Why address mental health at EU level?
- Mental ill health causes immense suffering for individuals, families and communities.
- Mental ill health puts pressure on health, educational, economic, labour market and social welfare systems across the EU.
- Mental ill health is highly prevalent and increasing in the EU: about 11% of the population are estimated to experience mental ill health. Depression is the most prevalent health problem in many EU-Member States, with suicide remaining a major cause of death. Nine of the ten countries with the highest rates of suicide in the world are in the European Region.
- In European countries, at least 30% of people with severe mental disorders do not have access to mental health care, and the majority do not benefit from the interventions that have proved to be effective in prevention and promotion.
- There is a link between mental health problems and losses of productive human capital: research has shown that there are substantial costs associated with mental disorders, such as higher presenteeism and absenteeism or significantly reduced earnings.
- Stigma, prejudice and discrimination unfortunately are widespread and have a huge impact on those affected seeking or receiving help and support.
- Mental health is a key factor for social cohesion, economic progress and sustainable development in the EU – so the need to prevent mental illness and promote mental health is clear.
- In many or most cases mental ill health can be prevented, cured, treated and managed. A more widespread understanding of this fact might help to combat stigma.
EU action to date
Over recent years the European Commission has taken various steps to ensure a place for mental health on the EU political agenda such as:
- The Commission Green Paper ‘Improving the mental health of the population: Towards a strategy on mental health for the European Union’ (2004) proposing an EU-strategy to focus on promoting the mental health of all. However – and disappointingly – the idea of a concrete strategy did not meet with sufficient support from the Member States.
- Instead, the Commission came forward with the European Pact for Mental Health and Well-being (2008); This concentrated on 5 themes, i.e. prevention of depression and suicide, mental health in older people, mental health in youth and education, mental health in workplace settings and stigma and social inclusion.
- Council Conclusions (2011), recognising mental well-being as an essential constituent of health and quality of life, and a prerequisite for the ability to learn, work and contribute to social life. These invited Member States to make mental health and well-being a priority of their health policies and to develop strategies and/or action plans on mental health including depression and suicide prevention.
- Joint Action on Mental Health and Well-being (2013), building on the findings of the Pact, aiming at building a framework for action in mental health policy at U level.
- EU-Compass for Action on Mental Health and Well-being -a mechanism to collect, exchange and analyse information on policy and stakeholder activities in mental health.
Currently, there is no specific EU action on mental health – instead, the topic has become part of the EU’s general chronic disease agenda. This obviously has an impact on its visibility and potential for EU action.
So, what next?
There is a need as well as a place for a comprehensive and broad-ranging EU Action Plan on Mental Health, like there have been Action Plans in other health and social areas (e.g. rare disorders, disability). 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.
Member States can (continue to) benefit from cooperation, mutual learning and the exchange of good (and bad) practice. Previous EU-level actions have already prepared the ground for more ambitious and structured actions, which will actually engage the relevant policy makers as well as other stakeholders (e.g. patients).
The EU on Mental Health could consist of 6 strands:
1 Mainstreaming: inclusion of mental health as a priority in health and social policy development:
There is a need to explicitly include mental health in all EU initiatives and policy areas that have a bearing on mental health, e.g. the European Pillar of Social Rights, the Health Programme, the European Social Fund, the Disability Strategy, the social Open Method of Coordination (addressing accessible, high quality and sustainable health and long term care systems), Horizon Europe, the European Semester Process, actions on Corporate Social Responsibility, health and safety in the work place, actions on long term care and the Employment Strategy and youth policy.- and of course, chronic disease.
2 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. A European Year of Mental Health and Well-being could be considered.
3 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 actions 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 people affected by mental ill-health have access to high-quality care, including diagnostics, treatments and rehabilitation. National plans can also be useful for mutual learning and exchange.
4 Financial support:
A number of the above EU initiatives hold the potential for funding (e.g. the Health Programme, the Structural Funds…). This funding could contribute to building the capacity of mental health organisations in relation to provision of concrete support and advocacy and supporting exchange of information and good practice.
5 Data collection and monitoring:
Horizon Europe should specifically target issues relating to mental health; 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.
6 Inclusion of relevant mental health stakeholders in 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 societal and policy sectors concerned.
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’. The momentum of previous actions should now be put to use as a helpful starting point for a more ambitious effort to ensure sound policy development, with the ultimate aim to improve the quality of life of those affected by mental ill health and their carers.
For more information:
60 Rue du Trone B – 1050 Bruxelles