How Europe can avoid a mental health pandemic

In the storm surrounding the recent pandemic, we must recognise - and act to prevent - any exacerbation to mental health challenges, write Alex Agius Saliba, Estrella Durá Ferrandis, Radka Maxová, Maria Walsh and Tomáš Zdechovský.
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By Alex Agius Saliba, Estrella Durá Ferrandis, Radka Maxová, Maria Walsh and Tomáš Zdechovský

Alex Agius Saliba (MT, S&D), Estrella Durá Ferrandis (ES, S&D), Radka Maxová (CZ, RE), Maria Walsh (IE, EPP) and Tomáš Zdechovský (CZ, EPP) are Co-Chairs of The MEP Alliance For Mental Health

23 Oct 2020

People across the world have been affected by COVID-19 and the measures that have been taken to limit its spread. The situation remains full of unknowns, but it is clear that we face a number of personal, societal and economic consequences.

The UN has warned that the world is facing ‘a pandemic of mental health problems either caused or exacerbated by the coronavirus situation’. These relate to fear and anxiety caused by, for example, worry, stress, confusion, frustration and isolation, often caused by new realities such as teleworking, fear of unemployment, home schooling and a lack of interpersonal contact. This may be aggravated by unclear or inconsistent messages, measures and miscommunication. Inadequate or lack of access to mental health care or early intervention services may also cause problems.

Indeed, the full mental health impact of the coronavirus pandemic may only be fully understood at a later stage, possibly several years later. In July, a meeting of the MEP Alliance for Mental Health, organised in cooperation with GAMIAN-Europe and the European Psychiatric Society, aimed to identify the mental health impact of the crisis for various societal groups and learn lessons from how the COVID-19 crisis has been addressed.

It became clear that the situation has a­ffected and changed the daily lives of families considerably. Being separated from friends and loved ones and having less access to hobbies and pastimes causes high levels of anxiety in both children and parents.

 “The time has come to put in place a comprehensive European Mental Health Strategy, as called for by the Council of Ministers in 2019”

Furthermore, there are serious concerns over rising levels of domestic violence. Those living with a pre-existing mental health condition are more vulnerable to the impact of isolation, loneliness and uncertainty or fear for the future. In addition, many social support and rehabilitation services have been interrupted or reduced.

For patients, this crisis has been a trigger for exacerbation and relapses of many di­fferent psychiatric disorders. For carers of relatives, neighbours and friends, it has also increased their sense of isolation, loneliness, the pressures of caring as well as increasing financial pressures. Doctors, nurses and other frontline healthcare personnel have been placed under exceptional stress, affecting their mental health.

In many cases, they experience symptoms of anxiety, depression and insomnia. Furthermore, they may be stigmatised, viewed by some as ‘disease spreaders. Isolation and more frequent illness and deaths among relatives and friends have exacerbated the mental health challenges faced by older people. The situation for those in residential care has been - and may again be - dramatic for older persons with dementia in particular.

Risk of abuse has also increased. Using technology to create social bonds - a ‘given’ for younger generations - can be challenging for older people. Last, recent research in the UK involving 2000 young people showed that 80 percent of respondents indicated that their mental health had deteriorated. The potential mental health impact on those that have recovered from the disease should also not be forgotten, but what should be done?

One positive is that the pandemic has made the importance of good mental health abundantly clear. Therefore, now is the ideal time to look at the e­ffects and at what might be from learned from recent events. This will help us better face the next stages of the pandemic and the post-COVID- 19 period; this is a multi-facetted and multidisciplinary exercise.

Obviously, in-depth investigations are required to explore and reflect on the outcome of the various containment measures taken, in order to improve current and future prevention and intervention programmes. To contribute to this debate, the MEP Alliance for Mental Health, in discussions with relevant stakeholders, have already identified various issues that policy and decision makers should consider.

These include embedding early intervention and access to adequate mental health support in any containment and post pandemic recovery plan. It will be vital to ensure that the representative organisations of citizens are engaged and involved, particularly in decision making. NGOs can play a crucial role in minimising the e­ffects on mental health. Equally, the protection and treatment of all persons should be safeguarded and solidarity across generations (as well as across countries) stimulated.

“The full mental health impact of the Coronavirus pandemic may only be fully understood at a later stage, possibly several years later”

The needs of frontline and medical sta­ff should be supported through proper risk management, with sufficient staffing and protective measures, encouragement and peer communication. The importance of carers should also be recognised, and they should be provided with adequate support to help cope with the stress and anxiety.

There should also be family and bereavement support as well as community-based, high-quality mental health services in place. COVID-19 crosses all barriers, impacting patients, families, carers and healthcare professionals. It does not di­fferentiate between political or religious beliefs, nor between gender, ethnicity or age. It serves to underline the pressing need for EU cooperation in the field of health - explicitly including mental health.

Moreover, and in line with the Economy of Wellbeing as proposed by last year’s Finnish Presidency, good mental health and wellbeing significantly improves economic growth and sustainability. Therefore, it will be crucial to make mental health an integral part of the EU’s recovery programmes and measures.

The time has come to put in place a comprehensive European Mental Health Strategy, as called for by the Council of Ministers in 2019, in which the above-mentioned recommendations are integrated and implemented. The MEP Alliance for Mental Health will continue its e­ orts to ensure this becomes a reality.