Hanover

11 May 2022

THE HANOVER VIEW

Mental health has been on the margins of the European health debate for a long time. Yet, one in six people in the EU, or more than 84 million people, are affected by mental health issues[1].

Despite these numbers, mental illness is still not universally accepted, as there is still significant misinformation and miscommunication around it. May is Mental Health Awareness Month and provides an opportunity to readdress the issue.

Introduction

There are many different types of mental illnesses, ranging from anxiety and depressive disorders to obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD).

Just as with physical health conditions, the development of mental illnesses can be triggered by genetic pre-conditions and a wide range of risk factors, such as abuse, trauma, stress, domestic violence, adverse childhood experience, bullying, conflict, social isolation or substance abuse.[2]

In the European Union, not only do these conditions affect millions of people – but they also incur economic costs of over 4% of the GDP. More than a third of these costs is driven by lower rates of employment and lower productivity at work. [3]

Some of these costs could be offset by increased investment in more interventions to promote mental resiliency and well-being and intervene early when mental health conditions occur.

Healthcare systems currently fail to deal with mental health due to traditional perspectives. One is that mental health is not as important as physical health. A second is the broader issue of healthcare systems trying to tackle health conditions once there is a problem, rather than investing in prevention.

Impact of COVID-19 on mental health

The COVID-19 pandemic has put a spotlight on mental health and well-being and highlighted how unprepared healthcare systems were. We now have an opportunity to strengthen public health systems in the long term.

COVID-19 has had a marked impact not only on people with pre-existing mental health conditions but also provoked new episodes of mental disorders including anxiety, depression and insomnia. According to the WHO, in the first year of the pandemic, anxiety had grown by over 20%[4]. This was the result of the unprecedented confinement measures and the disruption to daily habits, such as participation in the workplace, social connection and physical exercise[5]. Data shows a huge surge in people seeking help and of more young people increasingly reporting mental distress, especially during the first wave in spring 2020[6].

The debate around increased investment in mental health was therefore a natural development. Governments have prioritised this as part of their COVID-19 response plans and taken steps to increase mental health support. In particular, countries have introduced new forms of mental health support including informational materials, new mental health support phone lines, shifting mental health services to telemedicine formats and in some cases increasing service capacity or entitlement, and in some countries increasing investment in mental health.

Among others, Australia, Canada, France, Ireland, Israel, Italy, the United Kingdom, and the United States have all taken steps towards integrated youth mental health care by implementing initiatives based on integrated care models.

However, mental health provision is fragmented across the EU. Whilst there is an important policy narrative around mental health, stark inequalities across member states are still a reality.

What the EU is doing to address mental health?

This fragmentation also exists at the European level – with diverging approaches amongst the European Parliament, the European Commission and the Council.

While Members of the European Parliament – led by MEP Alliance for Mental Health- are carrying out coordinated actions to ensure a specific European strategy for mental health is developed, the Commission is only focusing on funding through existing initiatives.

In July 2020, the European Parliament[7] called on the European Commission to draw up a mental health action plan for 2021-2027 but no such plan has been published yet. Instead, the European Commission keeps addressing mental health as part of non-communicable disease activities, deprioritising an issue that deserves a standalone EU common strategy, akin to the one that has been done already for cancer.

The European Council is advocating for more awareness and mental health will potentially also be among the priorities of the Czech Presidency in the second half of 2022, with 2023 to become the European Year of Mental Health.

The increasing prevalence, burden and impact of mental ill health need to be addressed in all its aspects. A European-level strategy, with a holistic, cross-cutting and multidisciplinary approach, integrated into the public-health system, should foster cooperation between countries, identifying and addressing practical solutions to ensure that mental health problems are better diagnosed and treated.

Conclusions

The EU is instrumental in shaping the positive mental health of its society as it plays a key role in the coordination of health and public health promotion. To do it effectively, the EU needs a clear strategy for mental health. By doing so, the EU can improve the lives of millions of Europeans – both those affected by mental ill-health and their families – and contribute to a stronger economy, social cohesion and sustainable development.

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[1] Health at a Glance: Europe 2018: State of Health in the EU Cycle | READ online (oecd-ilibrary.org)

[2] Association of Stressful Life Events with Psychological Problems: A Large-Scale Community-Based Study Using Grouped Outcomes Latent Factor Regression with Latent Predictors

[3] A New Benchmark for Mental Health Systems: Tackling the Social and Economic Costs of Mental Ill-Health | en | OECD

[4] Mental Health and COVID-19: Early evidence of the pandemic’s impact: Scientific brief, 2 March 2022

[5] OECD iLibrary | Health at a Glance: Europe 2020: State of Health in the EU Cycle (oecd-ilibrary.org)

[6] European Parliamentary Research Service (2022). How are we coping with the pandemic? Mental health and resilience amid the Covid-19 pandemic in the EU.

[7] European Parliament resolution of 10 July 2020 on the EU’s public health strategy post COVID-19 (2020/2691(RSP))