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.