Boosting efforts to improve mental health in Estonia

By Srdan Tatomir, OECD

This week is European Mental Health Awareness week, which aims to raise understanding of mental health. In Estonia, mental health problems are significant. Adult suicide rates are high and above most OECD countries (Figure 1). The first Estonian National Mental Health Survey in 2022 found that a quarter of adults was at risk of anxiety and depression. Lower income groups, particularly men, were more likely to be affected (OECD, 2024). Among adolescent children, almost 30% report feeling depressed every week, and this has risen over time (TAI, 2025). Ill mental health carries a high human toll and is estimated to cost Estonia 2.8% of GDP each year (OECD, 2021).

Estonia has recognised this and expanded its efforts to improve mental health. The 2021 Green Paper on Mental Health developed the foundations and is being implemented through the Mental Health Action Plan for 2023-26. A new mental health department has been established within the Ministry of Social Affairs and funding for mental healthcare services has more than tripled to EUR 7 million in 2023. New surveys to monitor and better understand the issues have been put in place. This year, Estonia adopted its first Suicide Prevention Action Plan for 2025–2028.

These policies aim to create a comprehensive, intersectoral and multi-level mental health system and broaden access to both community-based and specialist healthcare services.

Better health of Estonia’s people, highlighted by the OECD’s 2024 Economic Survey, can be achieved in other areas as well. Life expectancy at birth has risen by around 8 years over the past two decades to 78.8 years by 2023. This is higher than in neighbouring Baltic countries but below most European and OECD countries. Around a third of the deaths can be avoided through faster treatment and more prevention. For example, with more than half of adults obese, physical activity levels need to increase and nutrition could be healthier. To address this, Estonia should introduce a tax on sugar-sweetened beverages and could tax unhealthy foods more broadly as done in Hungary.

Furthermore, alcohol consumption is among the highest in the OECD. Reducing affordability by raising alcohol excise duties and linking them to inflation as well as reducing availability through restricting opening hours and density of alcohol sales outlets can help lower consumption. To maximise their effectiveness, policies on alcohol need to be coordinated with other Baltic countries.

The number of healthcare staff, crucial to improving health outcomes, should increase. The number of health workers relative to the population is low compared to other OECD countries. In 2022, there were 6.6 practising nurses per 1 000 people, well below most OECD and EU countries. The ratio of practising doctors was 3.5 per
1 000 people, slightly below the OECD average and lower than in most EU countries. More nurses, school and clinical psychologists, and psychiatrists are needed in particular to deliver more mental health services (Sisask, 2023). Given that the workforce is ageing quickly, raising nurse and doctor training levels is paramount. This should be complemented by better remuneration and working conditions to make the healthcare profession more attractive, as discussed in the 2024 OECD Economic Survey of Estonia.

Estonia’s total spending on healthcare is among the lowest in the OECD (Figure 2). Population ageing is driving up demand for more healthcare and new services will ultimately require additional resources. Better use of technology, improved administration and enhanced financial incentives can free up more resources. This year’s increase in user charges for specialised care is a step in the right direction as it will help both raise revenues and lead to more efficient use of specialist services. Nevertheless, more revenues will be needed to fund public healthcare services and to ensure out-of-pocket spending does not cause financial difficulties for vulnerable households.

Better healthcare will improve the quality of life in Estonia, allow people to stay active longer and contribute to a stronger economy with higher tax revenues.

For further information, please visit the Estonia Economic Snapshot page.

Learn more about Mental Health Awareness Week.