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.