COMMUNICATION FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT, THE COUNCIL, THE EUROPEAN ECONOMIC AND SOCIAL COMMITTEE AND THE COMMITTEE OF THE REGIONS on a comprehensive approach to mental health
Date: 2023-06-07
Institutions: Directorate-General for Health and Food Safety, European Commission
Subjects: coronavirus disease, disease prevention, epidemic, mental health, mental stress, occupational health, right to health, work-life balance, workplace

EN 

  EN 

   EUROPEAN COMMISSION  Brussels, 7.6.2023  COM(2023) 298 final  COMMUNICATION FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT, THE COUNCIL, THE EUROPEAN ECONOMIC AND SOCIAL COMMITTEE AND THE COMMITTEE OF THE REGIONS on a comprehensive approach to mental health  
 
 
Mental health is an integral part of health. It is a state of well-being in which individuals 
realise their own abilities and can cope with the stresses of life and contribute to community 
life. Mental health is a precondition for a productive economy and inclusive society and goes 
beyond individual or family matters.  

Mental  health  or  ill-health  does  not  happen  in  a  vacuum,  it  is  conditioned  by  personal  and 
external  factors.  It  reflects  and  is  influenced  by  the  state  of  our  society,  our  economy,  our 
environment and also by the state of world affairs around us. The European Union (EU) and 
the  world  have  undergone  unprecedented  crises,  such  as  the  COVID-19  pandemic  and 
Russia’s  war  of  aggression  against  Ukraine,  energy  crisis  and  inflation,  shaking  everyday 
reality,  the  expectations  and  the  confidence  of  people.  The  triple  planetary  crisis  (climate 
change,  biodiversity  loss  and  pollution)  is  worsening.  Increased  digitalisation,  demographic 
change  and  radical  shifts  in  the  labour  market  bring  challenges  alongside  opportunities. 
Beyond  tackling  these  crises,  addressing  mental  health  challenges  is  key  to  boosting  the 
resilience of individuals and of the population. 

Better  mental  health  is  both  a  social  and  an  economic  imperative.  Before  the  COVID-19 
pandemic,  mental  health  problems  affected  around  84  million  people  in  the  EU  (one  in  six 
people),  at  a  cost  of  EUR  600  billion  or  more  than  4%  of  GDP1,  with  significant  regional, 
social,  gender  and  age  inequalities.  When  it  comes  to  the  workplace,  27%  of  workers  have 
reported experiencing work-related stress,  depression,  or anxiety during the previous twelve 
months,  which  increases  the  chances  of  absenteeism  with  serious  impact  on  workers’  lives 
and business organisation. The cost of non-action on mental health is already significant and 
unfortunately, it is forecasted to rise even more, in line with global stressors. Already in 2019, 
more than 7% of people in the EU suffered from depression2 and 13% felt lonely most of the 
time. 

The pandemic was a serious threat to mental health, especially among young people and those 
with  pre-existing mental  health  conditions.  During the pandemic, people in  the EU  affected 
by loneliness doubled compared to pre-pandemic years, reaching 26% across some regions3. 
Increased loneliness and reduced social interactions, concerns about one’s own health and that 
of  loved  ones,  uncertainty  about  the  future,  anxiety  caused  by  fear  and  loss4  all  generated 
post-traumatic stress disorders. 

Suicide is the second leading cause of death among young people (15-19 years of age)5 after 
road  accidents.  In  the  EU,  the  annual  value  of  lost  mental  health,  in  children  and  young 
people is estimated at EUR 50 billion6.  

1 Health at a Glance: Europe 2018. 
2  Eurostat News - Eurostat (europa.eu). 
3 New report: Loneliness doubles in Europe during the pandemic (europa.eu). 
4 The consequences of the COVID-19 pandemic on mental health and implications for clinical practice | 

European Psychiatry | Cambridge Core. 

5 The State of the World’s Children 2021: On My Mind – Promoting, protecting and caring for children’s mental 

health, Regional brief: Europe, UNICEF, 2021. 

6 SOWC-2021-Europe-regional-brief.pdf (unicef.org). 

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Behind  these  statistics  lie  millions  of  personal  stories.  Stories  of  children  and  teenagers  for 
whom tablets and smartphones, along with social media platforms and messaging apps, have 
become  integral  to  their  lives,  sometimes  at  the  detriment  of  physical  and  mental  health.  
Stories  of  socially  excluded  people  facing  discrimination.  Stories  of  elderly  people  feeling 
lonely, of workers experiencing burnout; parents no longer able to cope and of people feeling 
isolated, because of who they are or where they live.  

According  to  the  EU  Charter  of  fundamental  rights,  everyone  has  the  right  of  access  to 
preventive  health  care  and  the  right  to  benefit  from  medical  treatment  under  the 
conditions  established  by  national  laws  and  practices.  According  to  the  European  Pillar  of 
Social  rights,  everyone  has  the  right  to  timely  access  to  affordable,  preventive  and  curative 
health care of good quality. 

