Lithuanian EU Presidency conference
When it comes to the design of mental health services, the situation varies across countries but in general there has been a move towards a more integrated model and this has been complemented by the notion of co-production of services ensuring the participation of users. Alfonso Lara Montero, ESN Senior Policy and Research Officer
On 10–11 October, the Presidency of the Council of the European Union held the conference ‘Mental Health: Challenges and Possibilities’ in Vilnius, Lithuania. The goal of the event was to promote the implementation of the European Pact for Mental Health and Well-Being and urge representatives in various fields (health, social affairs and education) to share their experiences and enhance cooperation to prevent the onset of mental health problems.
The event covered the mental health of children, youth and the elderly with World Mental Health Day on the 10 October being dedicated to the elderly this year. Other issues included the impact of alcohol consumption, suicide risk and depression management, the stigmatisation of mental health, and the safeguarding of human rights. Around 200 participants from across Europe attended the conference. Speakers included Europe's top specialists in the field, as well representatives from the European Commission, World Health Organisation (WHO) and the Lithuanian Health Ministry. ESN was represented by members Ingvor Justinussen from Gigni, the National Institute for Children, Youth and Families in the Faroe Islands, Indrek Sooniste from the Mental Health Care Centre in Tartu, Estonia, and Pablo Garcia Cubillana from the Regional Ministry for Health and Social Welfare, Andalucía, Spain.
At the opening session Dr Matt Muijen reminded the audience of the WHO’s adoption of the Mental Health Action Plan calling for a change in the attitudes which have perpetuated stigma and discrimination of people with mental health problems. Michael Huebel from the European Commission emphasised that “six EU countries are included within the list of 15 countries worldwide with the highest rates of suicide” and that there has been an overreliance on treatment provided at psychiatric hospitals across the EU, not only in countries in transition of models of care.
Making the case for investment in mental health policies
During the first plenary session David McDaid from the London School of Economics listed several studies that demonstrate the return on investment of different behavioural and emotional mental health programmes for children, as well as a return on investment of 1 to 13€ per Euro invested in mental health promotion programmes according to a recent Commission report. Pim Cuijpers from the Amsterdam University highlighted that “by 2030 depression will bear the highest disease burden in Western countries and that, if only evidence-based treatment was used, it would be possible to reduce the burden of mental illness by 23%.” Another study from the Nottingham University in the UK showed some key findings on mental health systems in Europe:
- The percentage of expenditure in in-patient and community-based care varies considerably; for instance, Malta spends 97% in inpatient care while Slovakia spends 27%.
- Eleven countries continue to provide long-stay hospital care.
- There has been a reduction in the number of beds in mental health hospitals in several member states (Malta, Slovakia, Cyprus), whilst this number has increased in Finland and Lithuania.
- Some countries like Hungary may have reduced the number of psychiatric beds but this has not necessarily led to the development of community care services.
- Only eight countries have a comprehensive range of community-based services, including specialist services such as early intervention or assertive outreach.
- All countries have examples of prevention and promotion programmes; however, there are fewer promotion initiatives and only 6.6% of all reported initiatives targeted older people.