Pietro Vittorio Barbieri, a member of the EESC, and the rapporteur for the EESC opinion on mental health community services, emphasises the necessity for increased resources and enhanced coordination at the European level
It would be very easy to refer to the 54 articles of the European Union (EU) Charter of Fundamental Rights to set out the reasons that led to the approval of the opinion on Mental health community services. The special treatment of people who are suffering as a result of mental health problems goes against the principles of freedom and self-determination, which also constitute the foundations of the eighth United Nations document on human rights, known as the Convention on the Rights of Persons with Disabilities.
Segregation is prohibited. This is made crystal clear. Confining, or severely restricting the freedom of anyone who has not committed a crime, is unjustified. This is essential to the rule of law culture, something the EU wants to nurture. The concept of coercion is also placed on the table for those who have committed offences. It may not necessarily be the best solution, not even for the rehabilitation of offenders.
Confinement or the severe restriction of freedom is also unjustified when it comes to prevention, as science and the World Health Organization tell us. If adequate services are available locally, prevention works much, much better. In fact, this reduces all of the most dangerous forms of behaviour, even when current news is not helping sometimes.
Mental health issues in Europe today
An alarming number of people are suffering from mental health problems – even more so since the pandemic. These numbers alone would be enough to define a completely different scope of action compared to the past. Mental health issues have exploded among young people.
It would be of no use to picture cities being full of spaces of coercion, of fully-fledged institutions for minor or major forms of mental conditions. It would be better to build something more aligned with the cultural rootedness of human rights that has now become part of our communities.
After all, these psychiatric institutions were created to protect people from contexts that were unable to take care of them, either in terms of welfare, purely, or because of the dominant culture. These institutions belong to their time – the end of the nineteenth century. The knowledge we have today is very different. People’s awareness has also changed. Stigma and prejudice still exist, but speaking about mental health is no longer taboo.
Mental health community services
The solutions proposed by the opinion on Mental health community services are also different in terms of the structuring of services. Currently, financial and professional resources are concentrated around a single structure. In contrast, we propose a different system based on the availability of services in the region where the individuals concerned live. Such services include health and clinical services, rather than social and employment services.
The receptions of clinics must be more welcoming, including aesthetically. People experiencing mental health problems must also have a right to experience beauty. It may sound superficial, but the saddest and least stimulating environments are psychiatric clinics.
Social services must be personalised – foster care or residential homes for one to two people should be available. To summarise, these services must be made to measure and co-designed, a new process whereby the main person involved is the service user, who can express their own needs and life plan. Adequate spaces must be found for this new idea to become the model for a new mechanism to organise the services in the regions together, in this case, with mental health associations.
EU mental health policy priorities
One last step is needed. The EU has little competence in this area, mainly with the Member States. The opinion on Mental health community services seeks to describe a policy perspective to make the new paradigm a common heritage for all EU citizens, starting with national and local institutions in the Member States, as well as mental health professionals and the users of the services.
The key is to urge the European Commission to carry out a coordination role, without the goal of creating a new European standard, but rather with the intention of building open sharing processes, perhaps starting with a consensus conference to establish guidelines, with the involvement and subsequent approval of all participants. Therefore, everyone has a role to play in their daily lives and respective contexts. The way we spend in this area needs to be changed.