Part of a healthy society must be that people know that help can be found, and that support 
and  affordable  high-quality  treatment  can  be  accessed.  It  should  be  a  major  public  policy 
goal  to  ensure  that  no  one  is  left  behind,  that  citizens  have  equal  access  to  prevention  and 
mental  health  services  across  the  EU,  and  that  reintegration  and  social  inclusion  guides 
collective  action  addressing  mental  health  illnesses.  Effective  guidance,  coordination, 
reinforced  support  and  targeted  action  are  needed  to  bring  Europe  closer  to  that  goal.  The 
analysis  of  demographic  change  can  inform  targeted  interventions,  as  demographic  factors 
can help to identify high-risk groups that may require specific support or resources, and tailor 
policy accordingly. 

Responding to this reality and to the citizens’ call for action on mental health in the context of 
the Conference on the Future of Europe, President von der Leyen announced a new initiative 
on mental health in the EU. As part of the Commission’s priority ‘Promoting our European 
way of life’, this initiative marks a turning point in the way mental health is addressed in the 
EU. The Commission is also responding to the call for action from the European Parliament 
following its resolution from 2022 on mental health in the digital world of work7 calling  on 
the  EU  institutions  and Member  States  to  recognise  the  scale  of  work-related  mental  health 
problems  in  the  EU  and  to  act  accordingly.  This  Communication  is  the beginning  of  a  new 
strategic  approach  to  mental  health,  cross-sectoral  in  nature,  going  beyond  health  policy.  It 
focuses  on  how  to  bring  relief  to  people  suffering  from  mental  health  and  on  prevention 
policies. It draws on three guiding principles that should apply to every EU citizen: (i) to 
have  access  to  adequate  and  effective  prevention,  (ii)  to  have  access  to  high  quality  and 
affordable  mental  healthcare  and  treatment,  and  (iii)  to  be  able  to  reintegrate  society  after 
recovery. 

These guiding principles inform all aspects of this initiative and are directly mirrored in the 
chapters therein.  

Today’s  comprehensive  approach  to  mental  health  calls  upon  national  and  regional  actors, 
health and non-health policy sectors and relevant stakeholders, ranging from patient and civil 

7 https://www.europarl.europa.eu/doceo/document/TA-9-2022-0279_EN.html. 

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society organisations, to academia, and industry, to work together. It aims to put tools in place 
to drive change, including at global level, boost existing structures and monitor actions.  

It  will  support  Member  States  in  their  efforts  to  achieve  the  World  Health  Organization 
(WHO)  targets  for  non-communicable  diseases  by  20258  and  the  Sustainable  Development 
Goals (SDG)9 by 2030, including on mental health. 

a.  Integrating mental health across policies 

A  comprehensive  approach  must  recognise  the  influence  of  biological  and  psychological 
factors,  as  well  as  the  importance  of  the  family,  community,  economy,  society,  the 
environment and security. This includes the role of the combination between work and care, 
the  school  and  workplace  settings  as  well  as  the  digital  world,  the  social  (e.g.  levels  of 
violence  experienced,  gender,  behaviour,  education10),  economic  (e.g.  instability,  inflation, 
poverty  and  unemployment)  and  commercial  (e.g.  pressure  from  aggressive  marketing) 
determinants of health. 

Consequently,  policies  in  areas  such  as  education,  youth,  arts  and  culture,  environment, 
employment,  cohesion,  research  and  innovation,  social  protection,  sustainable  urban 
development, and the digital world, are needed to improve mental health and support mental 
health  resilience.  Obstacles  to  good  mental  health  cannot  be  overcome  within  the  health 
system alone11. 

Determinants  of  mental  health  interact  with  existing  inequalities  in  society,  putting  some 
people  at  a  higher  risk  of  poor  mental  health  than  others.  When  discrimination  based  on 
gender, racial or ethnic origin, religion or belief, disability, age or sexual orientation, violence 
and  hate  act  as  cause  for  poor  mental  health,  promoting  equality  in  our  societies  is  an 
important tool for prevention. The Commission adopted five equality strategies12 in 2020 and 
2021  to  make  progress  towards  a  Union  of  Equality.  All  strategies  stress  the  risk  of 
discrimination  leading  to  poorer  mental  health.  Childhood  is  a  crucial  stage  in  life  in 
determining future mental health, as stressed in the EU Strategy on the rights of the child13, 
which calls for a comprehensive approach to prevent and protect children from any form of 
violence.   

The 2022 European Year of Youth focused on re-establishing a positive outlook for young 
people and included activities supporting the mental health and well-being of young people. 

8 On the road to 2025 (who.int). 
9  SDG  Target  3.4  | Noncommunicable  diseases  and  mental  health:  By  2030,  reduce  by  one  third  premature 
mortality from non-communicable diseases through prevention and treatment and promote mental health and 
well-being.  

