Mental health management in the context of TB care in the WHO European Region: a consensus statement
Year: 2026
Type: article
Abstract: BACKGROUND: Integrated care for TB and mental health is critical, as mental disorders worsen TB outcomes. WHO guidelines recommend routine screening for mental health conditions and integrated care for TB patients, yet implementation remains uncertain. METHODS: We conducted a survey with the participation of 34 experts from 26 countries from the WHO European Region within TBnet and the ADVANCE-TB COST Action, followed by a Delphi process to assess the uptake of WHO recommendations and build consensus on strategies for integrated TB-mental health care. RESULTS: The survey showed substantial gaps: only 21% of experts, representing six countries, reported local or national guidelines integrating mental health into TB care, and systematic screening was rare, including for drug-resistant TB. Building on these findings, the Delphi process reached consensus on the need for validated screening tools at key treatment stages, structured referral pathways, and tighter alignment between TB and mental health services. Eighteen consensus recommendations were developed, addressing training, routine data collection, technology-supported care, and sustainable financing. CONCLUSION: Mental health remains insufficiently integrated into TB care across the WHO European Region. Routine screening coordinated referral systems and implementation of the proposed recommendations are essential to deliver people-centred, equitable, and effective TB care.
Source: IJTLD OPEN
Authors: C. Vilaplana, O. Konstantynovska, O. Rzhepishevska, L. Codecasa, L. Larocca, D. Zaçe, B. Häcker, R. Otto-Knapp, R. Duarte, M. Pinheiro, A. Aguiar, M. Janković, I.A. Pérez-Hernández, J.P. Millet, I. Nordstoga, M. Drage, A.M. Dyrhol-Riise, A. Dudnyk, P. Fraisse, M. Fréchet-Jachym, F.-X. Blanc, Z. Nanovic, G. Günther, A. Eichenberger, S. Degtyareva, J. Callum, M. Dedicoat, A. Dumitrescu, J. Bruchfeld, G. Auguste, D. Aznar, A. Lacoma, J. Cuevas, J. de Pablo
Institutions: Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, V. N. Karazin Kharkiv National University, Umeå University, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, University of Catania, Ospedale Garibaldi, University of Rome Tor Vergata, Universidade do Porto, Instituto de Ciências Biomédicas Albel Salazar, Institute of Public Health, University of Porto, Unidade Local de Saude de Barcelos/Esposende, University Hospital Centre Zagreb, University of Zagreb, Hospital Clínico Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Landsforeningen for hjerte- og lungesyke, Oslo University Hospital, University of Oslo, National Pirogov Memorial Medical University, Vinnytsya, Société de Pneumologie de Langue Française, Centre Hospitalier de Bligny, Centre Hospitalier Universitaire de Nantes, Institut du Thorax, Nantes Université, Goce Delcev University, University of Bern, University Hospital of Bern, Marienkrankenhaus Kassel, The University of Sydney, Homerton University Hospital NHS Foundation Trust, University Hospitals Birmingham NHS Foundation Trust, Institutul de Pneumoftiziologie "Marius Nasta", Karolinska University Hospital, Karolinska Institutet, Hospital Universitari Germans Trias i Pujol
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7160870070