Country-level alignment between youth mental health burden and reported workforce capacity
Abstract
ObjectiveTo assess country-level alignment between youth mental health burden, measured using disability-adjusted life-year (DALY) rates for mental and substance use disorders among individuals aged 10 -24 years, and reported national mental health workforce capacity, and to examine regional differences in this alignment.MethodsThis ecological analysis linked World Health Organization (WHO) 2021 mental and substance use disorder disability-adjusted life-year (DALY) rates with psychiatrist, psychologist, and mental health nurse densities from 2013 to 2017. Of the 196 countries with complete burden estimates, 193 had World Bank fiscal year (FY) 2022 income classifications and 139 had at least two core workforce indicators. The burden measure assigned equal weight to each of the three 5-year age groups. Percentile gaps were calculated by subtracting workforce percentiles from burden percentiles across the 139-country sample. Additional analyses compared staffing densities, described burden at five time points from 2001 to 2021, and tested sensitivity to economic, index, workforce-year, and spatial specifications.ResultsThe Eastern Mediterranean had the highest median gap (30.9 points), with 10 of 15 countries meeting the high-burden–low-capacity screen. Its gap was 51.9 points higher than that of Europe after adjusting for income group and 2021 health expenditure (95% confidence interval 37.6 to 66.2; exploratory p < 0.001), with a positive contrast across sensitivity analyses. Pooled youth burden increased by 9.9% from 2001 to 2021; income-group gaps were non-monotonic.ConclusionThe Eastern Mediterranean showed the largest burden–workforce percentile gap, which persisted across the main sensitivity analyses. A reproducible framework combining percentile gaps, observed staffing densities, and robustness checks may help prioritize national reviews of workforce deployment and youth access.
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BibTeX
@article{lai2026countrylevel,
title = {{Country-level alignment between youth mental health burden and reported workforce capacity}},
author = {Sihong Lai and Hanyu Zhou and Jinghua Wu and Xuanjing Wang and Yuwei Zhang and Xiaoya Qin and Hua Li},
journal = {Frontiers in Public Health},
year = {2026},
month = nov,
doi = {10.3389/fpubh.2026.1929691},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1929691},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Country-level alignment between youth mental health burden and reported workforce capacity
AU - Sihong Lai
AU - Hanyu Zhou
AU - Jinghua Wu
AU - Xuanjing Wang
AU - Yuwei Zhang
AU - Xiaoya Qin
AU - Hua Li
PY - 2026
DA - 2026/11/13
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1929691
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1929691
AB - ObjectiveTo assess country-level alignment between youth mental health burden, measured using disability-adjusted life-year (DALY) rates for mental and substance use disorders among individuals aged 10 -24 years, and reported national mental health workforce capacity, and to examine regional differences in this alignment.MethodsThis ecological analysis linked World Health Organization (WHO) 2021 mental and substance use disorder disability-adjusted life-year (DALY) rates with psychiatrist, psychologist, and mental health nurse densities from 2013 to 2017. Of the 196 countries with complete burden estimates, 193 had World Bank fiscal year (FY) 2022 income classifications and 139 had at least two core workforce indicators. The burden measure assigned equal weight to each of the three 5-year age groups. Percentile gaps were calculated by subtracting workforce percentiles from burden percentiles across the 139-country sample. Additional analyses compared staffing densities, described burden at five time points from 2001 to 2021, and tested sensitivity to economic, index, workforce-year, and spatial specifications.ResultsThe Eastern Mediterranean had the highest median gap (30.9 points), with 10 of 15 countries meeting the high-burden–low-capacity screen. Its gap was 51.9 points higher than that of Europe after adjusting for income group and 2021 health expenditure (95% confidence interval 37.6 to 66.2; exploratory p < 0.001), with a positive contrast across sensitivity analyses. Pooled youth burden increased by 9.9% from 2001 to 2021; income-group gaps were non-monotonic.ConclusionThe Eastern Mediterranean showed the largest burden–workforce percentile gap, which persisted across the main sensitivity analyses. A reproducible framework combining percentile gaps, observed staffing densities, and robustness checks may help prioritize national reviews of workforce deployment and youth access.
SN - 2296-2565
ER -