Since joining the European Parliament in 2019 Maria Walsh has been a driving force for the improvement of mental health policy and awareness. Here, she discusses the impact of the pandemic on mental health and the key measures needed to suitably address this crisis across the EU.
The conversation around mental health is changing. Although, in many ways, the pandemic created further hurdles to accessing care and support, it also helped to dilute the stigma around mental ill health and enable many to feel less afraid of voicing how they feel.
The scale of the mental health crisis is indeed challenging, in the UK alone England’s NHS announced a £10m investment to boost mental health support services this winter with mental health professionals working within ambulance control centres and accompanying paramedics on emergency call outs. In the UK, over 90,000 people per month have been referred to community crisis services. The picture is similar across Europe; the economy loses €620bn a year due to work-related depression, with young people up to four times more likely to experience depression and anxiety. Hoping to change these statistics is MEP Maria Walsh; since joining Parliament in 2019 she has rallied policymakers to address mental health challenges and ensure this important the topic of mental health policy remains a priority on the EU agenda. Lorna Rothery spoke to her about the key actions that the EU must take to support citizens and protect their mental wellbeing.
How has the provision of, and demand for, mental health services changed in recent years? What are the key factors driving the increased levels of poor mental health we are seeing today?
The pandemic has been a major catalyst in the mental health crisis and because of this, the demand on our mental health services is at an all-time high. Being socially isolated and unable to meet friends, family or co-workers definitely played a big part and this – coupled with the fact that we were all living in a constant state of anxiety for our loved ones’ health and safety – served to further worsen the problem.
According to the WHO, over two million people in Europe died from Coronavirus over the last two years. That is almost two million grieving families left behind. These things further exacerbated the crisis that was already underlying and worryingly, the WHO estimates an increase in anxiety and depression by about 25% worldwide as a result of the pandemic.
There is no doubt that the COVID pandemic further highlighted and exacerbated a critical, and widening gap in mental health care across Europe. According to a recent OECD report, an estimated one-in-two people experienced a mental health condition at some point in their lifetime before the pandemic, with one-in-five living with mental ill health at any given time. Since the crisis, levels of mental distress have increased, with the prevalence of anxiety and depression even doubling in some countries.
Despite the worrying statistics, it is important to note that we have also become much more aware of our mental health since the onset of COVID. If our mental health had worsened over the pandemic, without an increase in demand for mental health support, then we would need to be even more concerned. As it is, people are recognising that they are struggling with their mental health, and we are making strides in combating the taboo that has long existed in society. Without a doubt, there is still much to be done, but we must acknowledge that people are reaching out for help when they need it, and this is empowering. One of the main tasks now is to make sure that our services can meet this demand and to make sure our services are accessible to all who need them.
In Ireland, across all our Member States, and also on the European stage, we must work together to tackle mental health issues. Early intervention is key, and the mental health of our citizens must be at the core of our work. In Europe, mental health needs to be tackled, through a comprehensive EU Mental Health Strategy and a legislative framework to establish minimum requirements for teleworking across the EU. All Member States, and the European Commission as a whole, must include measures to address mental health in their Health Crisis and Pandemic Emergency Response and Preparedness plans. The pandemic saw politicians and governments protecting the physical health of citizens. We need to ensure that mental health policy is addressed with the same urgency.
During the pandemic, we saw a shift to more digital and remote working, how has this impacted employees’ mental health and wellbeing? What are the economic costs of poor mental health?
I was the author/rapporteur of the recent Report on Mental Health in the Digital World of Work, which tackled this issue. The Report noted that EU legislation was in urgent need of updating, to respond to the new realities of the digital way of working and to enable companies and countries to facilitate good mental health practices across the board. With this report, the ambition was always to create and become the gold standard when it comes to mental health and wellness in the European Union.
As a result of the pandemic, we saw that increasingly digitised workplaces – and the ability to work anytime and anywhere – can create both opportunities and risks for the wellbeing of workers. This became even more apparent due to the COVID-19 pandemic, as the health of teleworkers could not be monitored on a day-to-day basis, in contrast to office-based workers.