10 Education: a neglected social determinant of health - The Lancet Public Health.  
11 Fitter Minds, Fitter Jobs : From Awareness to Change in Integrated Mental Health, Skills and Work Policies | 

Mental Health and Work | OECD iLibrary (oecd-ilibrary.org). 

12  Gender  equality  strategy;  LGBTIQ  equality  strategy;  Roma  strategic  framework;  Strategy  for  the  Rights  of 

Persons with Disability. 

13 The EU Strategy on the Rights of the Child and the European Child Guarantee (europa.eu). 

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The European Year of Skills will promote during 2023 investment in training and upskilling 
to increase life opportunities and improve the adaptability of people and workers to change, 
which is of relevance to the promotion of a comprehensive approach to mental health. 

A  mental  health  policy  that  delivers  for  all  needs  to  work  across  relevant  policy  areas.  For 
instance,  there  is  a  growing  body  of  research  pointing  to  the  insight  of  inter-connectedness 
and reconnection to nature as having a positive impact on mental health. At the same time, the 
impact of pollution on mental health is widely recognised, including through air pollution or 
citizens’  exposure  to  toxic  chemicals.  The  targets  and  actions  under  the  European  Green 
Deal  to  promote  clean  environment,  re-naturalised  and  restored  sites  and  urban  greening, 
positively affect our physical and mental health.  

To  remedy  the  risks  related  to  the  use  of  digital  services,  including  risks  related  to  mental 
health,  the  Digital  Services  Act14  (DSA)  creates  a  wide  set  of  due  diligence  obligations 
applicable  to  online  intermediaries.  To  allow  targeted  remedies  and  address  public  policy 
concerns effectively, the DSA recognises the specific risks related to serious negative effects 
on  a  person’s  physical  and  mental  well-being,  as  well  as  consequences  at  physical  and 
mental  development  of  children  potentially  caused  by  using  these  platforms.  The  largest 
platforms and search engines, i.e. those having more than 45 million of users in the Union, are 
obliged  to  assess  the  systemic  risks  that  their  services  pose  on  mental  health  and  adopt 
measures to mitigate the identified risks15.  

The Commission is already supporting the transfer of relevant best practices from Member 
States and stakeholders to promote mental health across all policies in communities16 through 
the Expert Group on Public Health17. 

A study to analyse the effectiveness of upscaling policies on mental health and well-being 
in the Member States18 is underway to better support policy-making.  

FLAGSHIP INITIATIVES 

1. EUROPEAN MENTAL HEALTH CAPACITY BUILDING INITIATIVE  

 

In  2023,  the  Commission  will  allocate  EUR  11  million  under  the  EU4Health 
programme  to  support  Member  States  in  building  capacity  for  an  approach  that 

14  Regulation  (EU)  2022/2065  of  the  European  Parliament  and  of  the  Council  on  a  Single  Market  for  Digital 
Services  and  amending  Directive  2000/31/EC  (Digital  Services  Act),  https://eur-lex.europa.eu/legal-
content/EN/TXT/?uri=celex%3A32022R2065.  

15  This  might  include,  for  example,  mitigation  of  negative  effects  of  personalised  recommendations  and 
correction  of  criteria  used  in  their  recommendations,  discontinuation  of  advertising  revenue  for  specific 
information or adaptation of the visibility of authoritative information sources.  

16 Such as EAAD’s Best Practice Model to Improve Depression Care and Prevent Suicidal Behaviour in Europe 

funded under EU 3rd Health Programme: EUR 2 million. 

17 https://health.ec.europa.eu/non-communicable-diseases/expert-group-public-health_en 
18  Financial  support  under  EU4Health  2021  work  programme:  DP-g-07.2.1  Collection  and  support  for 
implementation  of  innovative  best  practices  and  research  results  on  non-communicable  diseases:  budget 
reinforced by redistribution of funds: EUR 1 million. 

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promotes mental health across all policies together with the WHO19. 

  The Commission will allocate EUR 10 million20 to support the role of stakeholders in 
promoting mental health in communities focusing on vulnerable groups, including 
children and young people and migrant/refugee populations. 

  In 2024, the Commission  will launch a  blueprint (toolkit) for a  multi-disciplinary 

approach to mental health capacity building. 21 

Member  States  are  urged  to  adopt  an  approach  that  promotes  mental  health  across  all 
policies. Particular focus should be placed on promotion, prevention22, early intervention, 
addressing  stigma,  ensuring  the  social  inclusion  of  people  living  with  mental  health 
problems.  In  addition,  Member  States  should  support  programmes  to  help  people  for 
employment or take part in return-to-work programmes. The digital domain, including at the 
workplace,  brings  psychosocial  risks  significantly  affecting  people,  organisations  and 
economies23. Particular attention to the promotion of work-life balance is needed. 

b.  Promoting good mental health,  prevention and early intervention for 

mental health problems 

People  experiencing  mental  health  issues  need  to  know  where  to  ask  for  help.  Today, 
available services and tools are scattered and vary largely across the EU. Also, they are not 
sufficiently visible and known to people. This needs to change.  

