Mental health policy: What progress are we making?
Member states continue to give much lower priority to promoting mental wellbeing compared to physical health, writes Marian Harkin.
Marian Harkin | Photo credit: European Parliament audiovisual
Each year when Mental Health Awareness week comes around, I reflect on what progress - if any - has been made in improving mental health services and supports in the previous year. Often it seems like we take one step forward and two steps back.
Yes, we have made some progress when it comes to the visibility and the de-stigmatisation of mental illness. Mental illness, as it were, has come out of the closet, but there it stands slightly awkward and frequently isolated.
In the EU alone, at any single point in time, almost 50 million citizens are estimated to be living with some type of mental illness. Despite this, we, as a Union - alongside most of our member states - continue to neglect the promotion of good mental health and provide a much lower political priority to resourcing mental health/ mental illness services than we do to the more visible, physical, noncommunicable diseases.
There is a well-established knowledge base of risk and protective factors that cross-governmental policies can influence; action in these areas offers opportunities for better and more equal social and health outcomes, particularly in the sphere of mental health.
I am co-Chair of the interest group on mental health, wellbeing and brain disorders, which has been active in promoting a future EU-level action programme on mental health and wellbeing prepared by the Global Alliance of Mental Illness Advocacy Networks-Europe.
This action plan consists of six strands: Inclusion of mental health as a priority in health and social policy development, i.e. mainstreaming; awareness-raising and good practice exchange, i.e. mutual learning exchange; stimulating development of national action plans on mental health and wellbeing; financial support - a number of the above initiatives hold the potential for funding, such as the health programme, structural funds, Horizon 2020; data collection and monitoring; and the inclusion of people affected by mental health problems in the relevant EU consultation and advisory fora.
We already know that complementary action and a combined effect at EU level can help member states tackle these challenges by promoting good mental health and wellbeing in the population. It will strengthen preventive action and self-help and provide support for people that experience mental health problems as well as their families.
Following on from the first strand of the action plan, good mental health can be promoted and supported by a range of EU policies. In the context of alleviating stress, which has such a negative impact on mental health, is much that we can do. Both health and mental health policy has almost disappeared from the EU radar.
Nonetheless, it is encouraging to see that current EU social policy proposals are, in my opinion, helping to underpin a more proactive and positive approach to stress management and therefore to the protection of good mental health.
As part of a follow-up to the European Pillar of Social Rights, the draft directive from the Commission on transparent and predictable working conditions aims to set a basic set of minimum standards. This will ensure that all workers, including those on atypical contracts, benefit from more predictability and clarity in their working conditions.
It is interesting that the Commission uses the term ‘predictable working conditions’ as huge stress and anxiety are often caused by unpredictable and precarious work. Most human beings crave a degree of stability in their lives. We need certain anchors in our lives, employment being one of them. Otherwise we can become the flotsam and jetsam of the labour market, tossed on the waves of market forces. New forms of work can place huge stress on individuals and we need robust legislation to underpin minimum workers’ rights at the very least.
The recent proposal on work life balance from the Commission sets a number of new and higher minimum standards for parental, paternity and carers leave. It also opens the door to more flexible working arrangements for those with caring responsibilities.
Given that 80 per cent of care in the EU is provided by informal or family carers and given that demographic change is increasing demand, there is an urgent need to reorient the world of work to take this new reality into consideration.
Positive outcomes will include a reduction in stress on carers and those they care for as well as a greater likelihood of carers remaining in the workforce. This will lead to greater social inclusion, less poverty and an improvement in mental health and wellbeing.
According to the European Agency for Safety and Health at Work, in the EU, work-related stress is the second most common work-related problem after back pain. It affects 28 per cent of EU workers. This stress can be caused by both psychosocial and physical hazards, and our legislation must address both sets of hazards in a meaningful way.
All in all, I think it is fair to say that since Mental Health Awareness week 2017, we have made progress at an EU level on a number of social policy initiatives that will help deliver better mental health outcomes.
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