Pioneering mental health strategies across Europe

There has been a rising level of attention paid to mental health in recent years. European governments are slowly responding to citizens’ needs for effective mental health care. Amidst the lack of concerted cross-sectoral EU action on mental health, there are several national pioneering initiatives to protect people’s mental health across EU member states.  The scoping review of national developments in mental health policies from 2017 to 2019 by Mental Health Europe outlines some good policy practices to promote mental health and well-being.

In February 2020, Finland’s Ministry of Social Affairs and Health released a national mental health strategy covering the next decade. It aims to support the mental wellbeing of the entire population, while also improving mental health services. It also puts the rights of people with lived experience of mental ill health at the centre: Finland’s strategy combats discrimination and stigmatisation and incorporates the rights of people with mental ill health into existing policies.

There are five areas the strategy focuses on. First, it emphasises the impact of mental health on physical health, well-being, studies, work and life overall. As the building blocks for positive mental health are laid in childhood and adolescence, the initiative includes prevention and support for children and young people. The third focus area aims to tackle misperceptions, discrimination and polarisation around mental ill health. On top of that, the strategy offers extensive and coordinated mental health services to citizens. Lastly, it provides mental health workplace policies which are vital for the prosperity of any society.

In addition to this positive Nordic case, several other EU member states showcase promising developments within the mental health sphere. In recent years, Lithuania, Poland and Slovenia have stepped up their efforts to improve mental health.

The Lithuanian government increased funding for mental health following a review of the Lithuanian Health Strategy for 2014-2025. To ensure equal access to good-quality and accessible mental health services for all, the Lithuanian Parliament approved a law on measures preventing mental health and behavioural problems. After updating the Lithuanian Health Strategy in October 2019, the Government plans to improve psychological and psychiatric care and increase preventive measures for persons with mental health problems.

Poland, on the other hand, appointed a plenipotentiary for mental health reform in 2019. The reform aims to move away from institutionalisation and to offer more community-based care to people with mental health issues. This includes piloting mental health community centres, increased investment in treatment, improvements in psychiatric and psychological care for children and young people, and more effective preventive measures.

Another example is Slovenia. The country’s resolution on the National Mental Health Programme 2018-2028 focuses on six areas: mental health promotion, prevention of suicide and alcohol-related problems, mental health services, de-stigmatisation, as well as awareness, research and evaluation. Furthermore, the establishment of a governmental Mental Health Council adds a cross-sectoral value by uniting relevant ministries, representatives of the Government Office for Development and European Cohesion Policy, representatives of service providers, users and their associations, local governments, as well as mental health education and research institutions.

Other EU member states with visible progress in national mental health policies include Germany, France and Malta.

In April 2019, Germany started its work on banning conversion therapies – psychological and spiritual practices to change someone’s homosexual or bisexual psychosexual orientation. If the ban gets implemented, Germany would follow suit of Malta, the first European country to prohibit conversion therapies.

Malta has taken two important steps to promote mental health. First, the 2020-2030 Mental Health Strategy aims to address the wider determinants of mental health, transform the provision of mental health services, support people with mental health problems and their families, and build the capacity of mental health services. Second, in line with the Sustainable Development Goals (SDGs), a government strategy on healthcare provisions for transgender people was adopted in 2018. It aims to address the medical, psychological and social aspects of gender affirmation from the perspective of healthcare services.

In the meantime, France’s national health strategy for 2018-2022 casts a spotlight on improving social conditions for citizens from lower socio-economic backgrounds. A roadmap for mental health outlines planned initiatives regarding social inclusion of people with psychosocial disabilities, prevention and early identification, coordinated and supported care provision as well as the promotion of positive mental health.

These good practices by EU member states show some significant progress within the mental health sector in Europe. Nevertheless, the implementation of mental health actions is still too fragmented.

There are many EU countries where citizens do not have access to efficient mental health care. Furthermore, those practices often do not measure up to the international standards of the United Nations Convention on the Rights of People with Disabilities (UNCRPD) to which the EU is a signatory. It becomes clear that an overarching, coordinated framework is needed to mainstream mental health policies among all sectors. If we are to step into a new decade of positive mental health, we need an immediate action from the European Union for a fairer, more inclusive, and more cohesive Europe.