Mental Health in Georgia: The Treatment Gap Nobody Measures

Mental health disorders affect an estimated 18% of Georgia’s population. Yet the country spends less than 2% of its health budget on mental health, and outpatient psychiatric care remains inaccessible for most. PHIG maps the treatment gap.

“The mental health treatment gap in Georgia is not a data problem. It is a political problem. When the budget allocation for all mental health services is smaller than the operating cost of one medium-sized hospital, the priority is clear.”

Pkhakadze G. PHIG Mental Health Systems Analysis. Tbilisi: PHIG; 2025.[1]

Introduction

The global mental health treatment gap — defined as the proportion of people with mental health disorders who do not receive appropriate care — averages 76–85% in low- and middle-income countries and 35–50% in high-income countries.[2] Georgia’s treatment gap, estimated by PHIG at approximately 78% for common mental disorders (depression and anxiety), places it in the most acute category for a country of its income level and places it well below its stated ambition of European health system standards.[1,3]

This analysis draws on the NCDC Georgia Mental Health Survey 2023, WHO ATLAS Mental Health Resources 2023, and PHIG’s own assessment of mental health services in six Georgian regions conducted in 2024.

The Georgian Mental Health System

Georgia’s mental health system remains predominantly institutionally-based. The four state psychiatric hospitals — in Tbilisi, Kutaisi, Gori, and Batumi — account for 81% of all mental health bed-days but are accessible only to those requiring inpatient admission. Community mental health teams are in nascent form; only 6 of Georgia’s 73 municipalities have a functioning community mental health service as of 2024.[3]

Primary care physicians — theoretically the first point of contact for mental health complaints — are not trained in brief psychological interventions, and the UHC benefits package does not include outpatient psychological therapy, creating a structural barrier that has no clinical justification.[4]

Figure 1. Mental Health Budget as % Total Health Budget: Georgia vs. European Countries 2024

Sources: WHO Mental Health Atlas 2023; national health budget data; PHIG analysis.[1,2,3]

Figure 2. Inpatient vs. Community Mental Health Service Mix: Georgia vs. WHO Recommendation 2024

Conclusion

Georgia’s mental health system is chronically underfunded, institutionally dominated, and largely inaccessible to the majority of people who need it. This is not a knowledge gap — the interventions required are well-evidenced and relatively low-cost. It is a prioritisation gap. PHIG calls on the Ministry of Labour, Health and Social Affairs to include a dedicated mental health reform package in the 2026–2030 National Health Strategy, with annual budget allocation targets rising from 1.8% to 5% of the health budget by 2030, aligned with the WHO Comprehensive Mental Health Action Plan 2013–2030.

References

1. Pkhakadze G. Mental Health Systems Analysis: Georgia 2024. Tbilisi: PHIG; 2025.
2. WHO. Mental Health Atlas 2023. Geneva: WHO; 2023. ISBN 978-92-4-008563-8
3. National Centre for Disease Control and Public Health. Mental Health Survey Georgia 2023. Tbilisi: NCDC; 2024.
4. Ministry of Labour, Health and Social Affairs of Georgia. UHC Benefits Package Review 2024. Tbilisi: MoLHSA; 2024.
5. Kessler RC, Aguilar-Gaxiola S, Alonso J, et al. The global burden of mental disorders: an update from the WHO World Mental Health Surveys. Epidemiol Psychiatr Sci. 2009;18(1):23–33.
6. WHO. Comprehensive Mental Health Action Plan 2013–2030. Geneva: WHO; 2021.

Prof. Giorgi Pkhakadze, MD, MPH, PhD

Professor of Public Health, David Tvildiani Medical University | Chair, Public Health Institute of Georgia | Founder, Accréditation Sans Frontières

Published on behalf of the PHIG Analysis and Intelligence Team · Tbilisi, Georgia

PHIG

Public Health Institute of Georgia