Unfortunately, through the digitalisation of our workplaces due to COVID-19, we have seen a huge rise in mental health issues. Cases of burnout, depression, anxiety and fatigue have especially increased among young people. The economic and societal impact that we are facing if we do not address mental health policy it now is enormous. It is not only this generation that will suffer from it but future generations, too.
In bringing the Report before Parliament, I called on the European Commission to create a comprehensive EU mental health strategy and a legislative framework to establish minimum requirements for teleworking across the EU. In addition, I asked that Member States and the Commission include measures to address mental health policy in their Health Crisis and Pandemic Emergency Response and Preparedness plans.
The Report focused on responding to the realities of teleworking and the opportunities it represents, to ensure work-life balance and wellbeing in the digital area. It illustrated the benefits and risks of digitalisation that society has experienced over the past two years and found that it was absolutely essential that EU legislation be updated to respond to the new realities of the digital way of working. The bottom line is that we need to ensure that collective EU mental health policies are put in place. The pandemic has resulted in the sharing of best practices between Member States, and we must use this information collectively at EU level.
The whole conversation around digital and remote working is a very complex topic and there are positives and negatives. Certainly, when working from home, we have an increased awareness of our right to disconnect, and of maintaining a work-life balance. That said, however, it has become much harder to separate work life from personal life when working remotely. This can lead to a risk of burnout, and employees and employers alike must be aware of this. We also have to be aware of the potential social isolation of employees due to remote working. There is a social aspect to going into an office every day and while some people have fully embraced the idea of working from home, there should still be an option for employees to work in an office environment if they so wish.
Another major positive of remote and digital working is that it has opened so many doors. Location is no longer a concern for many, and in lots of cases, it has made work-life balance easier to maintain with more flexible working hours. In addition, it has created more opportunities for people with disabilities by providing better work-life balance and better accessibility.
When it comes to mental ill health, there is definitely an economic cost. In 2018, it was estimated that one in six Europeans were suffering from a mental illness and that this was costing the EU €600bn. Out of this figure, 43% (or €260bn) is used for indirect public expenses related to unemployment and the reduced productivity of people affected by mental illness, while other amounts are used for direct care and social security programmes. After two years of the pandemic, we can only assume that this cost is now far greater.
Similarly, how has the adoption of telemedicine and digital health tools impacted the delivery of mental health care? How can these technologies be integrated positively and equitably?
There have been brilliant advances in digital health tools, particularly in being able to access therapies online during the pandemic. This makes therapy so much more accessible to those who work or cannot travel. In Ireland, Mind Matters, for example, provides excellent online therapy.
The next challenge, however, is making sure that therapy is accessible financially and without long waiting times. According to the WHO, those from lower socioeconomic backgrounds are about 10% more likely to suffer more from poor mental health. Mental health does not discriminate so neither should mental health policy. Mental health care must be affordable and accessible for every citizen, regardless of their situation or their location within the European Union.
Mental health has got to be a priority in Ireland, and Europe. There can be no debate or policy discussion on health, care, or the future of our European Union, without the mental health of our citizens at its very core. I very much intend to keep the mental health of all of our citizens, front and centre on the EU agenda. We cannot continue to stigmatise mental health, yet mourn its loss.
What actions are being taken at the EU level to address the mental health crisis?
I spent much of 2022 campaigning to have 2023 designated as the European Year Dedicated to Mental Health and, while my proposal did not make it over the line, I very much welcomed the announcement that mental health is to be one of the European Citizens’ Panels in the Conference on the Future of Europe. During her State of the Union address in September, European Commission President Ursula Von Der Leyen outlined the work done by the Commission over the past year, what it intends to do in the coming year, and its vision for the future.
I had been optimistic that my proposal would be ratified in Parliament, but instead, it was announced that 2023 would be the Year of Education and Training, and I absolutely see the value in this too. As well, I was delighted to see mental health policy announced as one of the European Citizens’ Panels at the Conference on the Future of Europe. The Panels are a key feature of the Conference and are organised to allow citizens to jointly think about the future they want for the European Union. Mental health is one of four priority areas involving 200 citizens from 27 Member States, with a third of the panel made up of young people.
