Europe’s Health System under strain as doctors and nurses face Mental Health Crisis.

The landmark survey, funded under WHO & Europe’s project with the European Commission, coinciding with World Mental Health Day, have analysed nearly 100,000 responses from 29 countries, from October 2024 until April 2025.

The key finding is that doctors and nurses are working in conditions that harm their mental health and well-being, and also impacting patients. “Ultimately, the mental health crisis among our health workers is a health security crisis, threatening the integrity of our health systems”, said Hans Henri P. Kluge, WHO’s Europe Director.

The numbers reveal systemic problems. One in four doctors work over 50 hours a week and a third are on temporary employment contracts, a situation strongly linked to increased anxiety over job security.

Meanwhile, doctors and nurses show double the prevalence of suicidal thoughts compared to the general population. 01 in 10 said they had thoughts of being “better off dead” or “hurting themselves” in the past two weeks, the WHO analysis shows. Such unsafe work is directly linked to poor mental health.

For the one in three doctors and nurses who experience violence, and the rest who work consistently long hours, experiences depression, anxiety and suicidal thoughts in common. “We chose a path of humanity, but that does not mean we stop being human ourselves”, said Mélanie Debarreix, a radiology resident from France. Despite the worrying figures, three quarters of all doctors and two out of three nurses expressed a strong sense of purpose and meaning resulting from their work.

The survey shows that 11% to 34% of health workers are considering quitting. This puts patients at risk of experiencing longer wait times and reduced quality of care, WHO said. A past WHO/Europe report found that already in 2022, recruitment of health and care workers was not keeping pace with rising demand, putting unbearable pressure on the overall system.

Europe is projected to have a shortage of 940,000 health workers by 2030 according to Dr. Kluge.

“Their well-being is not only a moral obligation, but is the foundation of safe, high-quality care for every patient”, he said. The report outlines actionable steps that can be taken to address the crisis including zero-tolerance for violence in the workplace, reforming shift patterns and ensuring access to high quality mental health support.

THE SURVEY –

To obtain a clearer picture of the mental health, well-being and working conditions of doctors and nurses, the WHO Regional Office for Europe launched the Mental health of Nurses and Doctors (MeND) survey in October 2024, under its collaboration agreement with the European Commission, “Addressing mental health challenges in the European Union, Iceland and Norway”.

The survey, which is the largest of its kind to date was disseminated between October 2024 and April 2025 across the European Union, Iceland and Norway, supported by a network of six European medical and nursing associations and their national members. Over 120 000 doctors and nurses across 29 countries responded, with 90,171 valid responses included in the final analysis. The analysis were accomplished on the following 07 sub-heads – AADMMSW:

• Alcohol dependence: This term is used to report on the outcome of probable alcohol dependence, as measured by a score of 2 points or higher on the CAGE (Cut down, Annoyed, Guilty, and Eye-opener) questionnaire.

• Anxiety: This term is used to report on the outcome of probable generalised anxiety disorder, as measured by a score of 5 to 12 on the 7-item Generalised Anxiety Disorder questionnaire (GAD-7), depending on the country.

• Depression: This term is used to report on the outcome of probable major depressive disorder, as measured by a score of 8 to 12 on the 9-item Patient Health Questionnaire (PHQ-9), depending on the country.

• Mental health: This term describes a state of mental well-being that enables people to cope with the stresses of life, realise their abilities, learn well and work well, and contribute to their community.

• Mental health conditions: This term is used to report on the collective mental health outcomes measured in the survey (e depression, anxiety, suicidal thoughts and alcohol dependence).

• Suicidal thoughts: This term is used to report on the presence of thoughts that one would be better off dead or of wanting to harm oneself, as measured by a positive score to the ninth item of the PHQ-9.

• Well-being: This term is used to report on the outcome of mental or emotional well-being, as measured using the World Health Organization-Five Well-Being Index (WHO-5). It encompasses experience of positive moods, calm and vitality. It is rated on a percentage scale from 0 to 100, with scores below 50 indicating a poor level of well-being.

This report synthesises the data collected using the MeND survey to understand how doctors and nurses are faring in their mental health and well-being, and what factors in their workplaces may be helping or harming them.

Based on these findings, and in line with prevailing frameworks and guidelines this report proposes a series of policy actions to prevent mental ill health, protect and promote mental health and well-being

and create the enabling environments necessary to reverse the worsening crisis facing health care systems.

• Enforce a zero-tolerance approach to bullying, harassment and other forms of workplace violence.

• Improve predictability and flexibility around shift work to protect mental health and provide workers with greater control over scheduling.

• Manage overtime in line with health workers needs and entitlements, while reimagining workplace norms and culture.

• Manage excessive workload to deliver quality health services, by focusing on improving staffing approaches and optimising workflows.

• Build the capacity of healthcare leaders and managers to promote and protect staff mental health and well-being.

• Make mental health and substance use support available and accessible to all workers and facilitate early intervention.

• Prioritise regular monitoring and reporting of mental health and working conditions.

Team Maverick