Mental health: a postponed right, a collective urgency

Maria is 17 years old and hasn't slept well for months. Diogo, 42, has stopped leaving the house for no apparent reason. Sofia has been waiting for more than three months for a psychiatric appointment. None of these names are real, but the stories are. And they multiply every day in Portugal.

It is impossible to ignore this reality. We are called to reflect on an essential and urgent issue: access to mental health care continues to be a postponed right.

Despite legislative advances and increasing public attention, profound inequalities in access to this care persist, aggravated by cultural stigmas, lack of resources and insufficient institutional responses.

According to the OECD, Portugal is the European country with the highest prevalence of symptoms associated with psychological problems: 23% of the population. And, among those who present symptoms, it is estimated that 60% do not have access to mental health care. The impact of the COVID-19 pandemic has worsened this situation, increasing the number of people with depressive and anxious symptoms, while significantly reducing the number of consultations carried out in primary health care.

The most recent study by the Health Regulatory Authority confirms the shortage of human resources in the area of ​​mental health in primary health care. Only one region of the country reports the existence of psychiatrists at this level of care, and coverage by psychologists is still far below the ratio of one psychologist per 5,000 inhabitants, defined by the Assembly of the Republic. There was also a decrease of more than 30% in referrals of users from health centres to hospitals between 2019 and 2020, revealing the pressure to which services continue to be subject. At the same time, the number of diagnoses of anxiety and depression increased, both in adults and children, in a scenario of growing regional asymmetry.

This panorama requires more than diagnoses. It demands concrete, persistent and collaborative commitments.

Promoting mental health cannot be the sole responsibility of the State. It is also up to each citizen to combat stigma and demand that psychological well-being be treated as a national priority. Schools, in turn, must educate about mental health from an early age. A study of Portuguese adolescents, published in the International Journal of Developmental and Educational Psychology, demonstrated a positive correlation between mental health literacy, emotional intelligence and well-being. Investing in these skills from childhood is essential to build more balanced, resilient and healthy generations.

Companies also have a key role to play. Promoting healthy work environments, preventing burnout and integrating psychological well-being into HR policies is not just an ethical issue. It is also a sustainability issue.

Investment in mental health must no longer be seen as a cost and must be recognised as what it is: a strategic investment in human capital. In 2022, for example, the cost of stress and psychological health problems at work in Portugal was estimated at 5.3 billion euros, due to lost productivity.

This month, the publication of the third edition of the survey by the Portuguese Laboratory of Healthy Work Environments showed that 27.7% of respondents admitted to being victims of workplace harassment in 2024, compared to 16.5% in 2021. This development is a clear warning sign: the work environment continues to be, for many, a source of psychological suffering.

The public sector has a duty to lead by example. Ensuring universal access and diversifying community responses are fundamental steps towards building a fairer, more accessible and effective system.

Mental health must be recognised as an essential pillar of citizenship. Promoting it is more than a right. It is a shared responsibility. May this European Mental Health Week be more than a symbolic milestone. May it be the starting point for lasting change, where everyone can access the best mental health care and live with balance and well-being.