This is not a mental health pandemic but it’s time to take mental distress seriously, footed on human rights

There is no health without mental health. This concept, often used as a slogan by mental health advocates, now appears in a very new light as we pass the one-year mark since the COVID-19 pandemic has become the all-encompassing parameter of our lives. While it is important to acknowledge the distress people are experiencing, we should be cautious and resist medicalising the current situation by describing it as a ‘mental health pandemic’ or a ‘pandemic of mental disorders.’

The past months have taught us that exposure to mental distress is something human and understandable; periods of discomfort are intrinsically linked to our personal feelings. Therefore, in a pandemic age, COVID-induced distress is an understandable human reaction to adversities.

The pandemic’s emergency measures have left marks on people’s well-being. In Ireland, demand for mental health support has increased by over a third compared to the previous year. In the Netherlands, three out of four people have experienced negative consequences of the pandemic on their mental health. Helplines have reported a rise in calls with people expressing feelings of fear, loneliness, and helplessness. For example, the German Association of Psychologists’ corona hotline registered over 12,000 calls in April and May. At the same time, the COVID-19 pandemic has disrupted or halted critical mental health services around the world.

While European member states are rushing to vaccinate their populations, experiences of mental health distress are likely to linger on. As mentioned by Dr. Hans Kluge, the Regional Director for Europe at the World Health Organisation, it is clear that even though the impact has varied, “no demographic or age group has been spared”. To better understand the pandemic’s implications on mental health, the EU should encourage systemic and harmonised data collections, disaggregated by key factors such as age and gender, through Eurostat.

Some may ask how the pandemic has impacted persons with pre-existing mental health problems, and the truth is that we do not know yet. While the assumption is common that emergency measures have had severe impacts, some people have expressed a notion of resilience. Previous experiences of loneliness and even having survived (forced) isolation were sometimes considered as a tool for resilience, recognising humans as ‘masters of adaptation’.

What we do know for certain is that infections and deaths resulting from COVID-19 were particularly high in medical institutions, including psychiatric hospitals. Many disability rights advocates have harshly criticised government failures to react, thereby making institutions hotbeds for the virus. The United Nations Convention on the Rights of Persons with Disabilities has called on the EU and its member states, as ratifying members to the Convention, to move away from institutional care and towards community-based support. What has been clear for many years as a human rights obligation is now exacerbated in urgency, with institutions posing a public health risk to residents, care workers, and visitors alike.

For mental health, this is particularly important. EU member states are still over-reliant on psychiatric institutions as a response to mental ill-health, despite prominent examples of deinstitutionalisation, such as Franco Basaglia’s radical psychiatry movement in Italy throughout the 1960s and 1970s. But hasn’t the COVID-19 pandemic and its lockdown measures demonstrated that forced isolation can have a detrimental impact on people’s well-being? The human rights call for freedom from coercion in mental health care, wherein coercion includes anything that does not meet the persons’ explicit will, seems more comprehensible than ever. The fact that electroconvulsive therapy (‘electroshocks’) is still commonly used in the EU and only currently being called for inquiry in the United Kingdom seems archaic. Mental health support needs to put the person at the centre of every decision, shifting the authority towards the individual as the agent of expertise.

In its final resolution, the German Presidency of the European Council put mental health on top of the agenda in the EU4Health Programme. Mental Health Europe has argued for a European Mental Health Strategy for a long time, as a common response to shaping mental health practice across member states. An EU-wide response would be able to draw upon promising national mental health strategies such as that of Finland, while also benefitting from lessons provided by the WHO and its QualityRights Initiative, which puts human rights at the centre of mental health reforms.

Moreover, COVID-19 is not solely a health crisis; it is also a crisis of increasing social and economic inequalities. Mental health is linked to social connectedness but it is also embedded in a complex web of social and economic factors. Governments must take a holistic approach to well-being, with job security, housing rights protection, and educational opportunities among the main focuses.

Today all policymakers seem to call for building back better, and mental health is no different. The pandemic has taught us many lessons on how to rethink, support, and recover mental health in the 21^st century – it’s time to press the mental health reset button.