Pandemic is a wake-up call for mental healthcare reform in Europe

With World Mental Health Day (WMHD) approaching on 10 October, we must shine a light on the mental health consequences of the COVID-19 crisis. For many, the pandemic led to social isolation, loss of family members and unemployment. Despite the disruption of mental health services, several EU member states have adjusted care provision to cushion the mental health blow of the pandemic.

Unsurprisingly, the coronavirus outbreak and ensuing restrictions have had a severe impact on citizens’ mental wellbeing. At the beginning of lockdown in France, for example, anxiety was twice as prevalent while life satisfaction dropped significantly. In Italy, where the pandemic caused particular havoc, eight in ten Italians said they needed psychological support according to a survey by Italy’s order of psychologists (CNOP).

Furthermore, Sweden saw an increase in self-reported mental health problemsduring the pandemic. The Netherlands and the United Kingdom reported similar deterioration of mental health. More than a third of Dutch citizens indicated they were feeling more anxious, stressed and lonely while about 20% were having more problems with sleep. In the UK, 57% of respondents of a major study reported symptoms of anxiety and 64% signs of depression.

While these reactions are deemed normal under such unprecedented circumstances, the restrictions caused by COVID-19 disrupted mental healthcare services. In Belgium, most face-to-face appointments had to be cancelled. Similarly, in the Netherlands, 60% of services reported partial or entire suspension. The city of Madrid was forced to reduce access to emergency mental health services by 75%. In the UK, one in four young people were not able to access mental health support they sought during the lockdown, according to The Health Foundation.

At the same time, initiatives to strengthen psychosocial support have sprung up across the EU while states were looking for innovative solutions to mental health care provision.

In Madrid, for instance, mental health services had to adapt quickly: services over the phone were introduced and home visits were organised for the most severe cases.

Many member states also established helplines to offer assistance despite social distancing regulations. Mental healthcare providers in Italy, the Netherlands and Scotland adapted their services to digital format to continue providing support during the lockdown. Although many service providers transitioned to digital solutions, they should not be considered as a long-term and only option to the continuity of services.

Before the pandemic, there were already several national initiatives to protect people’s mental health across the EU. Finland’s national mental health strategy, for example, acknowledges the impact of mental health on physical health, work and life while tackling stigmatisation and discrimination. Norway’s national strategy for mental health, on the other hand, mainstreams mental health policies in public sectors and includes persons with lived experience of mental ill-health in creating legislations. Belgium’s reform of community-based care for people with mental health problems can serve as a good practice of progressive mental healthcare services.

These examples show that improved national mental health policies are possible and already a reality in some member states. While these initiatives might not be a direct answer to the pandemic, they are essential for national responses to the aftermath of the COVID-19 crisis.

In fact, this pandemic could prove to be the catalyst for long-overdue mental healthcare reform. In line with the theme of this year’s WMHD, which calls for a scale-up in investment in mental health, governments should allocate adequate funding to mental health support and care. As recommended by UN Secretary-General António Guterres, peer support, community-based services, and integrated care deserve particular attention. Further funding is needed for preventive measures and to address the socio-economic determinants of mental ill-health such as poverty, unemployment, forms of inequality and discrimination, and barriers in access to healthcare.

It is highly important to improve awareness of mental health, and this might just be the right moment to consolidate our efforts. The stigma associated with mental health problems often prevents people from seeking support. Alongside national efforts, the EU must adopt a comprehensive and well-resourced European Mental Health Strategy as part of the long-term recovery to mitigate the consequences of the current crisis. More broadly, the EU should reaffirm its commitment to the rights of persons with psychosocial disabilities. A new strategy for disability rights in Europe should reflect key areas of concern for people with psychosocial disabilities (e.g. autonomy and coercion).

The most effective way to promote mental health in the long-term is to invest in a protective environment in all settings. Let the COVID-19 crisis be a wake-up call for much-needed mental healthcare reform in Europe.