The  promotion  of  good  mental  health,  prevention  of  mental  health  problems  and  early 
interventions are more effective and cost-effective than treatment. Economic evidence for the 
effectiveness of investments in this approach is strongest for early interventions focusing on 
maternal  and  infant  health,  children  and  adolescents,  mental  health  in  the  workplace  (see 
chapter e), and the prevention of suicide and self-harm24. Research needs to be strengthened 
in this area to better recognise early signals of concern and Horizon Europe has an earmarked 
budget for this25.  

People's health is influenced by their life experiences and environments in which they spend 
their lives. Health determinants, from nutrition and physical activity, harmful consumption 

19  Through  a  contribution  agreement  with  the  WHO  (budget  reinforced  by  redistribution  of  funds:  EUR  11 
million) under the EU4Health 2022 work programme: DP-g-22-07.02 Addressing mental health challenges. 
20  Financial  support  under  EU4Health  2022  work  programme:  DP-g-22-07.01/03/04  Call  for  proposals  on 

promoting mental health: EUR 10 million. 

21 Capacity-building on mental health: multidisciplinary training programme and exchange programme for health 

professionals: EUR 9 million 

22  Joint  Research  Centre’s  Health  Promotion  and  Disease  Prevention  Knowledge  Gateway  (prevention  of 

depression, work-related stress, and dementia). 

23 Communication on an ‘EU Strategic Framework on Health and Safety at Work 2021-2027’ acknowledges the 
importance of addressing psychosocial risks at work, including in the light of the digitalisation transition. 

24 https://www.annualreviews.org/doi/full/10.1146/annurev-publhealth-040617-013629. 
25  Horizon  Europe  Health  Calls  2023  -  The  Silver  Deal  -  Person-centred  health  and  care  in  European  regions 

(Destination 1) (europa.eu). 

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of  alcohol,  tobacco  and  drugs,  as  well  as  environmental,  social  and  commercial 
determinants, including living conditions, better housing, clean air, access to sport, culture, 
and  green  areas,  and  a  better  work-life  balance,  as  well  as  risks  of  violence  all  have  an 
important impact on mental health.  

Physical  activity  and  sports  play  an  important  role  in  the  promotion  of  good  mental  health. 
The EU will continue to promote sport and health-enhancing physical activity, via the EU 
work plan for sport and the European Week of Sport.  

Early  intervention  can  ensure  timely  support  and  may  prevent  further  deterioration  of 
wellbeing  and  mental  health,  especially  among  young  people26.  For  example,  early 
intervention can be key in recognising and addressing risk factors and signs of various forms 
of  distress  people  may  be  experiencing.  Also,  a  variety  of  settings,  such  as  schools, 
workplaces,  elderly  homes  and  prisons,  are  key  places  for  mental  health  promotion, 
prevention and  early identification and intervention. School-based programmes to promote 
mental  health  and  well-being  and  involving  a  variety  of  actors  and  services27  in  the 
community, for instance, can identify and address problems at an early stage.  

The  Commission  will  launch  a  call  in  2023  for  Member  States  and  stakeholders  to  submit 
best practices on mental health promotion, prevention, early detection and early intervention, 
via the EU Best Practice Portal28. It will develop, together with Member States, initiatives to 
the  key  behavioural,  economic,  social,  environmental  (including  pollution) 
address 
transgenerational and commercial determinants of mental health through collaborative work, 
under the ‘Healthier Together’ initiative  29.  It  will support the development of guidance on 
early detection and intervention and the screening of vulnerable groups in key settings to be 
piloted by Member States30. The Commission will step up its work on brain research with 
the launch of new projects, including through the use of digital health data31, computing and 
simulation infrastructures32. 

FLAGSHIP INITIATIVES 

2. EUROPEAN DEPRESSION AND SUICIDE PREVENTION INITIATIVE 

  The  Commission  will  dedicate  EUR  6  million  to  reducing  the  risk  for  people  to 
experience  severe  mental  health 
the  development  and 
implementation  of  depression  and  suicide  prevention  policies  in  Member  States 

issues  by  supporting 

26 Preventive psychiatry: a blueprint for improving the mental health of young people (nih.gov). 
27 In line with Pathways to School Success Council Recommendation. 
28 BP Portal (europa.eu). 
29 Through actions funded under the EU4Health Programme (2021-2027). 
30 Through funding under EU4Health 2022 work programme (technical support for expert groups).   
31 The Proposal for a Regulation on the European Health Data Space aims to facilitate better access to health data 

for research and innovation, including in the area of brain research. 

