Mental health challenges have intensified for the overall European population in the past years. Data prior to 2020 indicates that at least one in six people or 84 million in the EU were affected by mental health problems. Since then, this number has increased (even doubled) as the Covid19 pandemic exacerbated many risk factors associated with poor mental health and weakened many protective measures.
On 7 June, the European Commission unveiled its plan for a comprehensive approach to mental health in Europe, marking a significant milestone for the European Union's efforts in this area. However, amidst high expectations and calls for an actual European Mental Health Strategy – including clear objectives, timelines, indicators and sufficient funding – questions arise regarding the efficacy and strength of this new approach. Overall, it is clear that there is a need for further strengthening of the approach to overcome the effects of long-term under-investment in mental health and integrate it across policy areas.
A milestone for mental health in the EU
The EU's momentous stride in adopting a comprehensive approach to mental health – a pivotal building block of the European Health Union – is very welcome. The European Commission has shown that it recognises the significance of this initiative as a pillar in advancing mental health for all, across various policy domains. As such, this crucial step sets the stage for a future where mental health is prioritised, as well as integrated into every aspect of our society – e.g. employment, environment and digitalisation – and it represents an essential move to lay the foundation for the development of a more detailed European Mental Health Strategy.
As Mental Health Europe Director Claudia Marinetti highlights: ‘the burden must shift from individuals to structural and systemic changes. Investments should prioritise socio-economic factors and paths to recovery that go beyond individual healthy lifestyles and biomedical research.’
The Covid19 pandemic, the war in Ukraine, the climate crisis, as well as other challenges have significantly impacted the mental health of individuals across all age groups.
With the recognition of the broader socio-economic and environmental determinants that influence mental health, the new approach already takes a first step in this direction. By acknowledging the impacts of digitalisation, environment and intersectionality on mental health, the European Commission demonstrates a commitment to addressing inequalities and discrimination, especially regarding people in vulnerable situations. This inclusive approach is commendable.
The Covid19 pandemic, the war in Ukraine, the climate crisis, as well as other challenges have significantly impacted the mental health of individuals across all age groups, particularly those in vulnerable situations. To address this pressing issue, the EU and its member states have to strengthen systems and mobilise stakeholders to integrate mental health promotion, prevention and support at local, regional, national and European level. Regarding this, the ‘Mental health in All Policies’ approach outlined by the Mental Health in All Policies Thematic Network, for instance, recognises that the promotion of mental health is first and foremost a human rights imperative — but it also presents economic benefits and other opportunities of promoting mental health for both health and non-health policy areas.
The inclusion of this prevention-focused approach into the mental health initiative is an important step forward and the fact that the Communication development involved different Directorate Generals and services within the European Commission is a sign that the EU is beginning to prioritise mental health across various sectors and policy areas.
What is missing?
While prevention efforts remain important, it is equally essential to provide necessary assistance and resources to those who are currently experiencing mental health challenges. And yet, the EU still demonstrates a heightened focus on placing the burden of accessing mental health assistance and resources on the individual. Through embracing a holistic perspective in the mental health initiative and advocating for structural changes, the EU could have demonstrated a broader commitment to promoting and protecting the rights of individuals experiencing mental health problems.
The communication does acknowledge the continuum from wellbeing to psycho-social disabilities, yet, it falls short in proposing new actions to address and remove structural barriers and stigma faced by people with psycho-social disabilities. While the biomedical approach assumes that mental health issues stem from genetic predisposition or personal weakness, the psycho-social model recognises that various factors, such as life events, socio-economic conditions, relationships and environmental concerns can influence mental health. It is hence very important that these issues are also addressed in the suggested measures to promote mental health. Moreover, to truly promote mental health for all, initiatives and resources must embed a recovery-oriented approach that goes beyond prevention and wellbeing.
There remains a pressing need for more consistent and long-term resources for mental health.
Another factor that cannot be overlooked is the absence of a dedicated, comprehensive and long-term European Mental Health Strategy in the Commission's new mental health initiative – or any mention or indication of plans to develop one, in fact. This omission has left many advocates disappointed. The European Parliament Coalition for Mental Health and Wellbeing has responded, demanding an enduring, inclusive and coordinated action among EU Member States regarding mental health.
The absence of a dedicated European Year for Mental Health within the approach is another missed opportunity to further bolster implementation efforts. While the European Commission highlighted the European Year of Skills and Year of Youth, the lack of a similar initiative for mental health is disappointing. A dedicated European Year for Mental Health could serve as a catalyst for increased awareness, action, and resource allocation.
Additionally, while €1.23 bn as well as 20 flagship initiatives are steps in the right direction, there remains a pressing need for more consistent and long-term resources for mental health. Considering the allocated budget and foreseen flagship initiatives are meant to be implemented in the short-term period, it remains crucial to ask what the future of this initiative will be next year, particularly considering the changes that will necessarily come with the European Parliament elections.
The comprehensive approach to mental health in Europe marks a significant milestone and demonstrates a commitment to addressing this pressing issue.
The initiative’s emphasis on supporting individuals in vulnerable situations that are disproportionately affected by mental health issues is another positive development. It is particularly encouraging to see recognition of the challenges faced by children and young people, individuals in rural areas, older adults, LGBTQIA+ communities and people with disabilities. These groups often bear an unequal burden but at the same time struggle to access tailored mental health support. However, while the mental health initiative mentions different actions to support various groups of people in vulnerable situations, the flagship initiatives presented only focus on young cancer survivors and victims of crime. Additionally, while the EU’s commitment to Ukrainian migrants is appreciated, we would have liked to also see other refugees and migrants mentioned. It is crucial to ensure that mental health support extends to all people in vulnerable situations, fostering inclusivity and addressing disparities in mental health care.
The journey has begun, and it is crucial to persevere and remain committed to this important endeavour. Together with all stakeholders, we can forge a future where every individual in Europe has the support and opportunity to thrive and flourish at every stage of life, where disparities are addressed and everyone has access to the support they need.
