Written by Nicole Scholz,
Mental health problems not only exact a toll on the people affected, they also put pressure on health, economic and welfare systems. The EU is promoting mental health through various instruments. Globally, World Mental Health Day is held on 10 October each year to raise awareness.
World Mental Health Day, inaugurated at the initiative of the World Federation for Mental Health in 1992, is marked every year on 10 October. The WHO recognises it as an opportunity to raise awareness of, and mobilise support for, mental health issues. This year’s theme focuses on psychological first aid, meaning humane, supportive and practical assistance given by people who find themselves in a helping role – healthcare staff, teachers, firefighters, community workers and police officers – for those who have recently suffered a serious ‘stressor‘.
Mental disorders: some background facts
The World Health Organization (WHO) defines mental health as a state of well-being in which an individual can realise their own potential, cope with the normal stresses of life, work productively and fruitfully, and is able to make a contribution to his or her community. Mental disorders comprise a broad range of problems with different symptoms and varying degrees of severity. They are generally characterised by a combination of disturbed thoughts, emotions, behaviour and relationships with others. Examples of mental disorders include: depression; bipolar disorders; schizophrenia; anxiety disorders; dementia; and child development disorders, including autism.
Mental disorders affect men and women differently. A person’s mental health is shaped by various factors that may increase both the risk of developing mental disorders and their severity and duration (the ‘risk factors’), or improve people’s resistance to risk factors and disorders (the ‘protective factors’). These determinants can be individual and family-related, but also social, economic or environmental (for example, one’s living standards or working conditions). Mental disorders are often linked to stigmatisation and social exclusion. Mental health is also one of the most frequently reported health needs of undocumented migrants arriving in EU countries. The European Commission’s 2013 profile of national mental health systems across Europe maps the activity in terms of prevention and promotion of mental health, including access to care.
EU activities in the field of mental health
European Commission initiatives and projects
The 2005 Green Paper – at the root of current EU action on mental health – invited all interested parties ‘to contribute to the preparation of a possible EU Strategy and an Action Plan on Mental Health’ via a consultation. The European Pact for Mental Health and Well-being, launched in 2008, called for action in five priority areas:
- Prevention of depression and suicide, since depression is one of the most common and serious mental disorders and a leading risk factor for suicidal behaviour;
- Mental health in youth and education, considering that the foundation of life-long mental health is laid early and that up to 50 % of mental disorders have their onset during adolescence;
- Mental health in workplace settings, given that the changing pace and nature of work lead to pressures on mental health and that the mental health of the workforce constitutes a resource for productivity and innovation;
- Mental health of older people, as old age can bring with it certain risk factors for mental health, such as the emergence of physical or neurodegenerative illnesses (for instance Alzheimer’s disease and other forms of dementia) and that suicide rates are high in older people;
- Combating stigma and exclusion, since both are risk factors and consequences of mental disorders, which can create barriers to help-seeking and recovery.
The pact was followed by a three-year joint action on mental health and well-being, launched in 2013. It focused on five issues: mental health in the workplace; mental health and schools; depression, suicide and eHealth; community-based approaches; and mental health in all policies (MHiAP) – an approach that highlights the impacts of public policies on mental health determinants and aims to reduce mental health inequalities.
The joint action, which ran until January 2016, resulted in a framework for action on mental health and well-being, which provides policy recommendations that the Member States are invited to implement. To support their implementation, the Commission employs the EU compass for action on mental health and well-being (2015-2018), an instrument for monitoring policy and stakeholder activities in mental health and well-being. The EU compass mainly focuses on issues around depression and resilience; access; community-based mental health; suicide prevention; mental health at work and in schools; and integrated governance approaches. It disseminates European good practices (for instance through its newsletter) and collect data on stakeholders‘ and the Member States’ mental health activities through annual surveys. It also plans yearly reports and forum events as well as national mental-health workshops.
Mental health is also addressed by EU-financed projects. Examples under the EU health programme include CAMHEE (Child and adolescent mental health in enlarged European Union) and Pathways (Participation in healthy workplaces and inclusive strategies in the work sector). The EU framework programme for research and innovation, Horizon 2020, currently funds projects such as ICare (Integrating technology into mental health care delivery in Europe) and MEDIT-Ageing (Investigating the impact of meditation training on mental health and well-being in the ageing population).
European Parliament resolutions and Interest Group
In its 2009 resolution on mental health, Parliament called on the Member States to develop awareness of, and improve knowledge about, mental health. Parliament emphasised, among many other points, the need for specialist mental health services for children and adolescents, including the move from institutionalised care to supported living in the community (deinstitutionalisation). It made a case for early detection and treatment of mental health problems in vulnerable groups, notably minors, and called for more research (for example into working conditions liable to increase the incidence of mental illness). Suggestions from its 2011 resolution on Alzheimer’s disease and other dementias include launching a European Year of Mental Health as a way to raise awareness of brain-related diseases associated with ageing. Parliament’s 2015 resolution on health and safety at work underlined the importance of a physically and mentally safe and healthy working environment to achieve active and healthy ageing for workers. Its 2016 resolution on work-life balance highlighted the fact that women and LGBTI persons face gender-based sources of stress at work that threaten their mental health.
The European Parliament Interest Group on Mental Health, Well-being and Brain Disorders, chaired by Nessa Childers (S&D, Ireland), Jean Lambert (Greens/EFA, United Kingdom), Marian Harkin (ALDE, Ireland) and Cristian-Silviu Bușoi (EPP, Romania), was launched in 2009 with the support of the Global alliance of mental illness advocacy networks-Europe (Gamian Europe). The interest group’s mission is ‘to advocate the development of sound EU policies which contribute to prevention of mental health problems and ensure good services, care and empowerment for those affected by mental health problems’.
The 2011 Council conclusions on the European Pact for Mental Health and Well-being invite 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’.
WHO European Region activities on mental health
In 2005, the WHO European Region, the European Commission and the Council of Europe signed the Mental Health Declaration for Europe. The 2008 partnership project on user empowerment in mental health, co-funded by the WHO Regional Office for Europe and the Commission, followed up on the commitments made. According to the European mental health action plan 2013-2020 by the WHO Regional Office for Europe, ‘investing in mental health is essential for the sustainability of health and socioeconomic policies in the European Region’. Its objectives focus on: equal opportunity for people to realise mental well-being throughout life; rights of people with mental health problems; accessible mental health services; and the right to respectful, safe and effective treatment. A European mental health strategy is under development.