32 European Research Infrastructures (europa.eu). 

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based on the exchange of best practice (2023).  

3. HEALTHIER TOGETHER INITIATIVE – MENTAL HEALTH 

  The  Commission  will  allocate  EUR  8.3  million  to  strengthen  the  mental  health 
strand of the ‘Healthier Together’ EU non-communicable diseases initiative, with 
the  aim  to  support  Member  States’  actions  on  promoting  mental  health,  creating 
supportive environments and policies, enhancing social inclusion and tackling stigma 
and discrimination associated with mental health issues33. 

4. ACCESS GATE FOR PEOPLE EXPERIENCING MENTAL HEALTH ISSUES  

  The  Commission  will  create  an  EU  repository  under  the  EU  Best  Practice  Portal34 
compiling Member States’ best practices to  learn from  each other and  guide people 
towards effective care (hotlines, help points, etc).  

  To  help  people  navigate  through  available  support  services,  Member  States  will  be 
invited35  to  create  national  websites  for  people  to  have  one  point  of  reference  to 
improve access to treatment, support and care.  

5. EUROPEAN CODE FOR MENTAL HEALTH  

  The  Commission  will  dedicate  EUR  2  million36  to  empower  people  experiencing 
mental  health  issues  to  take  better  care  of  their  own  and  their  families  and  carers’ 
mental  health  by  providing  a  set  of  evidence-based  recommendations  that  will  be 
actively promoted and available online.  

6. DEVELOPING JOINT ECOSYSTEM FOR BRAIN RESEARCH 

  The Commission will strengthen research on brain health, including on mental health, 
by working closely with Member States to create an ecosystem. This ecosystem would 
bring  researchers  and  stakeholders  together  to  facilitate  and  coordinate  activities  in 
order to maximise EU and Member States’ research investments.  

Member  States  are  urged  to  use  EU  funding  opportunities  and  to  collaborate  to  implement 
initiatives  and  best  practices  on  mental  health  promotion  and  prevention,  to  address  the 
links  between  inequalities  and  mental  health  by  increasing  efforts  to  combat  stigma, 
discrimination,  hate  speech  and  violence,  and  to  provide  adequate  training,  upskilling  and 
reskilling of the health and social care workforce in the promotion of mental health and well-
being.  Countries  should  also  deal  with  the  challenges  related  to  the  prevention  of  mental 
health  problems  of  vulnerable  communities,  reinforce  early  recognition  of  mental  health 
issues,  provide  early  interventions  and  support,  and  address  the  links  between  exclusion, 
inequalities and mental health  by increasing efforts  to  combat discrimination,  hate speech 
and violence. 

33 Expert Group on Public Health. 
34 EU Best Practice Portal: BP Portal (europa.eu). 
35 Under the Expert Group on Public Health’s subgroup on mental health. 
36 2023 EU4Health Work Programme (europa.eu). 

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c.  Boosting the mental health of children and young people 

Europe is witnessing a worsening of the mental health of our younger generations. During 
the COVID-19 pandemic, most children were kept out of classrooms and deprived of social 
interaction  and  physical  activity,  and  depression  among  young  people  more  than  doubled37. 
Loneliness,  an  important  component  of  well-being  and  mental  health,  has  reached  alarming 
levels. In 2022, one in every five people aged between 16 and 25 reported feeling lonely most 
of the time38. 

Child poverty  can have  detrimental  effects  on mental  health. The Council  Recommendation 
establishing  a  European  Child  Guarantee39  addresses  some  of  those  challenges.  Bullying 
prevention programmes in schools40 are an effective way to support the psychological well-
being of children and young people.  

Young  people  are  increasingly  dealing  with  anxiety,  sadness  or  fear,  self-harm,  low  self-
esteem,  bullying  and  eating  disorders.  Forcibly  displaced  and  migrant  children,  including 
those who have been forced to flee Russia’s war of aggression in Ukraine, and children who 
are victims of sexual exploitation, other crime and abuse, are particularly at risk.  

Children  are  affected  by  different  interconnected  health,  environmental,  social  and 
commercial determinants, and also by the consequences of online crimes such as online child 
sexual  abuse.  There  are  instances  when  children  and  young  people  face  adversities  during 
some  of  the  most  vulnerable  and  formative  years  of  their  lives,  which  can  shape  their 
health and mental health throughout their entire lifetime.  

Young people are also strongly preoccupied by climate change and biodiversity loss. A recent 
survey41  concluded  that  75%  of  children  and  young  respondents  saw  their  future  as 
“frightening”.  At  the  same  time,  the  study  revealed  that  climate  anxiety  and  distress  were 
correlated with perceived inadequate government response and associated feelings of betrayal. 
The EU’s commitments to reaching climate neutrality by 2050 and to the Kunming-Montreal 
Global  Biodiversity  Framework  are  therefore  are  also  important  for  our  children’s  mental 
health.   

