‘Surviving not thriving’ : The outcomes of the youth dialogue on mental health and social inclusion

‘Surviving not thriving’

The outcomes of the youth dialogue on mental health and social inclusion

In December 2022, NLO, in collaboration with WHO Regional Office for Europe, hosted the Youth Dialogue on Mental Health and Social Inclusion. The event brought together youth representatives covering healthcare professionals, young people with lived experience of mental health conditions and services, representatives of marginalised groups, and other interested parties to discuss mental health and well-being among young people, with a focus on who is most at risk and left behind.

Interactive discussions gathered insights on the mental health interventions and support young people need, how they stay resilient to protect their mental health and well-being, and how youth communities should be engaged in policymaking. The dialogues offered a safe platform for participants to share their lived experiences prior to, during and after the COVID-19 pandemic. It resulted in identifying key barriers, offered concrete solutions to better mental health and well-being in youth and also portrayed the worrying reality in which young people are 'surviving, not thriving'.

Over the past months, we have been working to prepare the discussion paper, and it is now available. The event participants are invited to share their feedback with us via email info@nobodyleftoutside.eu by 1 May 2023.

The discussion paper provides answers to the following questions:

  1. What interventions and support do young people want and need?
  2. How are young people staying resilient and protecting their mental health and wellbeing?
  3. How should youth communities be engaged in policymaking?

Please find here the discussion paper ‘Surviving not thriving’.




NLO`s answer to "A comprehensive approach to mental health"

The European Commission asked for evidence in their initative: "A comprehensive approach to mental health". The Nobody Left Outside Initiative submitted cross-community and community-specific recommendations:

Cross-community recommendations on mental health

The COVID-19 pandemic has taken a serious toll on mental health and well-being and had an exceptionally detrimental effect on marginalised communities, who were already at a greater risk of poor health outcomes. There is an urgent need for real change through robust and ambitious EU action which prioritises the needs of the most impacted members of our society. The Nobody Left Outside Initiative (NLO) welcomes the EU’s initiative to improve mental health by integrating mental health into all relevant EU policies and to maximise the added value of EU policies in national and local efforts. We are glad to share three overarching recommendations and a call for advancing mental health in the EU by addressing mental health care disparities.

Address socio-economic determinants of mental health:

The mental health crisis in the EU requires a stronger focus on drivers of negative mental health and prevention-oriented approaches. Some of the most marginalised communities, such as people experiencing homelessness, LGBTI people, people who use drugs, prisoners, sex workers, undocumented migrants and children, are highly affected by socio-economic determinants of (mental) health, such as living wages, accessible housing, access to healthy and affordable food, health insurance. Food or housing insecurity has tremendous effects on physical and mental well-being and unhealthy, unsafe and overly long working hours contribute to this. Better mental health outcomes go hand in hand with improving living conditions and creating financial stability for all. Meaningfully addressing mental health among marginalised communities requires recognising and addressing the dimensions of mental distress that are symptom of depravation and social injustice.

Improve access to healthcare:

People in marginalised communities experience unequal access to mental health and social care services and sometimes lack information on their healthcare rights. On top of that, they can face stigma and exclusion from society and service providers. As a result, they suffer from chronic stress and are discouraged from seeking care. Healthcare systems and professionals need to be better prepared to meet their needs to enable access to affordable, tailored and non-discriminatory care. Services need to become more accessible, including reducing administrative burden of service users. Tools like the NLO Service Design Checklist help making health and social services more accessible.

Bring marginalised communities into the conversation:

Representatives of marginalised communities are not sufficiently involved in the development, implementation and evaluation of policies, programmes and services that affect them. There is a need for a continuous, structured engagement so that policymakers and public health institutions actively and directly inquire about the mental health challenges and needs of marginalised communities.

Public health services should work directly with community-led and community-based organisations in their decision-making to ensure policies and services are fit for purpose.

Please find here our full response including community-specific recommendations.




