Improving Internationally comparable Information on Mental Health Care OECD Presentation to IIMHL

Making Mental Health Count OECD brings together 35 countries from across the world “Today, our 35 Member countries span the globe, from North and South America to Europe and Asia-Pacific. They include many of the world’s most advanced countries but also emerging countries like Mexico, Chile and Turkey”¹ Mental health is a high-level OECD priority “[The OECD Council] RECOMMENDS that Members and non-Members…seek to improve their mental health care systems in order to promote mental wellbeing, prevent mental health conditions, and provide appropriate and timely services...”² OECD Health Ministers are committed to improving mental health care Ministers highlighted the significant burden mental ill-health presents for individuals, societies and economies, and that as of today, interventions to prevent, treat, and manage mental health are woefully insufficient. ¹http://www.oecd.org/about/membersandpartners/ ²Recommendation of the Council on Integrated Mental Health, Skills and Work Policy; https://legalinstruments.oecd.org/Instruments/ShowInstrumentView.aspx?InstrumentID=334&Lang=en&Book=False ³

More than 20 mental health or mental health systems variables Data and indicators on mental health in OECD Health Statistics 2017 Category Indicator Causes of mortality   Mental and behavioural disorders - Dementia - Alcohol use disorders - Drug use disorders External causes of mortality - Intentional self-harm Potential years of life lost Physicians by categories Psychiatrists Hospital beds Psychiatric care beds Hospital discharges by diagnostic categories - Mental and behavioural disorders due to alcohol - Mental and behavioural disorders due to use of other psychoactive subst. - Schizophrenia, schizotypal and delusional disorders - Mood [affective] disorders - Other mental and behavioural disorders Hospital average length of stay by diagnostic categories Pharmaceutical consumption Pharmaceutical sales N – Nervous system N02 – Analgesics N05B – Anxiolytics N05C – Hypnotics and sedatives NO6A - Antidepressants Health expenditure and financing of mental health care Available estimates of spending are mostly restricted to institutional care but it is possible to collect by disease and by provider (hospital/ambulatory/medical goods)

Health Care Quality Indicators Suicide   In-patient suicide among patients diagnosed with a mental disorder Suicide within 1 year after discharge among patients diagnosed with a mental disorder Suicide within 30 days after discharge among patients diagnosed with a mental disorder Excess mortality Excess mortality for patients diagnosed with schizophrenia Excess mortality for patients diagnosed with bipolar disorder Excess mortality for patients diagnosed with severe mental illness

Gaps and weaknesses in current OECD indicators 1 Gaps and comparability issues can be identified in existing indicators 2 Current variables capture only a small part of the mental health care activities 3 Some existing indicators would be more policy relevant if they were more granular

Next steps for OECD work on mental health Indicators

Development of an OECD Mental Health Performance Framework working with an Expert Panel followed by broad stakeholder consultation include the domains that matter to service-users, families, policy makers, health and care professionals… Collection of indicators to measure performance in each domain of the OECD framework a broad scoping exercise looking at quantitative and qualitative measures an ad-hoc data collection process Systematic mapping of policies using OECD framework identify evidence of effective policies a policy survey, and a series of phone interviews with relevant experts

Powerful tools for understanding and improving mental health care 2. An indicator set that measures and benchmarks mental health performance A comprehensive report comparing performance in mental health care

Patient-Reported Indicators Survey initiative OECD PaRIS Patient-Reported Indicators Survey initiative OECD to provide leadership in the international collection and reporting of patient-reported measures Includes patient reported experience measures (PREMs) and PROMs Implemented by Health Care Quality and Outcome (HCQO) Working Party; formerly Healthcare Quality Indicators (HCQI) Expert Group

PaRIS  Two work streams Addressing critical gaps in the measurement of patient- reported indicators Chronic conditions including multi- morbidity/complex patients New survey of patients of primary health care physicians Patient-reported outcomes & experiences With international partners & providers & patients Accelerate and standardise work already underway Cáncer, hip and knee OA, (then AMI, stroke, mental health,…) Supporting national health systems to collect patient- reported indicators in a comparable way

PROM/PREM indicators for Mental Health Care Activities Workshop on 16th May 2018 at the OECD ~30 participants Working Group launched at workshop, chaired by Denmark, with project term until November 2019 Countries can still confirm membership Next (virtual) meetings July, September, November

Survey of use of mental health PROMS and PREMS – initial results Country PROMS currently collected PREMS currently collected PROMs routinely reported PREMs routinely reported Australia Yes Canada Not sure Costa Rica No but plan to  NA Denmark Mexico No Netherlands Republic of Korea Sweden

Find out more… Email me Emily.Hewlett@oecd.org Follow us on Twitter @OECD_social Visit our website www.oecd.org/els Read our reports www.oecd.org/els/health-systems/mental-health.htm Understanding Effective Approaches to Promoting Mental Health and Preventing Mental Illness Fit Mind, Fit Job, 2015 Making Mental Health Count, 2014