A comprehensive approach to mental health
Mental health is an integral part of health. It is a priority for the Commission, which has supported actions and projects over the past 25 years that improve people’s mental health in the EU and beyond.
In her 2022 State of the Union speech, Commission President Ursula von der Leyen announced the Commission’s intention to present “a new initiative on mental health” in 2023.
On 7 June 2023, the Commission adopted the Communication on a comprehensive approach to mental health, which will help Member States and stakeholders to take swift action to deal with mental health challenges.
The Communication is a starting point for a new approach. A comprehensive, prevention-oriented and multi-stakeholder approach to mental health has been developed after extensive consultation with Member States, stakeholders and citizens.
The new approach recognises that mental health is about more than just health and, therefore, strongly involves areas such as education, digitalisation, employment, research, urban development, environment and climate.
The initiative builds on existing policies, approaches and actions. The Communication’s 20 flagships –identifying financing opportunities worth EUR 1.23 billion– will support directly and indirectly Member States in achieving a comprehensive approach to mental health.
Mental health situation in Europe
Worries, anxieties and feelings of depression caused by the devastating effects of the pandemic, Russia’s war of aggression against Ukraine, the climate crisis, unemployment and rising living costs, the pressures of the digital sphere and social media, all have exacerbated the already poor levels of mental health, especially for children and young people.
The Health at a Glance Europe 2018 report highlighted that mental health problems affect about 84 million people across the EU. In addition to personal suffering, mental health problems have financial implications for our society.
The total costs of mental health problems are estimated at more than 4% of GDP (more than EUR 600 billion) across the 27 EU countries and the United Kingdom.
The 2022 Health at a Glance report showed that almost one in two young Europeans report unmet needs for mental health care, and the share of young people reporting symptoms of depression in several EU countries more than doubled during the pandemic.
While many countries have implemented measures to protect and care for young people’s mental health, the magnitude of the current challenges warrants further action to prevent permanent scars on this generation.
This requires a shift of prioritisation towards prevention: to tackle behavioural risk factors and social, environmental and commercial determinants and to have more ambitious actions on mental health promotion and prevention of mental ill health.
Overview of actions on mental health
The European Commission has long been dedicated to improving the mental health of the population, as it is possible to understand through an overview of the past activities.
Overview of current projects:
1. Best practices
The Commission’s Best Practice Portal facilitates the collection, exchange and implementation of best and promising practices among EU Member States.
In 2018, EU Member States prioritised mental health as the area for best practice implementation. In 2019, a pre-selection of best practices was presented to the member states, who then ranked them according to their national priorities. The three highest-ranked practices were:
- mental health system reform focusing on strengthening client-centred, community-based services, as developed in Belgium
- a multi-level national suicide prevention programme, as developed in Austria
- a step-wise intervention programme to tackle depression, as developed through European cooperation
These practices are currently being implemented with financial support via the Third Health Programme’s 2020 Annual Work Plan.
The Joint Action ImpleMENTAL is rolling out (elements of) the Belgian mental health system reform and the Austrian suicide prevention programme. This action brings a total of 21 Member States together, supported by a financial contribution of €5.4 million.
The WHO Regional Office for Europe supports the Joint Action ImpleMENTAL’s efforts regarding training and capacity building, via a contribution agreement for the support of a mental health across policies approach, with a value of €11 million under the EU4Health 2022 work programme.
The depression programme is being implemented via the European Alliance Against Depression-Best project, in which 10 Member States participate, supported by an EC financial contribution of €1.6 million.
A call for best and promising practices on mental health was launched in July 2023. Out of this call, 29 practices were assessed either as best or as promising. These practices are available on the European Commission’s Best Practice Portal.
An online marketplace event is being organised on 11-13 March 2024, during which the owners of these 29 practices will present them in detail to the EU Member States representatives, who may be interested to transfer them in their respective countries.
2. ‘Healthier Together’ initiative
A comprehensive approach to mental health is also supported by Healthier Together - the Commission’s EU Non-Communicable Diseases Initiative presented in June 2022.
This initiative supports EU Member States in identifying and implementing effective policies and actions to reduce the burden of major Non-Communicable Diseases (NCDs), improve citizens’ health and well-being, and reduce health inequalities.
‘Mental health and neurological disorders’ form one of five key strands addressed by this initiative.
Following a co-creation process with EU Member States and stakeholders, the initiative supports the implementation of high-impact actions across the entire spectrum, from encouraging well-being and proactive prevention through to the social inclusion of people with long-term conditions.
The initiative’s work on mental health will cluster around four priority areas:
- Supporting favourable conditions for mental health and increasing resilience, implementing mental-health-in-all policies
- Promoting mental well-being and preventing mental health disorders
- Improving timely and equitable access to high-quality mental health services
- Protecting rights, enhancing social inclusion, and tackling the stigma associated with mental health problems
Action on these areas is already ongoing and will continue until 2027.
