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Tackling the structural inequalities at the heart of poor mental health

Guest Article: Fatima Awil, Advocacy & Policy Officer, Mental Health Europe

The disproportionate impact of COVID‐19

The right to health and access to healthcare is a basic human right; nevertheless, COVID-19 has laid bare the existing inequalities. Without urgent action around mental health care, the rise of psychosocial support demands will inevitably upsurge, contributing to an increase in the 84 million with mental ill-health across the European Union alone.

Disparities in the healthcare system is a systemic issue

Ethnic minorities, women and girls, people with disabilities, LGBTI, undocumented people, and those with difficult socio-economic realities are just a few examples of groups that are more likely to bear an unequal burden of morbidity and mortality. From lack of information to inaccessible standards of mental health support, discrimination is upheld and maintained at a structural level, preventing vulnerable groups from receiving adequate care.

Mental health problems have been further exacerbated, with more people being likely to experience mental health distress for a plethora of reasons: from the deterioration of social networks to the lack of community support systems, especially for people living in institutions. Without applying an intersectional approach to confronting such barriers, it is not possible to build a more equal and equitable healthcare system. This includes achieving a European shift towards a psychosocial rather than biomedical approach to mental health

Inadequate access to mental health care

This pandemic has also unmasked the substantial disparities in access to mental health care. People with psychosocial disabilities commonly have a hard time accessing adequate support services, further worsened by the pandemic. To achieve an equitable approach to mental healthcare, information must be accessible for vulnerable persons, including those with psychosocial disabilities. This is imperative considering the continued fast-paced and unexpected updates on the virus and restrictive measures. Support provided must also respect the will and interests of individuals at all times, be within reach, and flexible to their needs.

Lack of trust within communities towards mental health care can be attributed to wider issues in accessing support. Some examples include poor patient experiences, negative perception of and social stigma around mental health, financial factors, language barriers, and worry of being subject to coercive treatment. Distrust towards formal healthcare provisions within communities results in marginalised groups being less likely to seek help or be signposted to services. This could have wider repercussions on society at large, with more people seeking support elsewhere, including additional burdens placed on friends, family, and carers. Delays in early intervention can prompt increased cases of preventable yet serious mental and wider health outcomes.

Looking ahead: Early intervention but with a long-term approach

The COVID-19 pandemic showed the importance of intervening early, to provide the necessary frameworks to support the most marginalised, including people with psychosocial disabilities. Everyone has mental health and has the potential to develop mental ill-health. Proactive responses will prevent healthcare systems from being further overburdened and collapsing. The pandemic will continue to have an immense but unequal toll, and vulnerable groups, including people with psychosocial disabilities, will pay the highest price. Organisations, (ex)-users of mental health services, persons with psychosocial disabilities, their families, and carers, should be at the forefront of shaping such policies and services.

A human rights-based response to the pandemic is needed to prioritise individuals facing mental health difficulties, during and after the COVID-19 period, by addressing underlying systemic problems, with an intersectional approach. We cannot wait for another crisis to apply the lessons learned from the current pandemic.

Read Mental Health Europe’s key recommendations here.

Mental Health Europe also hosts European Mental Health Week, between 10-16 May 2021. Find out more here

Disclaimer: the opinions – including possible policy recommendations – expressed in the article are those of the author and do not necessarily represent the views or opinions of EPHA. The mere appearance of the articles on the EPHA website does not mean an endorsement by EPHA. 

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