Europe’s mental health depends on an economy we don’t measure

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An Expert View from Agnese Cattaneo, Chief Medical Officer at Angelini Pharma.

Mental health has become one of Europe’s defining challenges. One in five Europeans lives with a mental disorder (1) – which carries profound consequences not only for individuals and families, but for economies and societies at large. Yet, traditional economic measures fail to capture a critical dimension of Europe’s mental health response: the often-invisible work of caregivers who help to sustain the wellbeing of millions across the continent. (2) As we mark World Mental Health Day, the case for action extends beyond economic arguments. Almost half of the European Union (EU) population (45%) provides informal care, (3) contributions that represent an indispensable pillar of mental health support. Yet, they remain largely unrecognized in policy frameworks and economic statistics. (2)

The case for prevention and early detection

Last year, in our 2024 Headway Report, we focused on the economic dimension of mental health; every euro ($1.16) invested in prevention, early intervention, and community-based services generates an estimated 4.50 euros in benefits. (4) Europe could avoid more than 120 billion euros in costs annually by strengthening mental health systems. (9) However, despite the availability of effective and cost-effective interventions, almost one in two young Europeans report unmet needs for mental health care, with the share of young people reporting symptoms of depression in several EU countries more than doubling during the pandemic. (5)

This year, we want to broaden the perspective beyond the economic return on investment. True prosperity cannot be measured solely in financial terms. It encompasses people’s wellbeing, the strength of our communities, and the support we give each other. These dimensions are fundamental to sound mental health – without them no society can thrive. However, they don’t appear in traditional economic statistics.

The invisible economy of care

At the center of this reflection are caregivers. Caregivers embody the essence of the wellbeing economy. Their labor generates enormous value for others, while their own mental health is often put at risk. Supporting these groups is not only a matter of fairness, but also a strategy to build more resilient, sustainable health systems and stronger, more cohesive societies. The scale of caregivers’ contributions is staggering. In 2021, informal caregiving in Europe amounted to more than 10 million ‘years lived caregiving’, or YLCs, and this figure is projected to rise by nearly 50% by 2050, compared to figures from 2000. (6)

Furthermore, approximately 90% of people with serious mental illnesses receive practical and emotional support on a daily basis from family caregivers, (7) but many of these caregivers experience significant psychological pressure due to lack of preparedness for their roles. Women in particular shoulder a disproportionate share of this responsibility, often at the expense of their own health, employment status, and long-term financial security. (8) In this way, traditional measures like GDP fail to capture social value, though without it, healthcare and social systems would be overwhelmed.

A demographic imperative

The demographic reality intensifies this challenge. The caregiver support ratio in Europe is expected to progressively decline from 6:1 back in 2011 to just 2:1 by 2050, (9) meaning fewer potential caregivers will be available for each person needing care. This shift will place unprecedented strain on informal care networks, unless policy frameworks evolve to provide adequate support.

Additionally, as Europe's population ages and the prevalence of mental health conditions continues to rise, the gap between caregiving needs and available support will only widen. Without deliberate policy intervention to recognize, protect, and support caregivers, the continent faces a care crisis that will compromise both individual wellbeing and economic stability.

From evidence to action

The continuity between our 2024 and 2025 Headway Reports is clear. Last year, the report revealed that investing in mental health delivers measurable economic returns. This year’s publication shows that mental health is the cornerstone of Europe’s wellbeing economy, sustained by caregivers, communities, and networks of solidarity. (10) The perspectives in both reports converge on the same conclusion, that Europe cannot afford to neglect mental health, not in terms of GDP, nor in terms of human wellbeing.

Recognizing the immense value of informal care requires moving swiftly from awareness to targeted policy implementation. This means treating caregivers not as a societal afterthought, but as essential pillars of the health system. Concrete policy steps should include mandatory respite care programs, allowing caregivers to recover and prioritize their own mental health. Furthermore, financial and legal frameworks must evolve to offer social security protection and employment flexibility, particularly for women who take on a disproportionate burden of care. Investing in preparedness training and dedicated support networks can mitigate the psychological pressure faced by those supporting loved ones. This integrated approach is critical to building the resilient and cohesive societies Europe needs for the future.

World Mental Health Day serves as a reminder that short-terms debates on costs must give way to recognition of the full spectrum of value that mental health brings to societies. This requires embedding caregivers into policy frameworks, with concrete approaches to ensure they receive adequate protection and support. It also means treating investment in mental health not as an expense, but as a double dividend, growing the economy while also strengthening the social fabric on which Europe’s future depends.

In other words, investing in mental health is conducive to the improvement of all aspects of the European economy and society. The question is no longer whether we can afford to act, but whether we can afford not to.

References

1 OECD. Mental Health Promotion and Prevention. Available at: https://www.oecd.org/en/publications/mental-health-promotion-and-prevention_88bbe914-en/full-report.html. Accessed October 2025.

2 Barbabella F, Poli A, Santini S, Lamura G. The role of informal caregivers in long-term care for older people. Cultures of care in aging. Charlotte: Information Age Publishing. 2018 Jun 1:193-212.

3 Eurofound. Unpaid care in the EU. Available at: https://www.eurofound.europa.eu/en/publications/all/unpaid-care-eu. Accessed October 2025.

4 Angelini Pharma. New Headway Report shows that increased investment in mental health care can avoid costs of more than 122 billion euros across Europe. Available at: https://www.angelinipharma.com/news-media/press-releases/new-headway-report-shows-that-increased-investment-in-mental-health-care-can-avoid-costs-of-more-than-122-billion-across-europe/. Accessed October 2025.

5 European Parliament. Mental health in the EU. Available at: https://www.europarl.europa.eu/RegData/etudes/BRIE/2023/751416/EPRS_BRI(2023)751416_EN.pdf. Accessed October 2025.

6 Cattaneo A, Vitali A, Regazzoni D, Rizzi C. The burden of informal family caregiving in Europe, 2000–2050: a microsimulation modelling study. The Lancet Regional Health–Europe. 2025 Jun 1;53.

7 Cham CQ, Ibrahim N, Siau CS, Kalaman CR, Ho MC, Yahya AN, Visvalingam U, Roslan S, Abd Rahman FN, Lee KW. Caregiver burden among caregivers of patients with mental illness: A systematic review and meta-analysis. InHealthcare 2022 Nov 30 (Vol. 10, No. 12, p. 2423). MDPI.

8 Sahni S, Kaushal LA, Gupta P. Gendered differences and strategies for work-life balance: Systematic review based on social ecological framework perspective. Acta Psychologica. 2025 Jun 1;256:105019.

9 Ribeiro O, Araujo L, Figueiredo D, Paul C, Teixeira L. The caregiver support ratio in Europe: estimating the future of potentially (Un) available caregivers. InHealthcare 2021 Dec 22 (Vol. 10, No. 1, p. 11). MDPI.

10 Angelini Pharma. Empowering Brain Health in Europe: High-Level Event Sets Agenda for Epilepsy. Available at: https://www.angelinipharma.com/news-media/news/headway-a-new-roadmap-in-brain-health-focus-epilepsy/. Accessed October 2025.