IJSP Number 5, 2023

49 The reality is supervision has not garnered research interest [12] and if publication is a metric, nor has it garnered interest in systems or administration. However, before we address the possible reasons for the failure to incorporate a competency-based approach, we return to our fundamental position – supervision must explicitly focus on the development of professional competence AND competency-based clinical supervision provides the best approach to achieve that objective. Also, we maintain that incorporation of an orientation to competencies prepares the trainee to consider competence is not a static end state that one achieves but rather reflects the developmental and contextual nature of competence combining new and old knowledge and skills to address present problems [13]. 2. THE NECESSITY OF ENSURING EFFECTIVE MENTAL HEALTH PRACTITIONERS AND EVIDENCE-BASED PRACTICES In our view, the development of clinical competence through competency-based education and training offers the best possibility to meet the critical mental health challenges that our respective societies face. The scale of the task cannot (nor should not) be minimized. In the United States, about 1 in 5 persons experienced a mental illness in 2019 [14]. In Europe, the WHO European Framework for Action on Mental Health 2021-2025 [15] provided an overview of the state of mental health in the EU: According to global health estimates for the Region in 2019, the number of people with mental health conditions (including depression, anxiety disorders and psychosis in adults, as well as developmental and behavioural disorders in children and adolescents) stood at over 125 million, equivalent to 13% of the population. When these and other conditions are adjusted for the level of disability they cause, mental health conditions account for 15% of all years lived with disability. In addition, an estimated 119 000 lives were lost across the Region in 2019 due to suicide, which is an unacceptably high figure that includes an increasing number of young people. (p. 5) Further, due to the COVID-19 pandemic, “initial estimates show a 26% and 28% increase respectively for anxiety and major depressive disorders in just one year.” The third wave of the European health interview survey (EHIS), conducted for 2019, indicated that 7.2% of the EU population reported having chronic depression. Portugal had the highest share of its population (12.2%) reporting chronic depression among the EU Member States, while double-digit shares were also recorded in Sweden, Germany, Croatia, Denmark, and Luxembourg; an even higher share was recorded in Iceland (15.6 %). One in ten people aged 75 or older reported chronic depression and the standardized death rate for intentional self-harm was 16.6 for 100,000 inhabitants aged 65 and older. A 2020 survey also found that Europeans experience high rates of anxiety, for example, 21% of French respondents reported to be suffering from anxiety [16]. Further, survey research in the EU and internationally reported that 70 percent of the respondents experienced lifetime traumas, indicating high risk for PTSD, depression, and other mental disorders [17]. The European data reflect a disturbing trend that mental health