Join "Friends of NLO"


Friends of NLO is an informal network of interested policymakers and health stakeholders to explore policy solutions for designing inclusive health systems, support community input to policy development and discuss best practices to improve healthcare access for marginalised communities.

The Friends of NLO will be regularly informed about NLO`s activities, invited to events and receive NLO`s material such as the newsletter, open letters and recommendations. They further have the opportunity to reach out to NLO as a knowledge partner and expert on access to health and social care. When interested in including the point of view and the expertise of marginalised communities in health policy and advocacy work, the NLO secretariat will facilitate feedback and input from community representatives.

Members of Friends of NLO can be individuals such as policymakers, Brussels health stakeholders, patient representatives, industry representations, healthcare professionals, medical societies, representatives from marginalised communities, healthcare students, researchers, everyone interested in increasing access to healthcare for marginalised groups and creating inclusive health and social policies.

Please sign up here to become a Friend.




Nobody Left Outside of Healthcare Systems- join 'NLO in Conversation'

Lived experiences of marginalised communities during the COVID-19 pandemic

📌 Date: On 28 February, from 18h00- 20h00 CET
📌 European Parliament, SPAAK 7C50, 60 rue Wiertz, B-1047, Brussels
📌 Register here


The Nobody Left Outside (NLO) Initiative is delighted to invite you to the ‘NLO in Conversation’ film screening and discussion on 28 February at 18h00- 20h00 at the European Parliament in Brussels, Room SPAAK 7C50. The event is hosted by MEP Cyrus Engerer (S&D, MT) and Tiemo Wölken (S&D, DE). To attend the event, please register here.

The COVID-19 pandemic has shown with all urgency that existing inequalities to health and social care amplify in times of crisis. Over the past months, the NLO initiative has been working to create ‘NLO in Conversation’, a textual, atmospheric film that tells lived experiences of marginalised communities during the pandemic. The film will give viewers a deeper understanding and thought for discussion on how the COVID-19 pandemic has impacted access to health and social care for some of the most disadvantaged members of our society.

Following the film screening, the NLO members will share their experiences, main advocacy asks in accessing healthcare and reflect on how the learnings from the ‘NLO in Conversation’ could inspire policy solutions. In the context of the upcoming European elections, the NLO members will call to include health equity in party manifestos to ensure its continuity and prioritisation during the next Parliament term.

The event will also launch Friends of NLO, an informal network of interested policymakers and health stakeholders to explore policy solutions for designing inclusive health systems, support community input to policy development and discuss best practices to improve healthcare access to marginalised communities. The event will be concluded with a networking opportunity.

For more information, please consult our website or contact us via info@nobodyleftoutside.eu


NLO develops recommendations on mpox


In the summer, the WHO Director-General declared the escalating mpox outbreak a Public Health Emergency of International Concern. While everyone can catch monkeypox, not everyone is at equal risk. People who closely interact with someone who is infectious, including through sexual contact, are at greater risk for infection; particularly sexual partners, but also household members and health workers. Cases have been identified but not limited to communities of gay, bisexual and other men who have sex with men who have had recent sexual contact with a new partner or partners. 

As it is often the case with public health emergencies such as COVID-19, the impact of mpox has proven to be disproportionate on members of marginalised communities. In this view, NLO has been approached by the WHO Europe Office to share our input on mpox and has developed concrete recommendations, which is now available on our website.

