Mental health is everyone's concern. It affects the lives of people living with mental problems, their careers, as well as the productivity and the economy of society especially in times of COVID-19. Consequently, mental health underpins the core human values of independent thought and action, happiness, and friendship. Mental health problems are one of the most prominent public health challenges faced in Europe, with an estimated 17,3% of the EU’s population – approximately 84 million people – experiencing a mental health problem in 2020. Young people and people in lower-income groups are considered to be 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.

Poor mental health may have a profound effect on the quality of life of affected individuals and poses a threat to their safety. Europe has the highest rate of suicide compared to all other regions. There is a strong link between suicide and mental health. In low- and middle-income countries, approximately 77% of deaths by suicide can be attributed to mental illnesses.

Mental health contributes to healthier lifestyles, greater productivity, employment and earnings, more social cohesion and improved quality of life for societies and individuals. Problems regarding mental health are a growing hurdle European countries have to face. Stigma poses an obstacle to the integration of people with mental ill-health and their access to treatment.

Although stakeholders like the European Union and the World Health Organisation have acted in regards to addressing mental health illnesses, their actions have come short, as they fail to address social inequalities and the increased risk of mental illness for vulnerable people.
Moreover, national governments generally fail at confronting the issue of mental health in the workplace, restricting the integration of mentally ill individuals into society.

During the COVID-19 pandemic, concerns about mental health and substance use have grown, including concerns about suicidal ideation. In January 2021, 41% of young adults reported symptoms of anxiety and/or depressive disorder.

Mental health problems are difficult to diagnose, and people are often unaware of the symptoms resulting from inefficient treatment. Statistics have shown that merely 12% of those affected by mental health illnesses receive treatment and there have been several cases of misdiagnosis. Furthermore, access to healthcare for mental disorders has been consistently reported as low, as public hospitals and clinics often lack specialised personnel.

Moreover, the lack of comprehensive mental health policy in the EU, as well as the inconsistency amongst the national policies of the Member States, hinders the existence of a unified approach to the problem. Every Member State has a different multidisciplinary approach to mental healthcare, meaning that a variety of medical professionals are involved in the treatment of mentally ill patients and especially in times of COVID-19 there are even fewer than before.
It has been proven that television, movies, and social media are the most common means of stereotyping mental illness. The media often advertise a false image of mental illness, hence promoting false stereotypes. Mental health problems are often oversimplified, and the symptoms are generalised. Furthermore, venerating and romanticising mental health problems or using harmful phrasing may enhance the risk of death by suicide for individuals who are already ill. Aside from harming social relations and the self-esteem of individuals, stigmatisation, discrimination, and non-respect for those who are struggling with mental health problems may affect access to employment or housing and influence the decision of not returning to work. It may also lessen the likelihood of seeking treatment.

Social inequality is one risk factor for mental problems. Countries with higher levels of income inequality report higher rates of schizophrenia. Additionally, depression is more prevalent among the lowest income classes than the highest. In addition, lower-income countries are associated with increased exposure to other risk factors, including alcohol, poor diets, unemployment, and substandard housing.

Amongst the social factors contributing to the prevalence of mental health issues, the work environment is recognised as one of the key areas. Although employment may be beneficial to mental health through an increased sense of social inclusion, conversely, many psychological factors at work have been found to increase the risk of anxiety, depression, and burn-out, factors which lead to the desire for unemployment among mentally ill individuals. Although individuals suffering from disorders such as depression and schizophrenia are not exceptionally violent and may perform well in the workplace, rates of unemployment are much higher for those suffering from mental ill-health. For example, of the 25 to 64-year-olds with depression, only approximately 50% of them are employed, compared with 77% among healthy individuals. Research highlights that employers are hesitant to work with those experiencing mental illness and that much of society is hesitant about having mentally ill employees and partners, viewing them as dangerous or irrational.

Mental Health Europe (MHE) created a map of helplines and services to support your mental health during the COVID-19 crisis and beyond. Information from 36 European countries was gathered with the valuable support of MHE members and the European Federation of Psychology Students' Associations (EFPSA). Mental Health Europe (MHE) advocates for a lifespan approach to mental health, which looks at the context in which people are living. The pressures and emotional stress associated with the transition from childhood to adulthood are natural but can be unsettling. That is why they want to promote and provide services that are age-sensitive and appealing to young people who, for instance, spend an increasing amount of time online.

