Scaling innovation to tackle Europe’s growing mental health crisis

NR Times recently spoke to Dr Tamara Werner-Kiechle, Therapeutic Area Lead for Neuroscience, PH and CVM in Europe, Middle East, and Africa (EMEA). Tamara leads Johnson & Johnson’s medical affairs strategies and operational plans in EMEA. In this interview, Tamara sheds light on why innovation is urgently needed to address the rising rates of psychiatric disorders such as major depressive disorder (MDD) in Europe. She also explains how the shift from the current one-size-fits-all to adopting a more personalised approach – identifying the right treatment for the right patient at the right time can unlock transformative change. 

This content was paid for by Johnson & Johnson and produced in partnership with Neuro Rehab Times

NR Times: Do you agree that mental health is Europe’s silent crisis?

Dr Tamara Werner-Kiechle, therapeutic area lead for neuroscience, and cardiopulmonary in Europe, Middle East, and Africa (EMEA).

Dr Tamara Werner-Kiechle: From my perspective, the figures would certainly suggest so. In the past year alone, a recent survey conducted by the European Commission found that almost half the EU population – 46 percent said they had an emotional problem such as feeling depressed or anxious.¹

The prevalence of major depressive disorder (MDD) – one of the most burdensome mental disorders – is around 12 percent and rates continue to rise.^2,3

The risk of suicide is high amongst patients with MDD – around 15% and we also know that 30 percent of patients who have not responded to treatment will actually attempt suicide.^4,5,6,7,8

This is a crisis that can no longer be ignored. In recent years especially, the need to diagnose and treat mental illnesses successfully with appropriate medical resources has become more pressing. This is the key to helping people lead more fulfilling lives and contribute positively to their relationships, economies, and societies.

What are the key factors that are contributing to this crisis?

Europe’s current mental health crisis is a result of several factors. Although mental health has climbed higher on the health agenda regionally in recent years, it is increasingly difficult to access mental health care, in part because of a worrying decline in mental health workers.⁹

Stigma is still deeply ingrained in societal attitudes, creating barriers to care and treatment.¹⁰

What’s more, surging demand for care far outstrips available services – many European countries report poor working conditions for mental health professionals and a shortage of psychiatrists, cognitive behavioural therapists, and nurses.¹¹

Europe’s population is ageing rapidly and linked to this is a growing chronic disease burden.¹²

People with serious chronic diseases are at an increased risk of developing depression.¹³

The COVID-19 pandemic also created an environment where poor mental health was exacerbated and there is now an increased urgency to strengthen mental health systems.¹⁴

So, now you see how this interplay has led to this concerning situation that we must step up to address.

Why has progress in mental health innovation been so slow?

Yes, treatment advances have been painfully slow compared to many other disease areas. But mental disorders are some of the most challenging health problems faced by society.¹⁵

The brain is an extraordinarily complex organ, controlling thoughts, memories, emotions, and every process that regulates our body – every brain is unique too.¹⁶

However, most conventional therapies have a “one-size-fits-all” approach, leading to mixed outcomes.^17,18,19

This explains why people who share the same diagnosis can show wide variability and severity in symptoms and in treatment outcomes too.²⁰

Take MDD, for example – a particularly common mental health condition that can have a profound and devastating effect on individuals and their loved ones.²

Approximately seven out of ten people living with MDD will continue to experience residual symptoms following the first-line standard of care.²¹

So, it’s not surprising that innovation to address the needs of individuals affected by mental illness is highly challenging. Research and development in psychiatric disorders is notoriously difficult and despite recent advances in science and technology, the underlying biology of these conditions still needs to be fully understood – something that Johnson & Johnson is determined to address.

How can we accelerate innovation to forge a brighter future for patients? Can you summarise the challenges and opportunities ahead?

I believe we are entering a pivotal era for psychiatry which is being fuelled by advanced technology and rapid progression of our understanding of genetics and brain chemistry.²²

This is creating the prospect of genuine breakthroughs across a range of neurological disorders and promising fresh insights into serious mental health conditions like MDD.

Addressing the magnitude of mental health challenges is what motivates me every day to ensure a future where we can alter the trajectory of nervous system disorders and eliminate the burden they place on global health. This diversity of needs demands a more targeted approach to care. Our approach to neuroscience aims to tailor treatment to the individual patient and disease characteristics, departing from the traditional universal approach and instead harnessing precision medicine for a solution.

We must explore the whole picture, which is why we are investigating the underlying mechanisms of MDD to identify how we can work to reduce the impact of these residual symptoms. Diagnosing and treating earlier can make a world of difference to a person with depressive disorder and often lead to significant health improvements, such as fewer complications and disabilities, improved quality of life, and lower healthcare costs.²³ We are channelling the power of human genetics, data science, biomarkers, and digital health technologies to pinpoint precise targets for treatment, categorise patients based on their individual needs, and focus on therapies that will make a real difference.

However, this is something we know we cannot do alone – mental health treatment is inherently complicated: a web of challenging puzzles and varying perspectives on treatment.²⁴ Only by working together can we truly accelerate innovation and find solutions. That’s why we are partnering with key stakeholders; a recent example being our collaboration with the European College of Neuropsychopharmacology (ECNP) as part of the ‘New Frontiers’ initiative to create a consensus roadmap for building a new diagnostic framework for mental health disorders.

Johnson & Johnson recently attended the American Society for Clinical Psychopharmacology (ASCP) annual meeting. What hot topics were being discussed there?

I always find the research landscape in the US to be very inspiring and exciting, with so many interesting scientific developments, pathways, and targets within MDD being researched, and extensive participation in clinical trials. Several hot topics dominated ASCP, including the impact of diagnostic changes and personalised interventions based on biomarkers and genetic information. Our substantial scientific contribution at this meeting reinforces J&J’s commitment to driving innovation in mental health, and how both clinical and real-world evidence are crucial to drive progress in addressing unmet needs and offering new solutions to patients.

What are some of the most groundbreaking advancements in psychiatry that excite you?

As a clinician working in industry, I’m particularly excited about the potential of precision psychiatry, which can link individual or residual symptoms to a pathway that you can potentially target pharmacologically. Given that more than 150 million people in Europe now live with a mental health issue – the sheer scale of this challenge, and the diversity of needs, demands a more targeted approach.^3,25

The shift towards targeted treatments holds immense potential for revolutionising psychiatric care.¹⁹

By integrating our precision neuroscience approach with our deep-rooted expertise in depression, we are working to better understand symptoms and disease pathways, identify disease targets of interest and predict which individuals will respond best to a particular medication. We’re aiming to treat the right patient with the right treatment, at the right time.

Additionally, telepsychiatry and digital therapeutics hold enormous potential for advancing innovative solutions in expanding access and, ultimately, improving outcomes. These advancements collectively represent a transformative opportunity to enhance patient care and drive meaningful progress in mental health treatment.

What is Johnson & Johnson’s North Star?   

Patients will always inform and inspire our science-based innovations, which continue to change and save lives. By applying rigorous science with compassion and drawing on a century of collaborating with clinicians, we are focused on solving some of the most pressing mental health challenges through innovation at the intersection of biology and technology. We have a bold ambition to enable access to quality mental healthcare for all people living with mental illness across the world. Nothing will stop my team and me, along with the psychiatry community, from striving for better patient outcomes. Together, we are innovating with purpose, to lead where medicine is going.

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Article prepared in July 2024 (ref: CP-462906)