The impact of the pandemic on people’s mental health is extremely concerning, warned Dr Tedros, Director-General of the World Health Organisation in May 2020. However, the situation with mental health in Europe was already worrying long before COVID-19. Every sixth adult in the European Union alone was affected by mental ill-health before the outbreak – that is over 84 million people. What is more, the economic impact of poor mental health costs the EU 4% of GDP in lost productivity and social expenditure.
COVID-19 has exacerbated these numbers triggering social isolation, fear of contagion, loss of family members and distress caused by loss of income and often employment. The pandemic has highlighted the crucial role of the social determinants of mental health: where we live, work and age. It showed that distress is caused by a variety of factors, including wider socio-economic issues, and challenging or traumatic life events.
The mental health cost of COVID-19 will roll out in the months and years to come. Some European countries have already started investigating the pandemic’s impact on mental health. The results of a large study by the Belgian Public Health Institute show grave implications – depression rates have sharply increased, from 10% to 16%, compared to 2018. Over a third of adults in the UK said that the pandemic had affected their wellbeing between April and May. Similar results are coming from France and Italy.
Mental health services
Mental health services across Europe have also been severely affected. France and Greece reported rights violations of people living in institutions. Services in Belgium, Spain, the Netherlands and in many other countries were partially or entirely suspended. This only added to the already disproportionate impact of the pandemic on populations in vulnerable situations, including people with mental ill-health.
“The mental health cost of COVID-19 will roll out in the months and years to come. Some European countries have already started investigating the pandemic’s impact on mental health. The results of a large study by the Belgian Public Health Institute show grave implications – depression rates have sharply increased, from 10% to 16%, compared to 2018.”
Yet, we can turn the COVID-19 crisis into an opportunity to improve our mental health services, systems, and long-term policies to be both better prepared for any future crisis and to build resilience. This is the moment to put a spotlight on mental health and develop an actionable approach. Some European countries have already taken strategic steps towards better mental health of their citizens. To name a few, Finland, Malta, and Ireland have adopted their mental health strategies for the next ten years.
Even though the strategies might not be a direct answer to the pandemic, they are expected to play an essential role in shaping national responses to the ongoing and future challenges. All of them incorporate many crucial elements needed to develop more resilient mental health systems and draw on the lessons learnt from the COVID-19 pandemic.
The Irish “Sharing the Vision – a Mental Health Policy for Everyone” is seizing the moment by proposing a lifecycle approach to building positive mental health. Mental health difficulties can begin early in life, but the severity of the impact can be reduced through actions across the lifespan.
The Finnish and Maltese National Mental Health Strategies feature a robust human rights-based approach to mental health. The implementation of mental health rights protects everyone’s mental health, with a particular focus on users of mental health services as they are at higher risk of experiencing violations.
All three strategies work with wider determinants of mental health and use the approach of mental health in all policies. Positive mental health is not a matter for the health sector alone. All relevant public services should invest in the wellbeing of the population to support individuals with mental health difficulties in their recovery and to prevent mental ill-health across communities.
Finally, one of the most important observations coming from the COVID-19 pandemic is that to meet the societal needs in the mental health domain adequately, our services need to be able to quickly adapt to changing circumstances and maintain their continuity. This is possible through delivering support in community settings, which has also been recognised in adopted long-term national plans.
Despite visible progress in some Member States, there are still many that are lagging behind. Not only is this a lost opportunity, but also a threat to social cohesion, sustainability, and economic growth of communities and states. Europe needs a better alignment of action in the area of mental health. This includes a stronger role of the EU in supporting the coordination of national efforts. A European Mental Health Strategy, calling for the implementation of national plans, is not a new ask of the civil society and users of mental health services. The time to ignore this need has run out.