With this European interactive map of helplines for young people, MHE hopes to show young people in need that they can get appropriate help and support wherever they are. They want to let them know support is available if they need it, and that it can take many forms. This map is unique and was created with the precious help of Euro Youth Mental Health and MHE members from across Europe. It gathers helplines, chat services, social media accounts, peer support groups or national/local organisations that can provide support to young people in need.

The European Programme of Work, 2020–2025 – “United Action for Better Health in Europe” (EPW) has been developed through a process of extensive consultation with Member States. It sets priorities for the coming five years by starting from what citizens legitimately expect from their health authorities.

The development of the EPW’s vision started before the COVID-19 pandemic hit. Given the state of flux in European health systems, the EPW should be seen as a live document that will regularly be updated.

It aligns the work of the WHO/Europe with the multi-million targets while supporting countries in their commitments to implement the 2030 Agenda for Sustainable Development and the Global Action Plan for Healthy Lives and Well-Being for All.

The European Health Action Plan 2021-2027 sets seven objectives that have been developed in cooperation with Member States, NGOs, and experts. They were adopted by the Council of Europe and the European Commission, outlining effective action to strengthen mental health and well-being with the changes that ought to be made to improve it in the European Region.
European countries are obligated to work with the United Nations Convention on the Rights of Persons with Disabilities, which requires national governments to provide legal, social, and economic support for mentally ill individuals, allowing them to be recognised as normal citizens.
The European Framework for Action on Mental Health and Wellbeing aims to collect, exchange and analyse information on policy and stakeholder activities in mental health, a framework that aids Member States in assessing and improving their policies.

The 4th EU Health Programme outlines strategies for improving the state of health for Member States in the years 2021-2027. It funds the annual Good Practices in Mental Health and Wellbeing brochure, which provides information and spreads awareness on positive approaches towards mental health.

Mental health policies are important because they coordinate, through a common vision and plan, all programmes and services related to these objectives. Without this type of organisation, programmes and services are likely to be inefficient and fragmented. A paradoxical situation is emerging worldwide. As scientific evidence mounts concerning the cause, course, and consequences of mental disorders, and new treatments are emerging that can make real differences in the lives of sufferers, most people with mental disorders do not receive the most basic treatment, and suffer from stigma and discrimination. National policies and programmes in mental health are urgently needed to change this situation, yet over 40% of countries have no mental health policy, and over 30% have no mental health programme. The majority of countries’ mental health budget constitutes less than 1% of their total health expenditures.

A Mental Health Policy Project has been created by the WHO’s Department of Mental Health and Substance Dependence. The goal of the project is to bring together the latest information on mental health policy and service development, compile it into a guidance package, disseminate it to Member States, and assist with its implementation. The project will help countries to create policies and services and then put them into practice, which in turn will lead to improved mental health care, treatment, and promotion.

Key areas of Work

• A guidance package for mental health policy reform should be developed
• Planning and management (stewardship) on national level would be beneficial
• Trying to improve the finance sector
• Focussing on service organisation and delivery
• Assisting countries in the formulation and implementation of country-specific mental health policies
• Enhancing the capacity of countries to manage mental health policy issues over the long term instead of solving one-time problems

Important: Mental health: facing the challenges, building solutions
Public Health Approach on Mental Health in Europe

A comprehensive, whole-of-government approach in the WHO European Region can be traced back at least to 2005, when Member States adopted a Mental Health Declaration for Europe at a Ministerial Conference on Mental Health held in Helsinki, Finland, which was co-signed by the European Commission and the Council of Europe and endorsed by the WHO Regional Committee for Europe. This set an agenda for action to tackle stigma and discrimination and develop community-based services as well as to promote mental Health in All Policies. The European Pact for Mental Health and Well-being followed in 2008, which, in addition to combating stigma, devoted specific attention to the mental health of young people and older adults as well as workplace mental health and the prevention of depression and suicide. Subsequent joint actions on mental health and well-being have continued to support EU Member States in building and sharing knowledge in these and other prioritised areas of work.

Regional and global recognition of the challenge that mental illness poses to an individual’s and population’s well-being, health and welfare systems, as well as to economic and sustainable development, has continued to grow over the last decade. In 2013, Member States of the WHO European Region unanimously endorsed the European Mental Health Action Plan 2013–2020.

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