Mental health: Risk groups, trends, services and policies
Published: 2 September 2025
Anxiety and depression were already prevalent in the EU before the COVID-19 pandemic, during which they increased before levelling off again. Suicide death rates have declined significantly over the past few decades, but they have moved upward again recently. Poor mental health seems to have become more common among some groups, especially among older men and young women. In the EU, people typically have a formal entitlement to mental healthcare for free or at low cost, especially for particularly urgent care needs. However, people often do not seek care because of stigma and discrimination against people with poor mental health and because of the lack of access to care that is trusted and fits people’s needs. Mental healthcare services are frequently rated as low quality. Furthermore, care capacity is lacking, especially in rural areas and for children. Timely care for mild or moderate needs, particularly psychotherapy, is often only accessible to people who can pay for it. Nevertheless, care seeking, coverage and capacity have increased in many Member States. Greater emphasis is needed on the prevention of poor mental health by improving working and living conditions, making societies more inclusive, addressing loneliness and (cyber)bullying and enhancing social protection.
Poor mental health cost the EU 11.1 million years of life lost or lived with disability in 2021, two thirds due to depression and anxiety. After a dramatic decline, suicide death rates are rising again – especially among women under 20 and men over 85 – with suicide as the leading cause of death among Europe’s young.
Lower socioeconomic groups, people working in healthcare and social services, and marginalised groups face a higher risk of poor mental health. Long-term prevention can come from improved living and working conditions and enhancing social inclusion.
Women report poorer mental health and use primary mental healthcare more often, while men are less likely to seek care even though they are 3.7 times more likely to die by suicide. It is essential to tackle these gendered issues, including stereotypes on toughness; inequalities at work, in care provision and in housework at home; bullying; and domestic violence.
While most people in the EU are entitled to free or low-cost mental healthcare, stigma and discrimination as well as capacity limitations – especially in rural areas and for children – are often a barrier to entitlements in practice.
Nearly half (46 %) of those experiencing emotional or psychosocial problems rate the quality of mental healthcare services below five out of ten. Concern about low quality is a key barrier to accessing support and underlines the importance of providing support that actually meets needs.
Poor mental health affects many adults and children in the EU. Long-term trends affecting mental health include the shift from physical to digital working and living environments and climate change. Social insecurity, inequality and people’s concerns about their economic situation also play a role, notably during the cost-of-living crisis. Refugees escaping international conflicts have a higher risk of poor mental health. Furthermore, as the Great Recession illustrated earlier this century, the COVID-19 pandemic made it clear that even groups deemed less vulnerable to poor mental health are also at risk.
This report seeks to better understand the prevalence of poor mental health for different population groups, identify time trends and map barriers to accessing services. It also investigates policy measures directed towards mental health services, and actions taken in other environments (importantly, schools and workplaces) to prevent or address poor mental health. In this report, Eurofound brings together evidence from the literature, EU-level surveys, expert reviews and national administrative and survey data collected by the Network of Eurofound Correspondents and through desk research.
The European Commission’s communication on a comprehensive approach to mental health aims to put mental health on an equal footing with physical health and ensure a new cross-sectoral approach to mental health issues. EU action on mental health follows three guiding principles: adequate and effective prevention; access to high-quality and affordable mental healthcare and treatment; and reintegration into society after recovery. The EU also contributes more generally by, for instance, establishing the right to social protection benefits and services (through the European Pillar of Social Rights) and improving working conditions through occupational health and safety regulations.
In the EU, in 2021, poor mental health caused at least 11.1 million life years to be lost or lived with disability; of these, depression and anxiety accounted for 7.4 million.
The proportion of people at risk of anxiety or depression increased during the pandemic, but seems to have levelled off since then.
Among 15- to 29-year-olds in the EU, suicide is the main cause of death (18.9 % in 2021), followed by traffic collisions (16.5 %). Suicide death rates fell in recent decades. Between 2011 and 2021, the annual rate dropped from 12.4 to 10.2 per 100 000 people. However, the decrease has stalled since 2017 and there have been some increases, especially from 2021 to 2022.
People with lower incomes or levels of education, people who are separated or widowed, people who experience homelessness, and refugees are among the groups at higher risk of poor mental health.
Women are more likely than men to report poor mental health in surveys and are over-represented among primary mental healthcare service users. Suicide death rates are over three times higher for men than for women, and in several EU Member States men are over-represented among mental-health-related hospitalisations.
There are signs of increased poor mental health at both ends of the age spectrum, and over the past decade suicide deaths increased among women aged under 20 years and men aged 85 years and over.
One in four people working in human health and social work activities often or always feel emotionally exhausted by their work, more than in any other sector. Rates are also relatively high in education and in accommodation and food service activities, with one in five people reporting the same levels of emotional exhaustion.
Concerns about quality are a key barrier to accessing support. In the EU, 46 % of people who had experienced emotional or psychosocial problems in the previous 12 months scored the quality of mental healthcare services at below 5 on a scale from 0 (poor) to 10 (excellent).
Mental healthcare usage was already increasing in the EU before the pandemic and considerable increases in care usage have been observed in several Member States since the pandemic. Several Member States have increased care capacity and entitlements over the past decade, and stigma seems to have decreased.
People in the EU are generally entitled to free or low-cost mental healthcare, especially for particularly urgent needs. However, stigma and discrimination against people with poor mental health discourage people from seeking support. Furthermore, capacity limitations make these formal entitlements meaningless for many people.
