As GAMIAN-Europe expands its policy efforts, it increasingly engages in dialogues with EU institutions focused on mental health. Although health policy is mainly the jurisdiction of Member States, the EU plays a complementary role, as dictated by the Treaty. This role has seen the EU address various health-related matters, including mental health.

The Commission has progressively elevated mental health on the political agenda through several initiatives:

1. The 2004 Commission Green Paper proposed an EU-level mental health strategy, aimed at fostering cooperation among Member States and involving stakeholders. However, it didn’t garner sufficient Member State support.

2. In 2008, the European Pact for Mental Health and Well-being focused on five key areas: suicide and depression prevention, mental health in older people, mental health in youth and education, mental health in workplace settings and stigma and social inclusion.

3. The 2011 Council’s conclusions on the European Pact for Mental Health and Well-being called for Member States to prioritise mental health in their health policies.

4. The 2013 Joint Action on Mental Health and Well-being, built on the findings of the Pact laid out a detailed action framework focusing on five areas including workplace mental health and community-based care

5. The EU-Compass for Action on Mental Health and Well-being, funded by the Commission, collected and analysed policy information, promoting good practices and monitoring activities. This aimed to disseminate the ‘European Framework for Action on Mental Health and Well-being’ as developed by the Joint Action and monitored mental health and wellbeing policies and activities by Member States and non-governmental stakeholders.

The Compass has since concluded with mental health now part of the EU’s broader focus on chronic diseases. Unfortunately, no concrete follow-up activities are currently planned.

All in all, it is fair to day that, while relevant, EU-level action on mental health has been disappointing – and the current move to address mental health as part of the general chronic disease agenda will decrease the visibility and potential of mental health issues even more. So clearly, action needs to be taken to ensure a robust place for mental health on the EU policy agenda.

All Member States are facing the same issues in relation to tackling mental ill-health, both with respect to prevention and mental health promotion as well as the development and implementation of effective and sustainable care provision models. For instance, the current trend towards community health care requires clear strategies and policies to ensure quality of and access to appropriate care.

Many countries are struggling with this development and Member States can (continue to) benefit from cooperation, mutual learning and the exchange of good (and bad) practice.

GAMIAN-Europe and the Interest Group believe that, through the various EU-level actions that have already been taken, the foundations have been laid for more ambitious and structured actions, which will actually engage the relevant policy makers as well as other stakeholders (e.g. patients). There are EU level precedents for more ambitious actions in specific health areas, for instance in fields of cancer and rare diseases.

A more ambitious approach would also be in line with the expected outcomes of the Joint Action, which aimed to ‘build capacity of national mental health leaders and other stakeholders in mental health policy development and the creation of mechanisms supporting a structured collaboration between key actors in the implementation of mental health policies in Europe’.

The Action Plan would consist of 6 strands:

• Inclusion of mental health as a priority in health and social policy development: mainstreaming: There is a need, recognised by the Joint Action to explicitly include mental health in all areas that have a direct or indirect bearing on mental health, such as the Health Programme, the European Social Fund, the D disability strategy, the social Open Method of Coordination (addressing accessible, high quality and sustainable health and long term care systems), Horizon 2020 (research), the European Semester Process and actions on Corporate Social Responsibility, health and safety in the workplace and the Employment Strategy.

• Awareness-raising and good practice exchange: mutual learning and exchange: The EU Action Programme should ensure and coordinate an effective exchange of information, experience and good practice between relevant stakeholders and Member States. Another option to raise awareness would be to consider designating one of the coming years as the European Year of Mental Health and Well-being.

• Stimulate the development of national action plans on mental health and well-being: As already referred to in the 2011 Council Conclusions, national action plans on mental health could be put in place, using the existing national action plans on cancer and rare diseases as models: these plans should be established to explore appropriate measures for mental health in order to ensure that patients with mental health problems have access to high-quality care, including diagnostics, treatments and rehabilitation. National plans can also be useful for mutual learning and exchange., with the Group of Governmental Experts on Mental Health acting as a coordinating mechanism for a structured and effective exchange and mutual learning.

• Financial support: A number of the above initiatives hold the potential for funding (e.g. the health programme, the Structural Funds, Horizon2020). This funding could contribute to the capacity building of mental health organisations in relation to the provision of support (e.g. emotional support, exchanges, information) and advocacy (e.g. policy development, practical solutions). It could also support the exchange of information, research and networking.

• Data collection and monitoring: The Horizon2020 programme should continue to issue specific calls for research projects addressing mental health in future calls for proposals under the action ‘Tackling Societal Changes’, section ‘Health, demographic change and well-being’. The EU-funded ROAMER project has developed a sensible and inclusive roadmap for research in this area, which could provide guidance on priority setting and the most pressing issues.

• Inclusion of people affected by mental health problems in relevant EU consultations, fora and Advisory boards: Any strategy or policy addressing mental health should be developed as a joint effort by all key stakeholders from the societal and policy sectors concerned, including representative organisations active in the field of mental health should explicitly be included in social and health consultations as well as in relevant fora and advisory boards.

There are EU-level precedents for this type of Action Plan and given the impact and relevance of mental ill health on individuals, their families, their communities and society as a whole, it is imperative that action should be taken. It has already been recognised by the EU level that ‘complementary action and a combined effort at EU-level can help Member States tackle these challenges by promoting good mental health and well-being in the population, strengthening preventive action and self-help, and providing support to people who experience mental health problems and their families’. Initiatives like the Joint Action have laid the foundations for a more sustained and structured effort at EU and national levels. The momentum of the Joint Action should now be put to use as a useful starting point for a more ambitious effort to ensure sound policy development, with the ultimate aim of improving the quality of life of those affected by mental health problems.