Mental Health and Pain Policy
Ahead of the upcoming European Commission European Mental Health Strategy and under the umbrella of the Societal Impact of Pain (SIP) Platform, a gathering of ten European professional and patient organisations have developed a Joint Statement on the close link between pain and mental health. The nine recommendations call upon EU and national policy makers to ensure a range of aspects related to pain and mental health are acknowledged in health policy.
In Europe there are approximately 740 million people, most of whom experience an episode of severe pain at some point in their life. For approximately 20 percent, that pain persists for longer than three months and will be chronic pain. Therefore, at present, 150 million people are experiencing chronic pain across Europe, approximately equal to the population of France and Germany combined. Chronic pain is more prevalent in women than in men, with some estimates suggesting that women are twice as likely to experience chronic pain as men.
Mental health conditions and chronic pain frequently co-occur and influence each other, creating a vicious cycle of disability. Both pain and mental health conditions cause reduced quality of life, mobility and social participation across the lifespan. When treated in isolation, the treatment of mental health conditions is less successful if patients also have chronic pain, and the treatment of chronic pain is less successful if patients also have a mental health condition. Unfortunately, pain is not routinely assessed or addressed in people with mental health conditions. At the same time, mental health conditions like depression are often underrecognised and thus undertreated in people with chronic pain.
Both chronic pain and mental health conditions are best conceptualised as experiences involving complex interactions between biological, psychological, and social factors. Contemporary management of pain places a large focus on bio-psycho-social assessment and treatment, where all these factors are addressed when relevant to each individual patient.
Recognising and addressing pain in mental health settings and policies are essential to optimise meeting the needs of people with both pain and mental health conditions.
SIP Joint Statement on Pain and Mental Health
Recommendations: SIP Joint Statement on Pain and Mental Health
- Include an assessment of pain interference in people living with mental health conditions, such as major depression, anxiety, bipolar disorder, schizophrenia, psychosis, and substance use disorders.
- Better integrate pain and mental health services instead of treating them in isolation in separate services.
- Allocate adequate funding for research on the relationship between mental health and pain.
- Provide early access to pain management programmes for people with a high risk of developing chronic pain and those with chronic pain, to serve as a preventive programme for mental health conditions.
- Provide training to healthcare professionals in the strong bidirectional relationship between pain and mental health outcomes.
- Involve people with lived experience of mental health conditions and illnesses featuring pain, in developing integrated services.
- Recognise that good work conditions can have a positive impact on physical and mental wellbeing and therefore, prevention of work absence and the reintegration and adaptation of people living with pain and/or mental health conditions into the workforce should be supported.
- Ensure that the biological, psychological, and social factors of pain are comprehensively addressed in mental health policies, in order to address the needs of people both living with chronic pain and mental health conditions.
- Support cultural change in all countries, to reduce stigma in public and private conversations about mental health and pain, through awareness campaigns, including campaigns targeted specifically at healthcare providers, as well as the general public.