Timely access to care for mild or moderate needs, such as psychotherapy, usually requires out-of-pocket payments, and is often unaffordable for people on a low income and without supplementary insurance.
Access to mental healthcare tends to be particularly difficult in rural areas and for certain types of specialist care, such as child psychiatry.
Improving population mental health is key to preventing poor mental health. This can be achieved by improving living and working conditions; enhancing social inclusion and cohesion; addressing and preventing poverty, over-indebtedness and homelessness; stimulating physical health; and stopping domestic violence, bullying and discrimination.
Addressing stereotypes of caregiving roles can prevent poor mental health due to work–life balance problems (especially for women). Addressing other, usually gendered, stereotypes (e.g. about breadwinner responsibilities) can also help to reduce poor mental health.
Schools, workplaces, social workers, primary care providers and medical specialists in areas other than mental healthcare can play a key role in early intervention and improving population mental health.
Access to high-quality mental health support should be improved. Services need to be trustworthy, respect human rights and be person-centred. People who have experienced poor mental health should be involved in designing mental health policies and services.
While waiting lists for mental healthcare should be addressed, instant support that can identify the most urgent cases and direct people to the appropriate help must be prioritised. This may include referral to support beyond mental healthcare (e.g. debt advice) and, in non-emergency cases, to group sessions, peer support and online mental health promotion and therapy services.
Addressing stigma and discrimination against people with poor mental health is key to ensuring access to care. Addressing stereotypes about toughness can reduce care-seeking stigma (especially for men).
Care seeking can be encouraged by ensuring that people are not discriminated against based on having had poor mental health in the past (e.g. in the area of insurance). Because of such negative consequences, people with poor mental health may not seek support. These consequences also contribute to additional mental health risks for people who have previously had poor mental health.
Lack of access to care in underserved areas can be addressed by financing mobile service provision, strengthening the mental healthcare capacity of primary care posts and making better use of digital services.
This section provides information on the data contained in this publication.
List of tables
Table 1: Variation in depression and feelings of anxiety, EU (%)
Table 2: Waiting times for various types of mental healthcare services, EU and Norway, 2024
Table 3: Psychotherapy sessions: basic coverage, user costs, support for low-income earners and supplementary insurance by country, 2024
Table 4: Examples of mental health strategies adopted after and before the COVID-19 pandemic
Table 5: Suicide prevention plans, selected countries
Table A1: National correspondents or experts who contributed to the report
List of figures
Figure 1: Framework for poor mental health, access to support and policy-responsive causal factors
Figure 2: Measuring the prevalence of poor mental health: Survey, care use and diagnosis data
Figure 3: Feelings of anxiety, 2006 and 2012, EU (%)
Figure 4: Share of the population at risk of clinical depression, 2006, 2014 and 2024, 13 Member States (%)
Figure 5: Prevalence of anxiety and depression among adults, EU estimates, 2001–2021 (%)
Figure 6: Suicide deaths, standardised numbers per 100 000 people, EU
Figure 7: Levels of climate worry, 2016 and 2024, EU (%)
Figure 8: Problematic social media use, 2018 and 2022, EU and Norway (%)
Figure 9: Schematised gender differences in poor mental health: reporting, care usage and suicide deaths
Figure 10: Change in visits to psychiatrists/ psychologists by gender, 2014 and 2019, EU (%)
Figure 11: Prevalence of depression by gender, 2014 and 2019, EU (%)
Figure 12: Prevalence of depression by educational attainment and gender, 2024, EU (%)
Figure 13: Depression rates among people aged 50 years and over, by age group and gender, 2020 and 2022, EU (%)
Figure 14: Rates of feeling low in children aged 11, 13 and 15 years, 2014, 2018 and 2022, EU and Norway (%)
Figure 15: Prevalence of depression by household type and number of close confidants, 2024, EU (%)
Figure 16: Feeling emotionally exhausted by work (often or always), by sector, 2021, EU (%)
Figure 17: Limitation in daily activities, economic activity status and depression, 2024, EU
Figure 18: Barriers to accessing mental healthcare among people who experienced an emotional or psychosocial problem, by type of barrier, 2023, EU (%)
Figure 19: Number of psychiatrists per 100 000 inhabitants, 2022, EU and Norway
Figure 20: Mental healthcare services located too far to travel to, by people who experienced mental health problems, by degree of urbanisation, 2023, EU (%)
Figure 21: Rating of the quality of mental healthcare services by people who experienced/did not experience poor mental health in the previous year, 2023, EU (%)
Figure 22: Difficulty of affording healthcare services if needed, bottom-quartile income earners, 2016, EU (%)
Figure 23: Reported unmet mental healthcare needs, EU (%)
Figure 24: People with major depression not receiving adequate treatment, 2021, EU and Norway (%)
Figure 25: Gender equality and suicide deaths, correlation of Member State values, 2021
Learn more about the author of this publication.
Eurofound recommends citing this publication in the following way.
Eurofound (2025), Mental health: Risk groups, trends, services and policies, Publications Office of the European Union, Luxembourg.
ISBN
ISBN 978-92-897-2490-6
Number of pages
90
Reference no.
EF25029
ISBN
ISBN 978-92-897-2490-6
Catalogue number
TJ-01-25-013-EN-N
DOI
10.2806/1616679
Permalink
https://eurofound.link/ef25029
