Managing mental health care

MEPs Sara Cerdas and Tilly Metz spoke to Brian Johnson about why they are campaigning for EU action to improve mental health services across Europe.
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By Sara Cerdas & Tilly Metz

Sara Cerdas (PT S&D) and Tilly Metz (LU, Greens/EFA) are co-chairs of the European Parliament’s Coalition for Mental Health and Wellbeing

27 Oct 2021

What impact has the COVID-19 crisis had on mental health problems?
Sara Cerdas: The COVID 19 outbreak increased the risk of developing a range of mental health problems, particularly among young people and those in lower-income groups. It has aggravated many pre-existing conditions and mental health problems, such as stress, anxiety, depression, alcohol and drug use, mostly through isolation, social distancing and confinement measures.

Tilly Metz: Unfortunately, we know that the pandemic has had a massive impact on mental health. Young people and lower-income countries are considered particularly at increased risk. In addition, today we know that mental health is strongly affected by a wide range of social determinants, including how we live, our work and age. So, it comes as no surprise that factors such as isolation and loss of income have led to higher rates of stress, anxiety and depression.

What key structural issues, specifically linked to mental-ill health, has the COVID-19 crisis revealed?
Tilly Metz: The pandemic has exposed all the shortcomings of our approach to mental health. First, policymakers clearly underestimated its impact, and this was seen by the fact that some existing support for people with mental health problems was reduced, or even stopped completely, during lockdown. While at the peak of the pandemic physical consultations were not possible, it is hard to believe that in Europe, in 2021, they could not have turned to online services. Another important issue is our approach: today our systems rely solely on biomedical interventions rather than on strengthening integrated social and health care services, which can prevent mental-ill health in the first place.

Sara Cerdas: People living with mental health problems didn’t always get the care they needed. That’s why the pandemic was a warning of the importance of accessibility to mental health care, particularly for the most vulnerable and for those with pre-existing problems. I would also highlight the urgent need to reduce the stigma surrounding mental health problems, and the need to invest in health literacy in promoting awareness.

“The COVID 19 outbreak increased the risk of developing a range of mental health problems, particularly among young people and those in lower-income groups”
Sara Cerdas MEP

What are the economic costs of mental health problems in the EU?
Sara Cerdas: We know that the pre-pandemic impact of mental health problems in the EU was enormous. Overall, the cost of mental-ill health was around €600bn, including economic, social security and health care costs, around four percent of the EU’s GDP. In addition, one in five people were diagnosed with mental health problems. The direct and indirect costs of mental-ill health are expected to be much higher following the pandemic.

Tilly Metz: The economic loss, even if considerable, should not be our focus for mental health and wellbeing. The COVID-19 pandemic has caused serious suffering for people worldwide - losing their jobs, loved ones, have faced financial losses, suffered poor health and more. We urgently need to implement strategies for promoting and preventing mental health problems in appropriate, community-based settings. We also need to provide a comprehensive and multi sectoral approach to mental health and social care services.

Does the COVID-19 crisis provide any kind of silver lining? With the EU’s health and wellbeing inadequacies laid bare, is there an opportunity to radically improve mental health services and systems?
Tilly Metz: Yes, there is definitely an opportunity to improve mental health services and systems, but I would not go so far as to say it is a silver lining. The European Commission has been ignoring the multiple calls to adopt an “EU Action Plan on mental health” for the period 2021-2027, a request that came, in our resolution from July 2020, from both civil society and the European Parliament. 

Sara Cerdas: Yes, and that’s why we launched the EU4health initiative, with €5.1bn that can be invested in all sorts of health problems, including mental health. Much more must be done to promote and better manage mental health and that should be our focus.

What is the purpose of the European Parliament’s Coalition for Mental Health and Wellbeing? What do MEPs bring to the table?
Sara Cerdas: Our aim is to grow awareness of these important issues and integrate them into legislation. Greater efforts to promote mental health and improve early diagnosis and treatment of those with mental-ill health would improve the lives of millions of European citizens and contribute to stronger economic and employment conditions; that’s what we aim for daily.

Tilly Metz: Through the Coalition for Mental Health and Wellbeing, we advocate for a coordinated response to address the most pressing determinants of mental health. We gather insights from different stakeholders to transform them into political action.

“Through the Coalition for Mental Health and Wellbeing, we advocate for a coordinated response to address the most pressing determinants of mental health. We gather insights from different stakeholders to transform them into political action plans” 
Tilly Metz MEP

Why, despite the obvious benefits, is there not yet a comprehensive European Mental Health Strategy at EU level?
Tilly Metz: That’s a good question, but one I think that should be directed towards someone in the European Commission. Certainly, there are some technical challenges, as health is not an exclusive competence of the European Union and healthcare, and social systems differ between European Union countries. However, with a greater political will, I am sure we would have something more than mere slogans and declarations.

Sara Cerdas: Mental health is influenced by many factors and are affected by policies and actions across a broad range of sectors. When we launched the European Union for Health, the EU4Health programme, we managed to integrate important concepts such as “health in all policies” and the “One Health approach”. With this strategic vision, we can respond to a range of health problems, including mental health, with an intersectoral approach that takes into account the different determinants of health.