Estonia launches review to map gaps in children's mental healthcare

Estonia's Ministry of Social Affairs has launched an in-depth review of how children access mental health care, aiming to identify weak points in the system, reduce waiting times and improve coordination across sectors.

Officials say access to services currently varies significantly by region, waiting lists are long, and there is little clarity on how young patients move between healthcare providers, schools and social services.

The review follows a 2024 study showing that the mental health of Estonian schoolchildren has been steadily declining since 2010, with the decline sharpest among girls.

Unclear responsibilities and breaks in support

Krista Järv, a project manager in the ministry's Department of Children and Families, said specialists' roles and responsibilities are not always clearly defined, and this, combined with regional disparities and long waits, delays children from getting help. She noted that support often breaks down during key transitions — starting school, moving between grade levels, or aging out of children's services.

Two proposed solutions

The ministry has commissioned an 11-month study to map these gaps and design a future care pathway for children needing mental health support. Researchers will propose improvements to coordination between professionals, case management, information sharing and referrals between services, and will also assess whether legislative changes are needed.

To increase the likelihood that recommendations will actually be adopted, researchers have been asked to prepare two versions: one implementable with existing resources, and an optimal alternative requiring additional funding.

The study is expected to cost up to €100,000, with results due by mid-2027. Any resulting reforms would still require political decisions and cross-sector agreement, with additional funding needed in some cases.