Mental health: A comprehensive ‘comprehensive approach’ this time?

The European Commission released its Mental Health approach last month. It’s a start, but it fell well short. We need much more attention, ambition, and long-term structural thinking in the coming years if we are to tackle the challenge of mental wellbeing before it spirals further out of control.

The problem: Mind and body, two halves of a whole… but not in healthcare

Health in Europe is a tale of two halves. On one side is physical health, on the other mental health. We spend trillions on half one (around 10% of GDP in OECD countries), building staggeringly complex infrastructure, systems and funding groundbreaking research. The results are often astounding. We can develop and deploy vaccines in a handful of years at a global scale, repair a human liver using lab-grown cells, or even create a mechanical replacement organ like the artificial pancreas.

The other side is chronically underfunded. The richest health economy in the world, the US, spends only about 5% of its overall health budget on mental health, despite the terrifying reality that suicide is the second biggest killer of American young. Pre-Covid, the mental health of our young was in trouble. Globally, young adults were already three-to-four times more likely to struggle with their mental health than their parents’ generation. Post-Covid, and the isolation, fear and grief it brought with it, this decline has been accelerated.

Every single teen suicide is avoidable. These are lives lost because we’ve lost control.

Poor mental health is an insidious problem.  It’s complex. It is a (relatively) new field of human knowledge and research. We don’t really know what works at scale. It’s often perceived as hidden, difficult and expensive to address. It is surrounded by social taboos. The systemic causes are vast and challenging to tackle. But this cannot be an excuse. The exact same argument could be made about physical health, and look how far we’ve come on that.

Europe steps up to the plate, but forgets its bat

On 7 June, the European Commission launched its first foray into the world of mental health – its ‘Comprehensive approach to mental health’: twenty initiatives to raise awareness, support capacity building and de-stigmatise mental health, among others.

It is an ok start. The document will raise mental health’s political priority and start much-needed conversations. It also pays particular attention to youth mental health. But it is not the wide-reaching strategy many of us hoped for, nor is it comprehensive in any way.

There is no new money: €1.2 billion in existing initiatives has been re-categorised, which is nice, but does not change much. The commitments made mostly take us up to the end of 2025. Not really long-term. 

In the space where the EU has real teeth – digital – the proposals are underwhelming. More could be done to disincentivise the predatory social media business models that we know have profound consequences on our lives.

It also lacks an inspiring signature policy that would create significant change. Could we have been ambitious and suggested a mobile phone ban in schools like the Netherlands? The arguments for such a direction are powerful and while legal competences are tricky such an initiative would likely gain support across the political spectrum. Who doesn’t want kids to be well educated?

Where to go from here?

We know mental health is going in the wrong direction. Anxiety is on the rise. We are less trusting. Less satisfied with the system. All this is already expressing itself in problematic ways, and will only get worse without a change in direction.

Despite this bleak picture, there is hope. The next evolution of technology (AI) will herald a new era. Tackling the climate crisis, as large a threat as it is, requires many of the same types of social shifts. As does turning the page on our hyper-polarised societies.  

So, what could a comprehensive ‘comprehensive approach’ to mental health look like?

• We need a more robust independent civil society movement. Foundations like ours can play a role here.
• There needs to be a higher political priority on this topic. Here politicians need to step up.
• We need a massive increase in structural investment around mental health.
• We also need to know what works by creating a data environment that uncovers what is effective and what is not.
• We need to take the (perhaps double-edged) advent of AI and work out how it can be used to scale society-level solutions for mental well-being
• Then, ultimately, we must collectively challenge and change the root causes of poor mental well-being, such as financial precariousness, time poverty (loneliness) and a lack of community and belonging, to name but a few.

Society can only flourish with good mental well-being. We’ve neglected this area for too long. Philanthropy can and will help, but the change needed is wide and deep. If we can build such a system for physical health, we can do it for mental health. The only real barrier is our own political will, belief and imagination.