Digital  tools  can  have  a  positive  impact  on  mental  health  (e.g.  by  providing  access  to 
information,  support  groups,  and  therapy  services)  but  can  also  affect  mental  health 
negatively.  A  move  towards  a  safer  and  healthier  digital  space  for  children42  is  needed. 
This  includes:  protecting  them  from  inappropriate  content,  the  intrusive  harvesting  of 
information and aggressive online marketing of unhealthy food, beverages, beauty standards 
and alcohol and tobacco, a prudent use of social media, addressing online child sexual abuse, 
illicit  drugs  and  new  psychoactive  substances,  with  safeguards  against 
access 

to 

37 From pre-pandemic (2019 or nearest year) to pandemic levels (April 2020 -  August 2021): Health at a Glance: 

Europe report, 2022. 

38 Loneliness publications (europa.eu).  
39 Council Recommendation establishing a European Child Guarantee. 
40 Well-being at school | European Education Area (europa.eu). 
41 https://www.sciencedirect.com/science/article/pii/S2542519621002783. 
42 Creating a better Internet for kids | Shaping Europe’s digital future (europa.eu). 

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cyberbullying,  hate  speech,  excessive  screentime  and  the  digital  editing  of  images;  a  well-
balanced use of gaming, which helps to prevent compulsive use and negative effects on daily 
life. 

In  relation  to  physical  and  mental  development  of  children,43  the  Digital  Services  Act44 
(DSA)  recognises  certain  systemic  risks  stemming  from  the  design  or  functioning  of  the 
service  and  systems,  including  algorithmic  systems,  of  those  services  designated  as  “very 
large  online  platforms”  or  “very  large  online  search  engines”.  Such  risks  may  arise,  for 
example, in relation to the design of online interfaces which intentionally or unintentionally 
exploit the weaknesses and inexperience of minors or which may cause addictive behaviour. 

For  those  platforms  that  are  not  designated  as  “very  large”,  the  DSA  also  imposes  targeted 
measures to better protect minors online by, for example, designing their interface or parts 
thereof with the highest level of privacy, safety and security for minors by default, adopting 
protection  standards  or  participating  in  relevant  codes  of  conduct.  Furthermore,  the  DSA 
prohibits providers of online platforms presenting online advertising on their interface, when 
they are aware with reasonable certainty that the recipient of the service is a minor.  

The Better internet for children (BIK+) strategy45, complementary to the DSA, offers support 
for children’s mental health when online via the Safer Internet Centres and the BIK portal 
which offers a wealth of age-appropriate resources for children, families and teachers. These 
helplines  of  the  Safer  Internet  Centres  offer  practical  support  and  advice  to  children  facing 
problems online, such as cyberbullying, grooming and disturbing content, and to their parents 
or guardians. 

Children are in a more vulnerable situation than adults to express their worries.  In line with 
the EU Strategy on the rights of the child, the Commission will present in 2024 an initiative 
on  integrated  child  protection  systems,  which  will  encourage  all  relevant  authorities  and 
services to better work together in a system that puts the child at the centre. Children will be 
consulted  in  its  preparation,  including  on  the  mental  health  dimension,  under  the  newly 
created  EU  Children’s  Participation  Platform.  The  voice  of  children  should  be  heard,  and 
for  this,  targeted  tools  and  initiatives  are  necessary.  The  Commission  will  support  the 
implementation  of  the  EU  strategy  for  a  more  effective  fight  against  child  sexual 
exploitation  and  abuse46  by  improving  prevention,  assistance  to  victims,  and  investigation 
and prosecution efforts. To address the specific  challenges of children and youth living in 
rural or remote areas and particularly affected by insufficient mental health support services, 
the Commission will include dedicated actions under the EU rural action plan. It will ensure 
that the European Solidarity Corps will continue to support activities related to prevention, 

43 Article 34(2)(b) and (d).  
44 Digital Services Act.   
45  A  Digital  Decade  for  children  and  youth:  the  new  European  strategy  for  a  better  internet  for  kids  (BIK+) 

COM/2022/212 final. 

46 EU Strategy for a more effective fight against child sexual abuse (europa.eu). 

9 

 
 
                                                 
promotion and support in the field of health, in line with the HealthyLifeStyle4All47, with a 
special focus on supporting vulnerable or disadvantaged population groups.  

