Are we spending 4% of healthcare budgets on chronic wounds, yet missing half the problem?

Across Europe, chronic wounds affect up to 14.9 million people, creating a significant — and often overlooked — burden for patients, caregivers, and healthcare systems. The financial impact is substantial: an estimated 4% of European healthcare budgets is spent managing chronic wounds. Much of this cost is driven by delayed diagnosis, prolonged treatment, recurrent complications, and preventable hospital admissions (1,2,3).

Yet despite the scale of spend, an important question remains: are we simply treating the wound while overlooking the person living with it?

Significant economic burden, persistent challenges

The economic burden of chronic wounds is well documented, but most healthcare resources focus on managing the wound itself. Dressings, compression therapies, clinic visits, specialist consultations, and surgical interventions are all essential. However, chronic wounds are rarely a condition in their own right. More often, they result from trauma, surgery, diabetes, vascular disease, immobility, or other long-term health conditions.

What receives far less attention is the deep impact that living with a chronic wound can have on a person’s mental and emotional wellbeing.

Physical and mental health are closely connected. Physical illness can affect mental wellbeing, while psychological distress can influence physical recovery. Age, socioeconomic status, housing conditions, social support, and previous life experiences all shape how people cope with chronic illness and manage long-term conditions.

For people living with chronic wounds, these challenges can be particularly acute. Research suggests that up to 40% of patients with chronic wounds experience clinical depression, while many more report anxiety, stress, and emotional distress (5). Living with a wound that is slow to heal can create constant uncertainty and frustration. Patients may experience persistent pain, reduced mobility, unpleasant symptoms such as exudate or odour, and the disruption of regular treatment appointments. Over time, these burdens can erode confidence, independence, and quality of life.

Managing a chronic wound alongside an existing long-term condition can also have psychological and social consequences. Many patients experience heightened stress and anxiety related to appointments, treatment routines, or waiting for test results. Others may face low self-esteem, stigma, or feelings of discrimination because of the visibility or perceived impact of their condition. Social isolation and loneliness are also common, particularly for people who spend long periods in hospital or become confined to their homes because of reduced mobility.

The emotional toll can also show up as anger, frustration, or grief, especially when illness prevents people from doing the activities they enjoy or maintaining social relationships. Sleep disturbances, often caused by pain, discomfort, or treatment interventions such as compression therapy, can further compound both physical and psychological challenges. In some cases, chronic illness and emotional distress may contribute to less common but important mental health concerns, including eating disorders, malnutrition, or unhealthy coping behaviours (4).

The role of support in improving outcomes

The support patients receive during these vulnerable periods can make an important difference. Empathetic healthcare professionals, family support, community networks, and access to mental health services can help people build resilience and improve both emotional wellbeing and treatment adherence.

Yet evidence suggests that anxiety, depression, and cognitive impairment remain under-recognised and under-managed in many chronic wound populations. This is a missed opportunity — not only to improve quality of life, but also to support better healing. Psychological distress has been linked to poorer self-care, reduced treatment adherence, and physical responses that may make healing more difficult.

As healthcare systems continue to invest heavily in wound management, there is a growing need to move beyond care focused mainly on the wound bed and embrace a more holistic, person-centred approach. Integrating routine screening for mental health conditions and cognitive impairment into wound care pathways could enable earlier intervention, more tailored support, and better overall outcomes.

A strategic opportunity for better value in healthcare

The challenge is not just how to heal wounds faster, but how to better support the people living with them. If up to 4% of healthcare budgets is already being spent on chronic wound care, addressing psychological and emotional wellbeing alongside physical treatment may be one of the most meaningful opportunities to improve outcomes, enhance quality of life, and reduce long-term healthcare costs.

On World Mental Health Day, perhaps the real question is not whether we can afford to integrate mental health into wound care, but whether we can afford not to.