NLO recommends: 

  • Facilitate early identification of cases through ready access to testing care, and treatment. Ensure access to comprehensive treatment and care for those with mpox, including management of other infections. The NLO Service Design Checklist helps service providers, policymakers and community representatives to design targeted and equitable health services;  
  • Public health services should work directly with community-led and community-based organisations in their decision-making to ensure policies and services are fit for purpose; 
  • Increase access to vaccination programmes by prioritising people living in crowded housing, sex workers, men who have sex with men, trans people, and other groups at higher risk. Contact tracing and exposure limitation are among other important measures; 
  • Develop clear, inclusive, non-judgemental and non-stigmatizing communication in prevention and information strategies and actions. Communication strategies should incorporate the use of targeted channels and communities themselves that directly reach marginalized individuals. 
  • Be mindful of the negative impact of criminalisation, stigmatisation and other discrimination on population health.  
  • Improve data collection to inform equitable health efforts. Closely evaluate possible reasons why mpox cases are decreasing, understand the different factors of this development and identify successful measures to be able to answer with a strong public health response to future health emergencies. 



                                                                                                                Picture credits: Maurizio de Angelis/Science photo library

Youth Dialogues on Mental Health and Social Inclusion, NLO collaborates with the WHO Regional Office for Europe


NLO collaborates with the WHO Regional Office for Europe to host the Youth Dialogues on Mental Health and Social Inclusion

Join us to discuss a healthier mental health future that leaves no young person behind!

📌 Date: On 9 December, from 10h00- 12h00 CET via Zoom
📌 Register here 
According to the World Health Orgainsation, in 2019, the number of people with mental health conditions, including developmental and behavioural disorders in children and adolescents, stood at over 125 million, equivalent to 13% of the population; an estimated 119 000 lives were lost due to suicide- an unacceptably high figure that includes an increasing number of young people. Globally, one in seven 10-19-year-olds experiences a mental health disorder; depression, anxiety and behavioural disorders are among the leading causes of illness and disability among young people. It is evident- we are facing the youth mental health crisis and are in urgent need for a real change!

Since the creation, NLO proudly represents marginalised communities and advocates for fighting against stigma and discrimination associated with mental health conditions and social exclusion. We are delighted for the opportunity to collaborate with WHO and host the Youth Dialogues on Mental Health and Social Inclusion with an aim to:

  • Bring together different youth representatives to discuss the mental health situation of young people in the European region, with a focus on who is most at risk of being left behind;
  • Understand the reality of young people experiencing poor mental health and social exclusion and to share their lived experience, during the COVID-19 pandemic, before and after;
  • Share best practices, develop solutions and concrete suggestions that tackle the issues at hand and could make a real impact on the lives of young people.

We invite participants aged 18-29 from the WHO European region, who are representatives of patients or youth organisations, representatives of marginalised communities who are or were patients themselves, young healthcare professionals, social workers, students of relevant fields and other interested people.

The Dialogues will start with a short presentation on the solution space paper. The paper will be shared with the breakout group participants before the meeting for their preparation.
The breakout groups will then discuss two key questions across the solution spaces:

  • What kinds of interventions and support do young people want and need to improve mental health and social inclusion?
  • How are young people staying resilient amid increasing risks and challenges to protecting and promoting their mental health and wellbeing?

A summary outcome paper will be developed to share the identified solutions with the participants, the WHO Europe, Euro Youth Mental Health and other relevant stakeholders. The paper will be hosted on the Nobody Left Outside website

EFPIA Guest Blogpost: Nobody Left Outside

The Nobody Left Outside (NLO) initiative was created in 2017 when MSD reached out to NGOs representing the most marginalised communities in Europe including people experiencing homelessness, LGTBI people, people who use drugs, prisoners, sex workers and undocumented migrants. Since then, the NLO coalition has been showing great efforts to raise awareness of the challenges marginalised communities face in access to healthcare.

These efforts materialise through various activities such as conferences, articles, exhibitions, proposals and reports to World Health Organisation and the EU institutions.

Today, the NLO coalition is recognised as a single voice for the most marginalised and stigmatised communities through open dialogues with EU institutions and major health organisations.

Boris Azaïs, the Director of Public Policy Europe for MSD shares NLO's journey on this blogpost for the European Federation of Pharmaceutical Industries and Associations (EFPIA).

Read the blogpost here.