Prevention  and  early  interventions  by  professionals  in  contact  with  children,  such  as 
teachers, can promote the mental health resilience of children and young people and mitigate 
potential harms, in particular by giving them a voice. Nurseries and schools represent an ideal 
setting  to  equip  young  children  with  the  skills  to  regulate  their  emotions  and  develop  their 
understanding of mental  health, developing skills,  like empathy  and building self-awareness 
and self-confidence. This requires adequately trained staff, a worthy investment that can help 
reduce  stigma  around  mental  health  issues  and  build  a  more  resilient  and  cohesive  society. 
to  mental  health  have  been 
School-based 
demonstrated  to  improve  student’s  mental  health,  cognitive  skills,  attention  span,  academic 
outcomes  and  resilience  to  stressors48.  The  Child  Helpline  International49  provides  mental 
health  support  to  children  which  can  include  emotional,  psychological  and  sometimes  legal 
support to children who contact the helpline.  

including  holistic  approaches 

initiatives, 

The  Commission  will  support  Member  States  in  implementing  the  European  Child 
Guarantee,  in  line  with  their  national  action  plans  and  through  EU  funds,  in  particular 
European  Social  Fund  Plus,  and  by  facilitating  the  exchange  of  good  practices  between  the 
Child  Guarantee  Coordinators.  Countries  will  also  be  supported  in  their effort  to  strengthen 
national  capacity  building  for  health  care  and  other  professionals,  and  invited  to  use  the 
financial  opportunities  of  the  EU  budget  to  increase  action  on  prevention  and  early 
interventions  outside  the  health  sector,  namely  in  the  educational  setting.  The  Commission 
will also monitor progress via the European Semester.  

The  Commission  will  continue  to  implement  the  EU  Youth  Strategy  (2019-2027)50  to 
achieve better mental health and well-being and end stigmatisation. 

The  Commission  will  strengthen  mental  health  promotion  in  educational  settings  by 
supporting  the  implementation  of  the  Pathways  to  School  Success  initiative51.  The 
Commission’s  expert  group  on  supportive  learning  environments  for  groups  at  risk  of 
underachievement and for supporting well-being at school will develop guidelines in 2024 on 
a systemic,  whole-school  approach for well-being  for policy-makers  at  local,  regional  and 
national  level  and  for  schools52.  The  Commission  will  propose  a  self-assessment  and  self-
improvement  toolkit  on  well-being  at  school  and  will  put  forward  recommendations  for 
awareness raising activities at national and EU level. Funding opportunities for projects will 

47 The HealthyLifestyle4All Initiative | Sport (europa.eu). 
48 How school systems can improve health and well-being: topic brief: mental health (who.int). 
49 Home - Child Helpline International: funded under the Citizens, Equality, Rights and Values programme. 
50 EUR-Lex - 42018Y1218(01) - EN - EUR-Lex (europa.eu). 
51 EUR-Lex - 32022H1209(01) - EN - EUR-Lex (europa.eu). 
52 These guidelines should include mental well being and prevention of bullying, and also address work-related 
stress  of  teachers  and  violence,  as  well  as  bullying  of  teachers  as  part  of  a  whole  school  approach.  Link: 
https://osha.europa.eu/en/publications/occupational-safety-and-health-and-education-whole-school-
approach#:~:text=A%20Whole%2DSchool%20Approach%20to,pupils%20in%20school%20safety%20manag
ement 

10 

 
 
                                                 
be  available  through  Erasmus+  and  European  Solidarity  Corps,  to  foster  mental  health  and 
well-being of  young people and the Erasmus+ Training and Cooperation long-term Activity 
on  “Mental  Health  in  Youth  Work”  will  continue  to  raise  awareness  and  develop  mental 
health literacy. 

 FLAGSHIP INITIATIVES 

7. CHILD AND YOUTH MENTAL HEALTH NETWORK 

 

In 2024, the Commission will support the creation of a child and  youth  mental health 
network 
information,  mutual  support  and  outreach  via  youth 
ambassadors53.  

to  exchange 

8. CHILDREN HEALTH 360 

 

In  2023,  the  Commission  will  develop  a  prevention  toolkit  focusing  on  prevention, 
early intervention of children at risk and addressing the interlinks between mental and 
physical health and key health determinants54. Special attention will be paid to the risks 
of bulling in educational settings.  

9.YOUTH FIRST FLAGSHIP (A TECHNICAL SUPPORT INSTRUMENT 2023 FLAGSHIP55) 

 

In 2023, the Commission will develop tools for children and young people to actively 
address, for example, healthy lifestyles and the prevention of mental health problems in 
close cooperation with children and young people56 (EUR 2 million). 

10. HEALTHY SCREENS, HEALTHY YOUTH 
The Commission will support the following activities: 

  continuation of implementation of the Better Internet for Kids strategy (BIK+)57;  
  practical  guidance  for  authorities  on  improving  the  protection  of  children  in  the 
digital  world,  complemented  by  a  monitoring  of  the  impact  of  the  digital 
transformation on children’s well-being through the Better Internet for Kids portal; 
  code  of  conduct  on  age-appropriate  design58  to  be  facilitated  by  the  Commission 

 

building on the new rules in the DSA; 
facilitate  continuation  and  reinforcement  of  the  work  under  the  code  of  conduct  on 
countering illegal hate speech online, under the DSA59.  

