Jennifer Oroilidis and Marie Fallon-Kund, from Mental Health Europe, argue that in light of COVID-19, the time for mental healthcare reform is now
The global outbreak of COVID-19 forced many mental healthcare services across Europe to adjust. Lockdown restrictions led to a disruption of many services crucial for the mental wellbeing of people. Civil society organisations and the United Nations (UN) have called on policymakers to support mental healthcare reform now and beyond the pandemic. The biggest crisis can be an opportunity for much-needed systemic change. Service providers all over Europe are leading the way, as the examples below illustrate.
Germany: Focus on one goal – provide services to the people Pfalzklinikum, a service provider in the Palatine region of Germany, reduced their mental health services to nearly 40% of their regular workload. This measure ensures they have enough staﬀ to run services in case the virus breaks out among employees. As the crisis does not only take a toll on the mental health of clients, but also staﬀ, Pfalzklinikum has taken several steps to safeguard their wellbeing through daily check-ins with employees.
Although it is challenging to deliver services under these circumstances, they like other organisations, try to give their clients daily telephone calls and visits. Director Paul Bomke sees an opportunity for progress in mental healthcare as a result of the COVID-19 crisis. “Before the crisis, people were more reluctant to digitalise. Now, there is a boost in teleconferencing and bringing digital solutions to the outreach services,” he explains.
Examples of mental healthcare reform
The Netherlands: “Coﬀee to go” programme & digital alternatives Lister, a community-based mental healthcare service provider in Utrecht, introduced new ways of working
in response to the pandemic. For clients living on their own, they started the “coﬀee to go” programme. Caseworkers take clients out for a coﬀee and a walk to talk, thereby minimising the risk of contamination while still providing essential services.
Thanks to digital tools like WhatsApp or Skype, Lister is more in contact with clients than ever before, praises Jan Berndsen, CEO of Lister and President of Mental Health Europe. He also sees a great opportunity in the organisational shift to digital alternatives of mental healthcare. It will make services even more ﬂexible and adaptable to clients’ needs once the crisis has passed.
Italy: We need a European mental health strategy As COVID-19 has hit particularly hard in Italy, Tages Onlus is an example of a mental healthcare service provider in Florence and Bologna, who had to adapt to the new reality. Digitalisation also played an important role here. All services are being reframed in the long-term while a new online training platform is being developed. Weekly online meetings help to create a sense of community and support among the staﬀ.
But to Simone Cheli, President of Tages Onlus, it is clear, “we need a European mental health strategy.” Autonomous regions in Italy are moving independently from the central government. As a result, there is much chaos and a high rate of infections. Now and after the pandemic, a united direction from the European level is needed.
MEPs: Boost mental health policies now The Coalition for Mental Health and Wellbeing in the European Parliament sent an Open Letter to the Presidents of the European Commission and Council demanding immediate action.
The coronavirus pandemic has cast a spotlight on ﬂaws in current mental healthcare systems. Europe needs not only more but wiser investments in mental health. Moreover, European leaders and Member States need to follow already existing guidelines such as the UN Convention on the Rights of Persons with Disabilities and the European Pillar of Social Rights.
The Coalition has outlined a set of speciﬁc suggestions ranging from public communication initiatives to adequate access to mental health services.
UN: Human rights best “vaccine” for good mental health
The UN Special Rapporteur on the right to physical and mental health Dainius Pūras underlines that changes need to take place both within mental health services and beyond. He recalls that inequalities, injustice, discrimination and violence are the main determinants that threaten our mental health and wellbeing. Therefore, the most eﬀective way to promote mental health in the long term is to invest in protective environments in all settings. A human rights-based approach in all policies is the best antidote for mental ill-health.
Pūras implores governments to increase investments in mental health. Instead of the current over-reliance on medicalisation, it is high time for an alternative approach addressing the overuse of biomedical interventions and the power imbalance between providers and users of mental health services.
As Secretary-General of the United Nations António Guterres points out in the aftermath of COVID-19 “we must shift more mental health services to the community, and make sure mental health is included in universal health coverage”. Despite all the hardship the pandemic has caused, it can be a turning point for mental healthcare reform if we act now.