The Conference on the Future of Europe had some outcomes that were focused on improving education and services regarding mental health. Furthermore, a Commission initiative will be launched in 2023 that will be based on mental health, and that is very positive news. I have appealed to all nations and future presidencies of the European Union to keep mental health on the agenda at European level.
I have consistently called on the European Commission to agree to a dedicated EU-wide Mental Health Strategy. We need a comprehensive approach to mental health. An immediate initiative is needed to promote the wellbeing of millions of people across the EU, tackling the stigma and discrimination that continues to surround mental health. It is the uncertainty around mental health support and services that creates more hopelessness for those suffering from mental ill health and for their families too.
During their recent presidency of the Council of the European Union, the Czech Republic promised to make mental health one of their main priorities and at a recent conference (in November) entitled Resilient Mental Health in the European Union, they further reinstated that commitment. The event focused on the pressure that mental ill health puts on the health, educational, economic, labour market, and social welfare systems across the EU. It also looked at the impact of the COVID-19 pandemic on EU citizens, the current EU healthcare initiatives and their spillovers to mental health, best practices in mental health approaches, and tools to support mental health research in the EU.
It is encouraging that, at European level, more politicians and leaders are putting Europeans’ mental health at the heart of policy areas that would not have previously considered mental health and wellbeing within their remit. We are definitely moving in the right direction, but we must keep building on the momentum that we have and pushing mental health up the political agenda. Investing in mental health is an investment in our people, our economies, and our societies.
Across the European Union, each Member State holds the presidency of the Council of the European Union for six months on a rotational basis, with Sweden having just taken the reins on 1 January 2023. The task of the presidency is to determine the agenda and priorities of the Council of the EU, to preside over its meetings, to broker compromises among Member States, as well as to represent the Union at meetings with the other EU institutions and external partners. It will be Ireland’s turn to embrace the presidency on 1 July 2026.
Our time will come to influence the agenda and policies at European level, but in the meantime, it is vital that the legacy is carried forward and that we continue to ensure mental health is front and centre on the European agenda.
What’s next for your efforts on mental health policy?
I will never stop pushing mental health on the agenda at both an Irish and a European level. When I was elected as an MEP in 2019, I was told mental health was not a competency of the EU and so I began constructing a game plan, working on getting mental health to the forefront of the EU agenda. In June of last year, the European Parliament voted in favour of the report entitled ‘Mental Health and the Digital World of Work’. This report was solely focused on mental health and how employers and employees can safeguard their mental health in the digital world of work. By voting in favour of this report the EU were agreeing that (a) mental health was an important issue, and (b) something needed to be done about it. This attitude was very different to the one which was presented to me when I joined the Parliament in 2019. That very same Parliament voted overwhelmingly in favour of a report which was entirely centred on the issue of mental health.
Last year I also campaigned for 2023 to be the EU Year of Mental Health. We did not reach that goal, but I will continue to push for this in 2024. I have talked with organisations at home in Ireland such as Kinvara Alive, Pieta House, and Jigsaw to promote local community-based mental health initiatives and I will continue to work with these and other organisations to offer my support and to keep mental health front and centre on the agenda, both at home in Ireland and on the European stage.
Mental health is something that I am really passionate about and when the European Commission initiative gets announced, we will push the agenda, and ensure that there is action from the Parliament. One of the actions I would like to see is a conference of national health and mental health ministers and experts on mental health coming together to collaborate and share expertise. Early intervention is key, and the mental health of our citizens should be at the core of our work. In Europe, mental health needs to be urgently tackled, through a comprehensive EU mental health strategy.
One of my core campaign goals, from day one, was for the Parliament to focus on mental health and to make it a priority within the European Union. There can be no debate or policy discussion on health, on care, on the future of our European Union, without mental health policy at its very core. I very much intend to keep the mental health of all of our citizens, front and centre on the EU agenda.
This article is from issue 24 of Health Europa Quarterly. Click here to get your free subscription today