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23rd Oct 2021

Revealed: Hit to EU mental health services during Covid-19

  • Three-in-four mental health services were halted during the spring, across almost 40 percent of European countries (Photo: Ian Panelo)

The first wave of Covid-19 forced most countries to take drastic public health measures, hampering access to healthcare services - including those for patients with mental, neurological and substance-abuse problems.

During that first wave, 93 percent of countries surveyed by the World Health Organization (WHO) suffered disruptions to one or more critical mental health services.

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In Europe, nearly 40 percent of the participating countries reported worse outcomes than that, with three-in-four mental health services halted during the spring. That negatively affected the estimated 84 million people with mental health issues in the EU.

Simulltaneously, the pandemic increased demand for mental health services - particularly in those countries where the coronavirus restrictions were more severe.

In Italy, for example, 80 percent said they needed psychological support to overcome the impact of the pandemic - a much higher number than previous years.

Experts indicate that bereavement, isolation, loss of income and fear of infection can trigger psychological issues, or exacerbate existing ones.

The Belgian public health institute Sciensano revealed that depressive disorders increased from 10 percent in 2018 to 16 percent in the spring of 2020, with people aged 16-24 being among those most affected.

Meanwhile, more people are expected to face increased levels of alcohol and drug use, insomnia, and anxiety due to the pandemic.

Online replacement?

The closure and disruptions of most mental health services created the need to adapt medicine to the pandemic, with onlin 'telepsychiatry' services having reported unprecedented growth across member states.

However, not everyone was starting from the same point.

The Scandinavian countries have had a strong history in digital health solutions.

Only Finland, the Netherlands and Sweden had operational telepsychiatry programmes at the national level in 2015, according to a survey conducted by WHO.

Other countries, such as Cyprus, Greece and Spain, launched pilot programmes for online psychiatric care at the time, while Croatia, Italy and Lithuania had only informal initiatives, according to data released by EDJNet and Civio.

"Digital solutions truly helped to maintain the continuity of mental health services in many countries and communities, but [they] are not a good fit for everyone," said Marcin Rodzinka from Mental Health Europe, a network of psychological service users and professionals.

"To properly implement virtual mental health services - both users and professionals - have to have an adequate level of digital literacy, which in most of the vulnerable populations is still not the case," he added.

Moreover, Rodzinka pointed out that "it was strongly noted that lack of face-to-face contact cannot last [forever]" because there is a preference towards a blended approach.

Even though telephone and video services can help, particular attention is needed to respond to the mental health needs of vulnerable groups, such as those with psychosocial disabilities, homeless people, prisoners, sex workers, refugees, or people living at risk of poverty.

However, the pandemic has revealed the lack of resources limited to mental health care in Europe, in terms of staff and funds.

Germany, Greece and the Netherlands are the countries with more psychiatrists in proportion to their populations, while Poland, Bulgaria and Spain had the fewest.

Rodzinka told EUobserver that there are still "huge gaps in access to mental health services in Europe," mainly in terms of coverage and out-of-pocket payments. But such inequalities are likely to deepen due to Covid-19.

"What needs to change in mental health care is a better integration of health and social services and improvement of mental health care at the primary care level," he also said, adding that better coordination among member states is needed.

The latest data estimate that the overall costs related to mental ill-health exceed four percent of GDP across member states.

However, Mental Health Europe said this is seen as an underestimate of the real costs linked to mental ill-health.

They are calling on the European Commission to adopt a specific strategy on mental health as part of the bloc's long-term recovery strategies to mitigate the consequences of the current crisis.

Before the pandemic, the WHO previously warned about the "chronic underfunding" of mental health care since countries have traditionally spent less than two percent of their national health budgets on psychological support.

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