to support work- life balance and mental health outcomes Promote work-life balance for all groups Reduce the unpaid work gender gap Intervention 3 Recognise the value of unpaid work Intervention 2 Intervention 1 Employment and labour, corporate conduct, transport, urban design Employment and labour, taxation, family policy, social policy Statistics, economy, social policy, education For further details and concrete examples of existing policy practice, refer to Box 4.2 in the full report
- 22. Social Connections People with poor mental health are more likely to distrust others, feel lonely and have infrequent contact with family and friends, compared to the general population Social connectedness causally protects and promotes mental health. Social isolation may alter social cognition and loneliness can contribute to increased cortisol levels, disrupted sleep patterns, and a lowered likelihood to engage in protective behaviours. Young people have emerged as risk group for both loneliness and mental distress since the COVID-19 pandemic. OECD 26, 2013 & 2018 Note: Risk of mental distress is defined using the Mental Health Index-5 (MHI-5) tool. Source: OECD calculations based on the 2013 and 2018 European Union Statistics on Income and Living Conditions (EU-SILC), https://ec.europa.eu/eurostat/web/microdata/european-union-statistics-on-income- and-living-conditions. 0% 10% 20% 30% 40% Dissatisfied with personal relationships Feel lonely Live alone Do not see friends and family monthly No trust in others
- 23. Policy examples to support social connectedness and mental health outcomes Make improving social connectedness an explicit policy priority Expand support for existing social connection interventions, for example, into existing community and government service structures (e.g. social prescribing) or by increasing opportunities for social contact (e.g. creating public civic and green spaces) Intervention 3 Strengthen the evidence base on effective and scalable interventions for different population groups Intervention 2 Intervention 1 Central government target setting, social policy, local development Urban planning, health care, social policy, housing, education, sports and culture Social policy, healthcare, family and youth policy, sports and culture, education For further details and concrete examples of existing policy practice, refer to Box 4.3 in the full report
- 24. 0% 10% 20% 30% 40% 50% 60% 70% No trust in politics No trust in the legal system No trust in the police Feel excluded from society Civic Engagement There is emerging evidence that ‘political stress’ and concerns about polarization can be risk factors for mental health. Experiencing depression is associated with lower likelihood to vote and engagement in political participation. The significant stigma of mental ill-health might deter entry into politics (and representation on the agenda). Note: Risk of mental distress is defined using the Mental Health Index-5 (MHI-5) tool. Source: OECD calculations based on the 2013 and 2018 European Union Statistics on Income and Living Conditions (EU-SILC), https://ec.europa.eu/eurostat/web/microdata/european- union-statistics-on-income-and-living-conditions. People with poor mental health are more likely to feel alienated from public institutions and society, compared to the general population OECD 26, 2013 & 2018
- 25. Policy examples to support civic engagement and participation as well as mental health outcomes Ease participation and representation in politics of those with lived experience of mental ill-health Address political stress, or concerns about polarisation, as an emerging mental health risk factor Intervention 2 Intervention 1 (Civic) education, parliaments, voting and participation Health care, education, sports and culture, urban planning For further details and concrete examples of existing policy practice, refer to Box 4.4 in the full report
- 26. Western Australia, Denmark, Faroe Islands, Finland, Norway: Act Belong Commit (the ABCs of Mental health) Programme Western Australia: Western Australian Mental Wellbeing Guide Canada: Mental Health Promotion Innovation Fund & Positive Mental Health Surveillance Indicator Framework Finland: National Mental Health Strategy and Programme for Suicide Prevention 2020-30 New Zealand: Mental Health and Wellbeing Commission (Te Hiringa Mahara) Norway: Programme for Public Health Work in Municipalities Sweden: “It’s about life” Proposal for the new National Policy for Mental Health and Suicide Prevention Wales: Public Service Boards & North Wales Public Service Lab and Insight Partnership REALIGN: Whole of government approach REDESIGN: Well-being determinants for prevention and promotion REFOCUS: Emphasis on positive mental health RECONNECT: Building broad partnerships The final part of the report uses case studies to see how mental health initiatives around the OECD can …
- 27. Multidimensional frameworks can provide the mandate for agencies to contribute to common goals Implementation plans that address intersectoral collaboration can support delivery Sufficient resources – both time and money – are needed for success and relationship building New ways to align: independent oversight agencies; strategic grantmaking for broader well-being work at the local level REALIGN Whole-of-government approach, across sectors and levels of government
- 28. Designing and implementing policies that jointly address mental health and other areas of well- being – as showcased in policy examples throughout the previous section Creating new tools, such as mental health or well-being impact assessments REDESIGN Social, economic, environmental and relational well-being determinants for mental health prevention and promotion
- 29. Publishing data on positive mental health helps with agenda setting Strategies and funding are increasingly explicit in targeting mental health promotion REFOCUS Emphasis on positive mental health
- 30. Many strategies have a participatory element but it needs to continue beyond the planning stage Knowledge brokering is essential to share learnings The depth of partnerships matters for impact RECONNECT Building broad partnerships across society
- 31. The Centre on Well-being, Inclusion, Sustainability and Equal Opportunity (WISE): https://www.oecd.org/wise/ OECD work on mental health: https://www.oecd.org/wise/well-being-and-mental-health.htm https://www.oecd.org/els/mental-health.htm Subscribe to our newsletter: https://oe.cd/wellbeingnews Contact us: wellbeing@oecd.org lara.fleischer@oecd.org jessica.mahoney@oecd.org Thank you! Stay in touch with WISE