The sane approach

29 March 2012

MHE Senior Policy Adviser Josée Van Remoortel explains why it is crucial that mental health be put high on the political agenda when handling the financial crisis

It is not news anymore that the financial crisis has had a devastating effect on the world economy. Its consequences are felt in all areas of life – securing jobs has become more difficult, purchasing power went down, and so did people's trust in their governments. But the credit crunch also had an unexpected consequence, one that reflects a deep chasm in our society – a sharp rise in mental health problems, largely caused by uncertainty and fear for the future.

A world of 'others'
Research shows that one in four Europeans will experience mental health problems during the course of their lives. That amounts to over 125 million people in the European Union (EU) who will have to deal not only with often debilitating conditions, but also with the unrelenting stigma associated with them.

The stigmatisation of those with mental health problems comes as a result of a deep lack of knowledge about mental health. People with mental health problems are seen as different – unable to perform jobs or integrate into society and incapable of expressing firm opinions such as casting a vote. This could not be further from the truth. Mental health problems are not synonymous with intellectual inability, and people with mental health problems are not less valuable as employees. And still, according to the World Health Organization (the WHO) World Report on Disability, they have the lowest employment rate among people with disabilities, and least opportunities for job advancement. Therefore, during a financial crisis, they are more prone to living in poverty, and to depending on social welfare, which is in turn more likely to worsen their conditions. The media hype around the need for budget cuts in some European countries further deteriorated the image of people with mental health problems, as they were often portrayed as benefit-scroungers further burdening the economy.

Resisting change
The financial crisis also threatened to reverse even the small progresses made regarding deinstitutionalisation and social inclusion. Blaming the credit crunch, governments tended to reduce the funds allocated to community-based services, leaving more and more people without support. Reports from the UK showed that cutting services led to some families having to send family members to residential institutions, which have long been regarded by both researchers and by disabled people themselves as inefficient, outdated, and unable to protect against human rights abuses.

Moreover, some European countries used European funds to refurbish closed residential institutions and psychiatric hospitals. Despite numerous studies proving that services in the community were more cost-effective in the long term, and offered a better quality of care, many European countries lacked a holistic approach and were resistant to change.

All is not lost
It is important for governments and European policymakers to understand that the rise in mental health problems in Europe is due as much to the crisis as to governments' response to it. Budget cuts, the reduction of allowances for families and disabled people, diminishing benefits and a decrease in the number of staff working in social services will only worsen this already dire situation, and harm the poorest and most vulnerable members of society.

However, there are ways for the EU to support governments in addressing the challenges brought about by the increasing number of people with mental health problems. For example, the EU should insist that member states follow the EU's strategy for active inclusion, therefore granting an adequate minimum income to all, including those who are temporarily or permanently not able to work. A minimum income provision is crucial if people are to lead a dignified life and have access to quality healthcare. Economic downturns also result in smaller changes in the mental health of citizens living in countries with strong social safety nets.

Moreover, civil society should have a systematic engagement in policymaking through consultations and coordinated interactions with policymakers.

Working in partnership
For a lot of mental health organisations and Europeans with mental health issues, Brussels is a world away. Functioning in what appears to be a language of its own, and drowned in bureaucracy, the EU takes decisions that are often incomprehensible for the average European. And still, for the 25% of European citizens who have, or will develop mental health problems during the course of their lives, decisions taken in Brussels will directly affect them, whether in the area of employment, disability benefits or even access to education and healthcare. Similarly, for organisations working in mental health, the EU offers numerous possibilities for funding and partnership.

However, the link between national organisations or (ex-) users of mental health services and the European Union is often weak, or even lacking. Fortunately, organisations like Mental Health Europe (MHE) and the European Network of (ex-) Users and Survivors of Psychiatry (ENUSP) bridge this gap. MHE represents organisations and people interested in mental health at EU level and advocates for the rights of people with mental health issues, while ENUSP unites and directly represents the demands and concerns of users and survivors of psychiatry at EU level and across the whole of Europe.

By working closely with European bodies, MHE plays an important role in raising awareness and combating the taboos, stigma and prejudice associated with mental health. As John Bowis, former Member of the European Parliament, said: "Mental Health is on the European political map and Mental Health Europe is one of the key players who has put it there. It is fundamentally important that its voice is now heard loud and clear."

The financial crisis will not last forever, but rushed measures taken by national governments to patch their economies will surely have prolonged effects. Therefore, now more than ever, it is crucial that mental health is put high on the political agenda. As social welfare is not only a right, but a means to improve mental wellbeing, governments and organisations like MHE must work together to protect the most vulnerable groups in society. In a world where rationality is giving way to impulse, it is the only sane decision to make.