Response from the European Federation of Psychologists’ Associations (EFPA)
The European Federation of Psychologists’ Associations1 (EFPA) is the umbrella organisation in Europe for national psychologists’ associations and comprises associations from 37 European countries, including all 27 member countries of the EU. EFPA is a partner in many EU Commission funded research and development projects and sets a European standard of education, professional training, and competence in psychology—EuroPsy2.
EFPA welcomes a recognition of the importance of ensuring that EU and national policies proactively promote good mental health, as well as work to prevent, mitigate and respond to mental health challenges. EFPA appreciates the opportunity offered by the Commission to help develop this comprehensive approach. Specifically, the seven priorities outlined below are offered as concrete ways to ensure sustained and meaningful EU-level action. Ideally these priorities would become workstreams of a coherent strategy, which could be launched and effectively bound together in the form of an EU Year for Mental Health.
1—Mental health should feature in all EU policies, be properly funded (e.g., through EU4Health), and be properly resourced with dedicated unit staff at the European Commission. An EU Year for Mental Health could support a wider public knowledge of the impact of various policies on mental health and be part and parcel of any future initiative.
There is an increasingly greater awareness of the importance of mental health—in society at large and in the EU institutions—as well as of the need for psychological support as indicated by Commission President von der Leyen’s recent State of the Union address. In addition, MEPs are actively campaigning for an EU Year for Mental Health and an EU Health Strategy. EFPA has supported this campaign since its inception.
2—Mental health should be a core part of any policy response to current and future societal crises.
On many occasions EFPA has underlined the importance of ensuring attention for the mental health of the most vulnerable. We advocate that any future EU activity on mental health should take account of the various effects of societal crises on the mental health of citizens, including the COVID-19 pandemic, the war in Ukraine and its consequences for costs of living and poverty as well as the anxieties and worries related to the effects of climate change.
3—EFPA supports WHO’s call for more community-orientated mental health services and urges the Commission to ensure that a future initiative stimulates EU Member States to exchange ideas and good practice, to learn from each other on how to adapt their mental health service delivery.
Recently, the WHO has made the case for a stronger investment in mental health, more specifically in community-orientated mental health. Indeed, many European countries are struggling to reform their mental health systems from a hospital-centred perspective towards a more community-orientated focus. EFPA supports that recommendation and is currently working with its Member Associations on how to support psychologists making that transition and how to make psychological services more accessible across the board, i.e. in prevention, self–care, community and primary care. The WHO’s model on mental health services delivery3,4 offers a helpful framework to make that transition.
EFPA actively endorses this approach to mental health and has participated in a number of practical examples of its implementation. Community based care which is aimed at prevention as well as addressing current need is the appropriate approach and its implementation at the national level should be encouraged. RECOVER-E—a European Commission HORIZON 2020 project5 in which EFPA is a partner—is one example of an initiative contributing to this type of approach through supporting the development and evaluation of multidisciplinary Community Mental Health.
4—Given the central place of work in the lives of European citizens and the importance of economic wellbeing to social wellbeing, mental health in the workplace should be a focus of the future initiative and should be enshrined in health and safety regulations to ensure robust implementation at the national level.
As another practical example: the European H-WORK project6 aims to promote healthy workplaces by applying and validating a multi-level intervention protocol in public organisations and SMEs. H-Work’s purpose is the design, implementation and validation of effective multi-level assessment and intervention toolkits, the evaluation of individual and organisational outcomes of the adopted measures and the provision of further innovative products and services. The project is currently working on specific EU policy recommendations which could be useful for the Commission’s future work.
5—Mental health is indivisible from the challenge of climate change and support programmes for children and young people especially should be introduced.
A survey of 10,000 children and young people across 10 counties including countries in Europe7 showed worry about climate change across all countries with 59% very or extremely worried and 84% at least moderately worried. Worry about the future is stronger for the youth group, because they are the ones who are going to live in a future substantially affected by climate change.
Across Europe children and young people will be differently impacted by climate change depending on the natural environment where they live. Programmes of support—for example in schools—can nonetheless have a common thread so examples of good practice can be promoted across the EU. These are particularly important for adolescents to build personal resilience, at the same time as fostering collective action and a sense of efficacy around pro-environmental communication and behaviour changes. They can also promote human-nature positive interaction with eco-therapy or eco-interventions.
6—The training of mental health practitioners should be based on a recognised standard, properly funded to ensure enough practitioners to meet citizens’ needs, and their practice properly regulated with requirements to keep up to date through continuing professional development.
All practitioners working in mental healthcare should be fully trained to the appropriate level. Training places should be sufficient to ensure an adequate pipeline of staff to meet need. EFPA offers as an example the European Certificate in Psychology, entitled EuroPsy, which is a European standard of education, professional training and competence in psychology. The EuroPsy encourages and promotes continuing and specialised education throughout Europe.
7—European citizens should have equal access to the appropriate mental healthcare and healthcare professionals and should be engaged as partners and stakeholders in how mental health and wellbeing is assured.
EFPA recognises the crucial role of equality of access for citizens to the services of mental health professionals including psychologists, both in relation to the prevention of mental health challenges as well as in the promotion of mental health and wellbeing. Psychologists should be included in the health and social care system as a matter of course. The opportunities, and challenges, posed by digitalisation must also be actively considered as part of this process. EU action should ensure a lifespan approach to mental health, taking account of age-specific requirements and needs. Active input from relevant stakeholders, particularly patients (e.g., GAMIAN-Europe), and wider citizens’ representative organisations—for example for youth, older people, minorities—in the development, implementation, monitoring and assessment of future EU action on mental health will be indispensable.
7) Hickman, C., Marks, E., Pihkala, P., Clayton, S., Lewandowski, R.E., Mayall, E.E., Wray, B., Mellor, C. & van Susteren, L. (2021). Climate anxiety in children and young people and their beliefs about government responses to climate change: a global survey. The Lancet Planetary Health, 5(12), e863-e873.