3. Capacity building
In parallel to the Communication on mental health, the Commission set up projects with the World Health Organization and the Organisation for Economic Cooperation and Development to provide tailor-made support for each Member EU Member State via technical assistance and capacity-building in transferring and implementing best practices on mental health.
Funding of mental health projects
The Commission provides financial support under the EU4Health annual work programmes to Member States and stakeholders to implement activities to prevent and manage mental health.
More than EUR 30 million has already been allocated to projects addressing public health aspects of mental health in the past three years, including mental health system reform.
On 22 November 2022, the 2023 EU4Health work programme was adopted, which will continue to provide support in promoting mental health and preventing mental health problems. Under this work programme, over EUR 18 million will be available:
- EUR 6 million to Member States’ authorities to collaborate in a joint action to address mental health challenges,
- EUR 2.36 million for stakeholders to support projects related to mental health promotion, prevention and management of mental health problems.
- Both actions will target particularly vulnerable groups such as migrants, refugees, Roma people and persons displaced from Ukraine.
- EUR 10 million has been allocated to
- projects that aim to address mental health challenges in cancer patients and survivors, and their carers and families, and
- the development of a European Code for Mental Health that will empower citizens, help raise awareness on mental health and improve health literacy.
Governance
The Commission works closely with Member States and stakeholders to promote good mental health and prevent mental ill-health.
Cooperation and exchange with Member States take place within the mental health sub-group of the Public Health Expert Group. Its members have strongly supported mental health actions with EU added value.
The Commission's support and coordination will help them to reduce human suffering, improve the resilience and sustainability of their healthcare and social welfare systems, reduce the costs for economies and societies, and help to build and ensure a healthy workforce.
This will help us to reach the UN Sustainable Development Goals and the WHO targets on non-communicable diseases.
Regular interaction and cooperation with all key stakeholders will take place via a dedicated network on mental health at the EU Health Policy Platform.
Supporting Ukraine – mental health of displaced people and refugees
Refugees and displaced persons, notably those fleeing from war – such as displaced people from Ukraine – need mental health support and early responses to reduce distress .
The Commission has mobilised over EUR 30 million from the EU4Health programme to help people fleeing Ukraine in urgent need of mental health and trauma support.
More specifically, a EUR 28.4 million contribution agreement has been signed with the International Federation of Red Cross to help people who have fled Ukraine deal with the trauma they have suffered and offer them mental health support.
The EU Member States where the Red Cross works are Poland, Hungary, Romania, Czechia and Slovakia.
Ukraine’s displaced people are also the focus of a EUR 3 million call for 4 proposals from non-governmental organisations for best practices to improve mental health and psychological well-being in the migrant and refugee populations. All four projects were launched in 2023.
In addition, the Commission offers a range of online courses and other training material on migrant health via the websites of the ECDC’s Virtual Academy and the network Migration and health: training for professionals on the Health Policy Platform.
These courses were developed with the support of the Third Health Programme.
The network Supporting Ukraine, neighbouring EU Member States and Moldova on the Health Policy Platform has been established to combine the efforts of civil society, patient groups and health professionals to meet the medical needs of Ukraine society and of displaced people.
Mental health and COVID-19
The pandemic and its aftermath increased the burden on the mental health services.
The Health at a Glance Europe 2020 report noted that the COVID-19 pandemic and the subsequent economic crisis caused a growing burden on the mental well-being of the citizens, with evidence of higher rates of stress, anxiety and depression.
Young people and people in lower-income groups are considered at increased risk. Disruptions to health care for those with pre-existing mental health conditions constitute a significant part of the negative impact that the pandemic had on mental health.
A few months after the onset of the pandemic, the department for Health and Food Safety set up a dedicated network space on its Health Policy Platform for health and social stakeholder organisations to exchange specific mental health practice and knowledge related to COVID-19.
Co-ordinated by Mental Health Europe, this virtual network focuses on the needs of vulnerable groups such as the homeless, people with pre-existing conditions, and older people. The web space also holds a virtual library.
Two projects (Mentality and Step in) are funded to support the implementation of best practices on the ground with a direct impact on the effort to tackle mental health challenges during COVID-19.
The EU4Health 2021 annual work programme supports the implementation of best practices on the ground directly impacting the effort to tackle mental health challenges during COVID-19 by an EC financial contribution totalling €750 000. Awarded projects are expected to start in the autumn of 2022.
The Commission rewarded community-based initiatives alleviating the mental health impact of COVID-19 via its 2021 EU Health award. The award ceremony took place on May 4, 2022: prize-winning and shortlisted initiatives are presented in a booklet awarded initiatives on the mental health impact of COVID-19.
