Study reveals stark socioeconomic gaps in mental health care access across EU
New research highlights how financial barriers disproportionately affect lower-income Europeans seeking mental health support, with some countries showing alarming inequality ratios.
A comprehensive study of unmet mental health care needs across the European Union has revealed significant disparities in access based on socioeconomic factors, with financial barriers creating substantial hurdles for vulnerable populations. The findings, presented at the European Psychiatric Association Congress 2025 in Madrid this month, point to complex patterns of inequality that vary considerably between member states.
Financial burden disproportionately impacts lower-income groups
The cross-sectional analysis, led by João Vasco Santos from the University of Porto, examined data from the 2019 European Health Interview Survey spanning 26 EU countries. Researchers focused specifically on self-reported unmet needs for mental healthcare attributed to financial reasons, examining how these vary across income brackets, education levels, and urban versus rural settings.
The results reveal striking disparities, with self-reported unmet mental health care needs ranging from just 1.1% in Romania to a concerning 27.8% in Portugal, with a median figure of 3.6% across the EU.
Perhaps most troubling was the consistent pattern of inequality related to income. In almost every country studied (with Hungary being the sole exception), citizens in the lowest income quintile reported significantly higher rates of unmet needs. Greece demonstrated the most extreme disparity, with a staggering inequality ratio of 23.8 between lowest and highest income groups.
“This study highlights the substantial and wide socioeconomic inequalities in unmet mental health care needs across the EU,” stated João Vasco Santos. “While income inequality consistently impacts access, the role of education varies, and rural areas often report higher unmet needs.”
Education and geography create complex inequality patterns
The relationship between education level and access to mental health support revealed a more mixed picture across the bloc. Fifteen of the 26 countries showed higher unmet needs among less-educated populations, with Bulgaria demonstrating the most severe education-related inequality.
Interestingly, the research found that rural areas generally reported lower unmet needs for mental health care in 21 of the 26 countries studied, with Romania showing the highest rural-urban ratio at 2.0.
Economic impact underscores urgency for policy action
With mental health conditions affecting approximately 17% of EU citizens according to OECD figures, and costing member states over 4% of GDP annually, addressing these inequalities represents both a public health and economic imperative.
Dr. Julian Beezhold, Secretary General of the European Psychiatric Association, emphasized the study’s significance: “This research provides critical insights into the disparities in mental health care access across the EU, revealing a complex interplay of socioeconomic factors that influence an individual’s ability to seek and receive necessary care.”
Dr. Beezhold further highlighted that the findings “reinforce the importance of addressing these multifaceted socioeconomic factors, not just income, but also education and geographical location, to ensure truly equitable mental health services for all citizens.”
The researchers assert that policymakers must prioritise strategies to ensure financial access to mental health services, enhance mental health literacy, and improve service availability for vulnerable populations to address these persistent inequalities.
Reference
Santos, J. V. (2025). Socioeconomic inequalities on unmet needs for mental health care: a cross-section analysis in European Union countries. Paper presented at the European Psychiatric Association Congress 2025, Madrid, Spain, 5-8 April 2025.
