According to a study from the National Board of Health (Sundhedsstyrelsen), the number of patients seeking hospital care for mental illness has increased 30 percent in the past 10 years. That’s more than double the 13 percent increase among those seeking care for physical diseases, like diabetes or cardiovascular disease.
The increasing demand for mental healthcare has propelled the National Board of Health to outline a series of ambitious goals to improve mental healthcare in Denmark over the next 10 years.
The proposal follows a 2019 statement where the Social Democrats, Social Liberals, Socialist People's Party and Unity Party agreed on the need to establish a 10-year plan with binding goals for improving psychiatric care in Denmark.
The binding goals include a reduction in readmissions, reduced waiting times, and an increase of the average life expectancy of citizens with mental illness. The parties also identified the need for more preventative care and psychological help to younger individuals.
Here are the 12 main recommendations from the latest proposal:
- Destigmatize mental health: “A basic precondition for achieving more equality for people with mental illness is breaking down prejudices,” reads the proposal. It recommends a national destigmatisation effort in collaboration with regions, municipalities, national authorities, and civil society organisations.
- Expand research & professional development: The National Board of Health also calls for additional research into mental disorders and recommends the creation of interdisciplinary groups to support professional development and continuous quality improvement, similar to the Danish Multidisciplinary Cancer Groups for cancer treatment.
- Educate about mental health: Another core component of the plan is to increase mental health awareness for the general population, but also in workplace and educational settings. These efforts include the promotion of active community participation and engagement in meaningful activities as ways to counteract declining mental health, among other strategies.
- Improve detection: The proposal also calls for improved early intervention for adults through the use of validated tools for early detection and identification of risk groups for mental disorders by municipalities and general practitioners, as well as improved detection of mental illness among children and young people. This includes training and equipping staff in general practice, social psychiatry, and psychiatric wards to identify and treat known risk factors.
- Make care more coherent: The proposal recommends that people with mental disorders have a holistic assessment and a coherent course of treatment, with patient and family involvement. It also recommends streamlined coordination for treatment of people with mental disorders across all sectors, as well as improved digital solutions for data sharing as needed. This includes enhanced collaboration between health authorities and social, education, and employment areas to better support people with mental illness in, for example, school or work contexts. Furthermore, patients who have both an addiction and a mental illness should be offered integrated and coherent care, and the family of people struggling with mental illness should be offered resources and support.
- Improve care for children: The Board recommends an easily accessible offering for children and young people from municipalities that is both of high quality and uniform across the country.
- Reduce waiting time: The proposal also recommends that regions and municipalities ensure people with mental illness receive screenings, preventative care, and treatment in a timely manner. It also outlines the importance of addressing capacity issues by establishing more acute psychiatric facilities and specialised beds.
- Minimise coercion: The Board also recommends reducing the use of force and other coercive measures in psychiatry to an absolute minimum.
- Reconsider mental health and crime: In response to a significant increase in the number of people with mental illness being criminally sentenced, the proposal recommends a review of legislation in this area. It also recommends strengthening the framework for proper visitation for psychiatric treatment, as needed.
- Prevent suicide: The proposal also calls for a national action plan for suicide prevention, as well as follow-up care after a suicide attempt.
- Expand support for relatives: The Board also recommends additional resources and support for relatives of those struggling with mental health issues.
- Improve digitisation: The proposal also calls for the improvement of digital solutions related to mental healthcare. For example, digital solutions to increase accessibility and patient-perceived quality, as well as data sharing across sectors.
‘Do to psychiatric care what’s been done to cancer care’
The National Board of Health says that psychiatric care has to be rebuilt from the ground up, similar to the way in which Denmark has overhauled cancer care since the early 2000s.
Clear and prioritised goals, “as with the cancer plans” is the way forward, said Torsten Bjørn Jacobsen, the psychiatrist who is chairs Denmark’s Psychiatric Foundation .
A press release from the Foundation said the recommendations will help guide political negotiations for a 10-year plan for psychiatric care in Denmark, “which everyone in and around psychiatry has been waiting for since the government took office in 2019.”
Helene Probst, deputy director of the National Board of Health said that many of the recommendations in the January 2022 report had been previously identified in reports from 2018 and 2013, but that they had never been implemented due to insufficient and unreliable funding.
The difference today is that there is now an agreement between the Social Democrats, Social Liberals, Socialist People's Party and Red Green Alliance on the need for a 10-year plan to improve psychiatric care in Denmark.
What comes next?
It is now up to the Danish Parliament (Folketing) to decide what to do with the recommendations. Health Minister Magnus Heunicke (S) told the broadcaster TV2 he did not want to comment on the report before the upcoming political negotiations.
Jane Heitmann, chairman of Parliament’s Health Committee told TV2 that she hoped that proposals were implemented, saying that “psychiatry has had the role of ‘little brother’ in the health service for far too long."
Jacobsen, the chair of the Psychiatry Foundation said that it was important that parliament acted.
“It is absolutely crucial that politicians work together to raise psychiatry to the level that people with mental illness, those at risk of developing it, and their families have been calling for decades,” he told the Ritzau newswire.
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