EUropean Mental and physical health Initiative for people with severe Mental Disorders – EU-MIND

Over a 3-year project, EU-MINDs ambition is to bring a European solution for improving the organization of care for comorbid severe mental disorders (SMD) and physical disorders. Why is it a priority? SMD (which includes schizophrenia, bipolar disorder and major depressive disorder) represent the leading source of years lost to disability from all medical illnesses and constitute three of the top ten causes of disability. In EU countries, it has been estimated that over 80 million women and men of all ages would experience some form of mental disorders. Mental disorders have also a high economic burden for society with total costs estimated at over 600 billion across the 28 EU countries. People with SMD die up to 15 years earlier than the general population, with around 70% of this mortality gap attributed to physical comorbidities. More than one in three persons with SMD has one or more physical comorbidities. The poor physical health and the associated gap in life expectancy experienced by people with SMD have either not improved or worsened over the last decades. Besides modifiable lifestyle factors and side effects of psychotropic medications, access to and quality of health care remains remain critical priority for individuals with SMD. Where do we go from here? Clinical practice guidelines are already available but not sufficiently and/or adequately provided. Person-centered and integrated care models are critical for supporting effective implementation approaches to translate evidence into practice. However, the challenge lies in implementing these models effectively. There is therefore a need to prioritize the most effective and appropriate integrated care models through a consensus-based approach, informed by a systematic review of available evidence and real-world data on health care utilization and trajectory of care. EU-MIND intends to focus on the sustainability and the environmental impact of the selected integrated care models. Additionally, the feasibility, resourcing implications, potential savings, and cost-effectiveness of these integrated care models must carefully be evaluated to ensure their successful implementation. Finally, addressing the physical disorders of people with SMD also requires a comprehensive and collective approach that encompasses a broader societal perspective which can represent barriers to the models dissemination. How to close the gap? EU-MIND is an ambitious collaborative and interdisciplinary initiative from six EU countries (i.e., Denmark, Finland, France, Italy, Poland and Sweden), supported by highly recognized Partners and composed of six work-packages. First, health care utilization and trajectory of mental and physical care will be assessed through the analysis of EU nationwide databases to identify actionable gaps in care pathways. Second, we will identify and describe integrated care models for comorbid SMD and physical disorders through a scoping literature review. Third, we will build a European consensus from a Delphi panel including patients, healthcare professionals and policymakers about which integrated care models they consider most acceptable and promising. Fourth, we will investigate, through a health economic evaluation, the societal knowledge, attitudes, practices and willingness to pay and the financial impact of implementing an integrated care model. Fifth, we will perform a feasibility pilot study in two real-world settings to provide valuable insights into the practicality and sustainability of integrated model of care. Finally, we will strive to promote the dissemination and translation of knowledge using multiple channels through inclusive and collaborative efforts that involve multiple stakeholders. With the collaboration of patients, healthcare professionals, policymakers and citizens across Europe, EU-MIND aims to pave the way for more effective, person-centered care for those with comorbid SMD and physical disorders.