The Big Question: Can we really afford not to invest in mental health care?
Two thirds of people around the world struggle to access mental health support but can we economically afford to continue down this path?
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00:00The investments in mental health is not just in that area.
00:03If we do that well, it's an investment in the society,
00:06it's an investment in our economy,
00:07and it's also an investment for all those affected.
00:17Hello and welcome to a very special live edition of The Big Question here in Brussels.
00:21Today, I am joined by, and please welcome to the stage,
00:24Nedim Pipic, Senior Vice President and Global Head for Mental Health from Boehringer Ingelheim.
00:31So, thanks for joining me today.
00:32We'll dive straight in.
00:34The world is talking a lot more about mental health these days.
00:37But how big is the actual problem?
00:41Wow, where to start?
00:43One in eight people at the moment are suffering from a mental health condition.
00:47Sadly, one of two people in this room are going to be affected by a mental illness
00:54in the course of their lifetime, statistically.
00:57So, that already raises a high sense of urgency of saying,
01:00is that something we could address better?
01:03On top of that, when you look at the consequences,
01:06serious mental illnesses are the leading cause of disability worldwide.
01:11And it affects those who suffer from it in a way
01:15where then 10 to 20 years of a lifetime is cut compared to the general population.
01:22Maybe a concrete example,
01:24Maybe a concrete example,
01:26schizophrenia, we don't often talk about it,
01:28but it's a disease which affects one in 300,
01:3124 million people,
01:33and also has the highest societal cost per patient of all the mental illnesses.
01:40The other issue contributing to the problem is lack of access.
01:44Already before COVID,
01:46many who would have liked to seek mental health care
01:52had issues getting effective care,
01:55getting solid treatments,
01:57and that gap has only increased post-COVID.
02:00Actually, 70% of those in Europe who seek it
02:06lack access to mental health care.
02:08So now, imagine if we had that same issue with cancer care,
02:12probably we would already have a national public health emergency.
02:23And going back to, you know,
02:25you compared serious mental health issues with cancer
02:29and kind of the approach,
02:30so let's touch upon that a little bit more.
02:32You know, thinking about physical illness versus mental illness,
02:35can you maybe compare that difference in the level of research
02:39and funding and access to support?
02:41The state health care system area,
02:43just as much in the industry area of research and development,
02:47there's a clear under-investment and under-representation of mental health.
02:52Health care sometimes seems like the ugly brother,
02:54but mental health care within health care
02:58is maybe then the ugly child that nobody wants to address or talk about,
03:02which is shocking.
03:04If you look at the health care systems,
03:05while on the one hand,
03:06the amount of those who need support for mental health issues is increasing,
03:12the health care systems are not adequately prioritizing it.
03:15In Europe, less than 2% of the health care budgets
03:19is actually being used to deliver mental health care.
03:23Again, comparing to cancer care,
03:25this is where 6% of the health care budget spending
03:28is being used to improve cancer care,
03:30so definitely a topic to be aware of.
03:34Thinking about the industry and the research and development,
03:38there's a clear lack of innovation,
03:40especially for serious mental illnesses.
03:42There are very few new treatments, for example,
03:44in schizophrenia in the last 30 years.
03:47Some progress has been made,
03:48but still a huge gap to be closed.
03:51You mentioned that less than 2% of health care budgets
03:54are dedicated to mental health.
03:56What do you think it should be in order to tackle the problem?
03:59Maybe to focus on two things which are so connected.
04:03We probably all see it.
04:04By the way, coming from the UN General Assembly last week,
04:08the issues are very similar in developed or developing countries.
04:12The size of it might be different,
04:14but there's a clear under-resourcing
04:17in the delivery of mental health care services.
04:20There's a lack of personnel on the psychiatry side,
04:23so health care professionals, nurses, psychologists.
04:26There's maybe new people starting, but also stopping,
04:30and there's no backfill coming in,
04:32so it's almost like a vicious circle.
04:34This under-resourcing is something
04:36that needs to be addressed right away,
04:38and that combined with,
04:39you also need to deliver on a care pathway,
04:41so you need to address the patient journey.
04:43Care pathways in mental health are broken.
04:45We have issues with diagnosis, comes too late,
04:48lack of treatment or lack of effective treatment,
04:51or people don't dare to ask for it.
04:54Rehabilitation and addressing relapses is also not working,
04:58so addressing the broken care pathways
05:00and the under-resourcing are the two points
05:02which could definitely make a difference.
05:07I'm sure everyone in this audience would agree
05:10that we all deserve a happy and healthy life,
05:13but maybe that's not always necessarily how the world works,
05:16and so is there a business case?
05:18I guess the big question here is,
05:20can we afford not to solve the mental health crisis?
05:23For me, it's a rhetoric question.
05:25No, we cannot afford it.
05:28We cannot stand still.
05:30I hope everybody agrees this is good mental health,
05:33is truly essential to a well-functioning society,
05:36so some action needs to be taken now,
05:39maybe to look at it from a global perspective.
