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The development and results of the European Mental Health Integration Index (2014)

Peter John Huxley (Professor of Mental Health Research, Centre for Mental Health and Society, Bangor University, Bangor, UK)

Journal of Public Mental Health

ISSN: 1746-5729

Article publication date: 21 December 2015




The purpose of this paper is to report on the development and results of the Mental Health Inclusion Index.


Data gathering and interviews with key policy makers in 30 countries in Europe (the EU28 plus Switzerland and Norway). Data gathered enabled the production of an 18 indicator benchmarking index ranking the 30 countries based on their commitment to integrating people with mental illness.


The main findings were: mental illness exacts a substantial human and economic toll on Europe, and there is a substantial treatment gap, especially for people with common mental health problems. Germany’s generous social provision and strong healthcare system put it number one in the Mental Health Integration Index. The UK and Scandinavian states come next. The lowest-scoring countries in the index are from Europe’s south-east, where there is a long history of neglect of mental illness and poorly developed community services. One needs to understand that the leading countries are not the only ones providing examples of best practice in integrating those with mental illness. Employment is the field of greatest concern for people with mental illness, but employment is also the area with the most inconsistent policies across Europe. A distinction can be made between countries whose policies are aspirational and those where implantation is support by substantial and most importantly sustained, resource investment. Europe as a whole is only in the early stages of the journey from institution- to community-based care. Lack of data makes greater understanding of this field difficult, and improvement can only be demonstrated by repeated surveys of this kind, based on more substantial, comprehensive and coherent information.

Research limitations/implications

Usual caveats about the use of surveys. Missing data due to non-response and poverty of mental health inclusion data in many European countries.

Practical implications

The author reflects on the findings and considers areas for future action. The main implications are: better services result from substantial, but most importantly, sustained investment; and that employment is most important to people with mental health problems, but is one of the most inconsistent policy areas across Europe.

Social implications

Supports the need for consistent investment in community mental health services and more consistent employment policies in Europe.


This survey is the first of its kind in Europe, and was conducted by the Economist Intelligence Unit in London, and sponsored by Janssen.



This paper is by one of five expert advisors to the development of the Mental Health Integration Index (MHII) (2014) a recent Europe-wide survey on social integration and mental health, and the policies and provisions for supporting people in the community. The MHII provides facts on integration in order to inform mental health service policy development. This paper is based on research conducted by the Economist Intelligence Unit and sponsored by Janssen and supported by GAMAIN Europe.


Huxley, P.J. (2015), "The development and results of the European Mental Health Integration Index (2014)", Journal of Public Mental Health, Vol. 14 No. 4, pp. 205-210.



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