New multisectoral approach to disentangle supply inequalities in mental health service ecosystems

Abstract Introduction Need for accessible, efficient, well-integrated and equitable mental health (MH) services is constantly growing. In Europe, 1/6 people live with ill MH impacting also the informal, educational, employment and justice sectors. Nevertheless, no multisectoral assessment of supply-related inequalities in an existing MH service ecosystem has been performed yet. Methods We comprehensively assessed all multi-sectoral human services for MH in Vienna. Services and required meta-data were identified through extensive literature, document, web and professional organisation list searches, expert consultations and provider surveys (Sept 2023-May 2025). Supply-related inequalities were mapped and synthesized by sector, target group, service activity, and supply area based on a new, modified, international classification of human services (DESDE), and visualized for policy interpretations. Results We identified 384 micro-level organisations that provide MH-related services in Vienna. While 75% operate in health and social care, only comparatively few services are available in the informal (13%), education (5%), justice (5%) and employment (1%) sectors. Child&adolescent services are <20%. Most services are consultation-based, while others are 9% residential, 13% day, 13% self-help, 12% information/evaluation and <2% access oriented. We further extracted and mapped 6,916 individual professional outpatient services (99% health and social). Population-adjusted density of services differ 7-fold for organisational and 11-fold for individual services across main supply regions. Conclusions This first multisectoral assessment of supply-related MH service ecosystem inequalities indicate major distributional imbalances across sectors, target groups, care segments and supply areas. Comparative supply-demand assessment against population-level MH-related administrative hospitalisation and medication data is ongoing for refined policy and planning recommendations. Key messages • New multisectoral mapping allows disentangling complex supply-related inequalities in MH service ecosystems. • Future MH service planning should focus both on reduced distributional imbalances and improved integration.