The draft amendment to the Public Health Act seeks to establish clear and uniform rules for providing early psychological support, introduce new types of services, and create the conditions for replacing project-based funding with sustainable financing. The change also supports the development of stepped care for mood and anxiety disorders, where early support is part of a comprehensive care pathway. Stepped care means that a person first receives lower-intensity support and progresses to more specialised services only if necessary.
According to Minister of Social Affairs Karmen Joller, mental health concerns are increasingly common, especially among young people. Nearly one third of people experience symptoms of mood disorders and one quarter experience symptoms of anxiety.
The Mental Health Department of the Ministry of Social Affairs has been preparing the stepped-care system for several years. Among other sources, it has taken into account bottlenecks highlighted in the Estonian Human Development Report and studies commissioned by the Ministry on the stepped-care model. Similar approaches are used in other countries, such as Finland and the United Kingdom, where early mental health support is part of the healthcare system. The Ministry involved mental health experts as well as healthcare and social sector partners in developing the draft.
Minni Timberg, Head of Mental Health Policy at the Ministry of Social Affairs, noted that everyone benefits from early support services: “Many mental health concerns do not arise overnight and do not immediately require a family doctor or psychiatrist. Early support is often enough to prevent a condition from worsening and the need for intensive treatment—just as managing high cholesterol helps prevent a heart attack. The new system will reduce the workload of family doctors and other specialists, but even more importantly, people will receive help as soon as symptoms appear, before problems escalate.”
People will be guided to appropriate support by professionals from different sectors. Social workers, schools and primary care teams can play a role in identifying needs and sharing information, supported by a developing digital solution that allows individuals to assess their condition and find the next steps. If necessary, people will be referred to the next level of care, such as psychological counselling or specialist treatment.
Providing support at an earlier stage helps to use specialist resources more efficiently for cases that require intensive care. This will help reduce waiting times and improve access to services.