NLO publishes open letter on vaccine equity

The Nobody Left Outside initiative published an open letter calling on European policymakers to ensure equitable access to COVID-19 vaccination among marginalised communities.

We emphasise the critical importance of including marginalised groups in ongoing vaccination programmes if they are to achieve their goal of herd immunity and public health protection.

To this end, NLO recommends that policymakers:

  • Take a stronger stance on vaccine equity as the guiding principle for the design and implementation of national COVID-19 vaccination strategies
  • Implement specific outreach measures to reach and vaccinate people who face barriers to mainstream healthcare – the NLO Service Design Checklist can help here
  • Address vaccine hesitancy and lack of trust in government and health bodies
  • Assure access to health services for people who are undocumented or face criminalisation without fear of repercussion
  • Combine COVID-19 vaccines with other inclusive public health measures, including public engagement and test, trace and isolation measures that are accessible and suitable for everybody
  • Ensure equitable and sustainable access to all forms of healthcare and health information, fostering community engagement to help achieve this
  • Support calls for a strong European Health Union with explicit health policy competences for the EU.

Read the full letter here

NLO receives honourable mention for 2021 World Changing Ideas awards

We are proud to announce that the Nobody Left Outside Coalition has been recognized with an honourable mention by the Fast Company World Changing Ideas Awards.

The contest in its 5th year honours products, concepts, companies, policies and designs striving for the good of society and the planet.

The NLO Coalition has received an honourable mention in the Social Justice category for its work to increase access to health and social services for marginalized communities.

More on Fast Company 2021 World-Changing Ideas here

More on the finalist and honourable mentions here

NLO celebrates World Health Day 2021

April 2021

Building a fairer, healthier world – where nobody is left outside

Today we celebrate World Health Day 2021, with its motto “Building a fairer, healthier world“, during an ongoing global pandemic.

COVID-19 has severely impacted the health, lives and livelihoods of many millions of people worldwide. Marginalised groups such as people experiencing homelessness, undocumented migrants, sex workers, people who use drugs, lesbian, gay, bisexual, transgender and intersex (LGBTI) people and prisoners are among those hardest hit by the pandemic and yet are among the least protected.

The problems are not new, or specific to the COVID-19 pandemic. The aforementioned marginalised communities already faced difficulties accessing healthcare, social care and support services well before the pandemic, as did others subject to racism and other forms of systemic discrimination. And yet, while the problems were clear, there has been limited, effective action to address them.

COVID-19 has emphasised that nobody is safe until everybody is safe. In order to protect our societies from this and future pandemics, and to deliver better health for all, healthcare must once and for all be truly and equitably accessible to everybody.

The recent Call to Action of the Pan European Commission on Health and Sustainable Development, convened by Dr Hans Kluge (WHO Regional Director for Europe) and chaired by Mario Monti, states that:

“We cannot achieve a sustainable future for health and development in Europe if we fail to address the conditions that allowed the COVID-19 pandemic to inflict unprecedented damage on lives and economies. We need to accept that the global system has failed.”

This Commission calls for action at all levels of society to fix the fractures that left so many people vulnerable to the pandemic. This includes:

  • Making health systems more inclusive, ensuring that everyone can participate in decision-making at all levels and access health and social services, and
  • Re-emphasizing the Sustainable Development Goal of achieving universal health coverage (UHC), which is key to ensuring societal cohesion, economic growth and sustainable societies.

The Nobody Left Outside (NLO) initiative welcomes and supports this Commission and its Call to Action. The recommendations reflect the core goals of NLO to address the social determinants of health and to achieve equitable access to health and social care, including underserved, marginalised communities – as expressed in our Joint Statement.

We call on EU and national policymakers to institute policies that protect everyone from the effects of the COVID-19 pandemic, future pandemics and other health threats based on the principles of evidence-based public health, human rights and equity, as further explained in the NLO COVID-19 briefing paper.

In 2021 we must build a fairer, healthier world – for good.