The state of mental health in Greece: An international comparative analysis using data from the Global Mental Health Countdown 2030.

Background: Effective mental health systems depend on the functioning of a variety of factors that can be systematically monitored across countries. Macro-level assessments are needed to identify potential areas for improvement in the health sector, particularly in countries that face significant access barriers such as Greece.

Aim: To analyze Greece's mental health-related indicators in comparison to countries with similar socioeconomic contexts and geography and identify priority areas for the national mental health system.

Methods: Data was sourced from the Global Mental Health Countdown 2030, an initiative gathering 48 indicators from 193 countries, classifying metrics into four domains: mental health system performance, determinants of mental health, factors influencing the demand for care, and wellbeing. We analyzed 39 indicators available for Greece to perform a comparative analysis with three groups of countries (27 European Union, 55 high-income, and 52 upper-middle income nations). We employed content analysis to organize mental health system indicators into a framework to inform policy and practice.

Results: Greece exhibited low performance in several indicators related to mental health provision, with four metrics falling below the 12.5th centile for all comparative groups ('interventions in primary care', 'policy implementation', 'promotion and prevention', and 'frequency of collection of data'). A content-analysis framework grouped indicators into categories related to the mental health system, with low-scoring metrics clustering around 'policy and planning', 'affordability of care', 'coordination of services', and 'data collection and quality assessment'.

Conclusion: This analysis provides a contextualized overview of Greece's mental health system, identifying areas for improvement based on a panel of evidence-based indicators. Priority policy actions should focus on enhancing mental health insurance coverage and freely-available mental health services, organizing provision into a stepped-care and coordinated service network, and establishing systematic data monitoring mechanisms with unified electronic registers.