Publications

Guest article by Lars Münter, Founder and International Director, Nordic Wellbeing Academy

Most would guess the conclusions of this article from the headline. Clearly, it’s a bad idea to turn off your navigation system when flying in volatile weather (and often in good weather too), but even so, there’s still a significant lack of indicators that can guide us towards effective tools and health literacy for mental health in Europe. Which becomes extra challenging with a combination of our post-pandemic trauma, pre-climate disaster anxiety, and democratic-demographic status quo stress factors. A perfect storm. 

So, while we could (and should) talk a lot more about effective initiatives, funding for health promotion, and redesign of workplaces and educational facilities, we need to also talk about something a bit more basic and for some downright boring. KPIs.  

The short, but crucial acronym of key performance indicators (KPIs) that also can cover every data source you can think of. But should be the result of a thorough double materiality assessment, that can lead to a selection of the special, essential indicators that would ensure that your airplane can reach its destination as quickly and safely as possible and preferably with all passengers in good health too. 

Plenty of reasons why 

The financial argument for stronger action is strong. Considering the current discussion about European competitiveness that is needed to help us in our joint voyage in rough seas (another metaphor, mea culpa) it should also be interesting to not just think about our ship’s engine, but the current holes in the hull. The economic burden of poor mental health in the EU is substantial, estimated at €600 billion annually, or approximately 4% of the region’s GDP. This cost includes healthcare expenses, lost productivity, and the broader societal impacts of mental health issues. A significant portion—about 1.6% of GDP—is due to reduced employment and productivity, with the rest attributed to healthcare and social security costs. 

So, in other words, we have a huge potential for investment that is a win-win; it has a positive ROI economically, ethically, and in QALY.  Reducing mental health services and funding for schools/education, increasing financial stressors, and maintaining some 18th industry century mindset about working from home in the 21st digital century will only exacerbate the problems.

Looking closer at data 

What are then some of these vaunted KPIs? Well, if we were talking about hospital and patient safety, a minimum could be the rate of hospital-acquired infections and medical errors. In mental health, reporting on absenteeism rates in terms of both workdays and school days would be a start – and to do so across regions, countries and institutions to also enable us to do targeted interventions (and implementation research). 

Tracking both employee and community wellbeing scores could give good insights about the links between workplaces policies, urban design, demographics and more – and the effectiveness of initiatives to actually move the status quo.  

On a more general level, keeping track of access rates across regions or seasons (e.g. too low in winter, maybe?) is also essential to have both a specific idea about the needs for services (and where to put them) and the overall “temperature” of the many relevant groups. For the latter, reporting on issues like burnout, stress, conflicts, or complex divorces would also be relevant – supposing we also have the intention of using the information to steer the airplane, that is. 

Nothing comes from nothing 

Why the last comment? Well first and foremost, because KPIs are not an action of and in themselves. They are essential for a system or organization that has the intention to improve its performance. That’s almost in the name, of course, but the data must be connected to the action of the pilot and a willingness to also adjust the course, if the data suggest we’re on the wrong course. 

So, would I strongly recommend better KPIs for mental health? Yes. No doubt. Do we need more research before we select the KPIs? No. But more research in implementation practice would be welcome. And do we need more action for better mental health? Yep – and KPIs would prevent us from flying blind. But first and foremost, we need to be willing to fly better, further, and safer – more KPIs blinking red while the pilot doesn’t look or care makes little difference, of course. 

We live in challenging times. Challenged by climate, social inequity, war, and more. All are destructive forces in a landscape of mental health, making it harder to navigate. My hope is that we remember that lack of insight and flying blind will never be wise, safe or cheap. That we both build the data needed and remind the pilot of their duties; to make sure we all make it safely to our future destination with our head straight.