05:42Mental health illnesses and the conditions
05:45that are challenging so many around the world
05:48have an economy burden globally
05:50of around $2.5 trillion U.S.
05:53That is going to almost triple by 2030 to $6 trillion U.S.,
05:57and I know it sounds like a big number,
06:01but to put it into perspective,
06:04$6 trillion, that's larger than the size of Germany's GDP.
06:08That's one-third of China's economy.
06:11So sometimes, and this is why I get goosebumps when I talk about it,
06:14because why are we not addressing that?
06:17And maybe as a takeaway, the investments in mental health
06:20is not just in that area.
06:22If we do that well, it's an investment in the society,
06:25it's an investment in our economy,
06:27but it's also an investment for all those affected
06:30and their loved ones, their caregivers,
06:32so all the individuals could benefit from that.
06:35And why do you think currently mental health is so underfunded?
06:39So maybe on the why,
06:41maybe let me connect it to the actions to be taken.
06:45So there's three areas.
06:47Policymaking, as we already mentioned,
06:50the needed investments to drive the change,
06:53and the third one, definitely still a lot of education
06:56that needs to be done.
06:58So maybe that also explains the why.
07:00It's the lack of those.
07:02Let's start with the first one on the policymaking, policy-shaping side.
07:05There's no better time than now
07:07to really act from a government perspective,
07:10from a national perspective,
07:12following a comprehensive mental health care plan
07:15that has now been lined out by the EU Commission,
07:17following a comprehensive mental health care plan
07:20and the 2030 UN Sustainable Development Goals,
07:23that are also lined up at the UN level,
07:26but the governments need to commit.
07:28It's always nice to have a piece of paper,
07:30but what are you going to do nationally?
07:32I do have to say it's important to have it at a UN level,
07:35but it will be worth nothing
07:37if nationally it is not being addressed properly.
07:40Investment.
07:42So investment requiring change.
07:44I do want to again re-stress,
07:46we are talking about a domestic gap of around $200 billion
07:50that would be needed to close,
07:52that was the estimation in the latest research,
07:54to really close this under-investment at least to a decent level.
07:58So again, focus is key
08:00because we will not get to $200 billion now.
08:03Lack of resources to address that,
08:05the under-resourcing of health care professionals
08:08and really again to address the patient journey
08:11to help repair those care pathways
08:13to truly help those who live the experience.
08:16Lastly, on the education side,
08:18we need to create more acceptance,
08:20a better understanding for all of the people
08:24living with the experience of having a serious mental illness.
08:27And that actually means putting their lived experience
08:30at the centre of everything we do.
08:32Share real life stories.
08:33Use the World Mental Health Day on October 10th
08:35to actually expose those stories.
08:37So many would like to share it.
08:39We need to let them.
08:41That will create understanding, acceptance, empathy
08:44and also hopefully help them lead the lives that they want,
08:48get jobs, keep their jobs.
08:51So I think a lot of topics that we can do better
08:55towards a more inclusive society in this case.
09:03And just on that point of keeping jobs,
09:05there was a Eurobarometer survey last year
09:07and 53% of respondents said that financial security
09:10is a contributing factor to good mental health.
09:13There were statistics that suggest that
09:15following diagnosis of schizophrenia, for example,
09:17rates of employment and education dropped to 12%,
09:20which is a shocking statistic.
09:22So, you know, what needs to be done
09:25to keep people happy, healthy and employed?
09:29Maybe then let me pick up the point of the lack of innovation.
09:32Because as you mentioned, schizophrenia is a very good example.
09:36There's just been almost no new therapies
09:39in the last 20 to 30 years.
09:41And that's an issue.
09:42So how do you help those in need
09:45to actually be able to function better in daily life, right?
09:49How do you make sure that they can do everyday activities?
09:54Because on that example, that's exactly what was mentioned.
09:57To go shopping, to be able to cook,
09:59to be able to follow on with their education
10:02and keep and execute on a job on a daily basis.
10:06And I think that innovation part is so crucial
10:08of also getting new treatments.
10:10You know, working at a pharmaceutical company,
10:12obviously that's something we need and are committed to.
10:16But also to be honest,
10:17the lack of innovation was also driven by just,
10:20it's very hard to succeed in mental health
10:24when it comes to clinical development,
10:26which is harder to execute.
10:27Endpoints are not always clear.
10:29So the probability of success for new treatments
10:31is lower than in many of the other therapeutic areas.
10:34So this is something that we all need to commit to,
10:36including us at Beringer,
10:38to make sure that we can deliver on that.
10:40It's also something that will take time
10:42and we will take a lot of learnings along the way
10:44until we truly have something that will help patients out there.
10:47Yeah, absolutely.
10:48And on that note, unfortunately,
10:50I would love to sit and chat to you all day,
10:52but that's all we have time for.
10:53But thank you so much for joining me today
10:55on this live episode of The Big Question.
10:57And thank you so much for your fascinating insights.
11:00Let them pay for each other.