The  Commission  encourages  Member  States  to  collaborate  on  policies  and  initiatives 
targeting the specific challenges related to children and young people’s mental health, and 

53 Under the Healthier Together initiative and funded under the EU4Health programme. 
54 Under the Healthier Together initiative and funded under the EU4Health programme. 
55 EUR 2 million under the TSI 2023 work programme: project will be launched in autumn 2023. 
56  The  Commission  will  provide  technical  support,  together  with  UNICEF,  to  Cyprus,  Italy,  Slovenia  and 
Andalusia,  to  enhance  collaboration  between  different  sectors:  health,  education,  social  services  and  child 
protection systems: . 

57 Better Internet for Kids Strategy. 
58 The Code of conduct on age appropriate design will support the implementation of Art 28 of the DSA, and be 

recognized as a code under art 45 of the DSA 

59 Engagement of the European Board of Digital Services is foreseen for any DSA Code of Conduct.  

11 

 
 
 
 
 
 
 
                                                 
to  address  the  links  between  mental  health  problems  and  health  determinants  and  use  of 
digital tools. The Commission invites Member States to identify children as a priority target 
group in their national mental health strategies and build up networks with families, schools, 
youth, and other stakeholders and institutions involved in mental health of children. Member 
States are urged to ensure that children have better access to mental health services, as well 
as  equal  and  easy  access  to  healthy  nutrition  and  regular  physical  activity,  live  in  safe  and 
supportive environments, and are protected from consumption of alcohol, tobacco and drug-
use  problems  and  negative  impacts  of  digital  use.  Member  States  are  invited  to  implement 
innovative approaches and best practices identified in the ‘Healthier Together’ initiative on 
the mental health of children and young people and participate in the initiative’s collaborative 
work to address the impact of health determinants, including economic, commercial, social 
and environmental determinants, and the impact of the digital transformation on children and 
young people’s mental health and wellbeing. 

d.  Helping those most in need 

Mental illness is associated with many forms of inequalities and special attention must be paid 
to people in vulnerable situations. Individuals may belong to one or more vulnerable groups 
at the same time, such as for example single mothers in poverty or disabled people recovering 
from severe illness.  

In  the  context  of  challenging  demographic  changes  mental  health,  social  and  long-term 
care  services  must  be  accessible,  affordable,  integrated60,  community-based  and  user 
friendly. Older people61 should be empowered to lead a healthy and active lifes, manage their 
own mental  health and  to  increase  their social interactions62  and reduce loneliness. Creative 
solutions such as intergenerational housing, are to be encouraged. 

The Commission is raising awareness on the need to address loneliness and social isolation 
to promote good mental health63, and will support Member States through the collection and 
transfer of best practices via the EU Best Practice Portal. 

Women are almost twice as likely as men to experience depression. This is due to a multitude 
of factors such as biology, life circumstances and cultural stressors.64  

Victims of gender-based violence (GBV) are particularly vulnerable. The Commission will 
enhance  the  protection  and  support  to  victims  of  gender-based  violence,  including  cyber 
violence,  through  the  implementation  of  the  EU’s  upcoming  obligations  under  the  Istanbul 
Convention65  and  the  EU’s  future  directive  on  violence  against  women  and  domestic 

60 An integrated care system for older people means that older adults get the health care they need, where and 

when they need it: Ageing and Health unit (who.int). 

61  In  2021  over  20.8%  of  the  EU  population  was  over  65  years,  a  figure  that  is  projected  to  rise  to 30.3%  by 

2058: Council Conclusions on Mainstreaming Ageing in Public Policies. 

62  Council  Conclusions  on  Human  Rights,  Participation  and  Well-being  of  Older  Persons  in  the  Era  of 

Digitalisation. 

63 Loneliness (europa.eu). 
64 WMH REVIEW FINAL (who.int). 
65 Istanbul Convention: Action against violence against women and domestic violence. 

12 

 
 
                                                 
violence66. The Commission will address the prevention and combating of harmful practices 
against women and girls67 and establish an EU network on the prevention of gender-based 
violence and domestic violence. Postnatal depression and other mental health issues that can 
arise during pregnancy and afterwards must be addressed, to protect the mental health of both 
children and women.  68 The EU-funded HappyMums project69 will explore the physiological 
mechanisms  to  enable  effective  science-based,  clinical  interventions.  Challenges  such  as 
unequal  access  to  employment,  including  non-permanent  contracts  and/or  to  equal  pay, 
unequal  sharing  of  domestic  and  family  care  responsibilities,  and  economic  pressures  and 
dependencies experienced by women must also be tackled. The Commission will contribute 
to improving the situation by ensuring that Member States fully and correctly transpose and 
apply the EU’s legislation on equal opportunities and equal treatment of women and men in 
matters of employment and occupation, on work-life balance for parents and carers as well as 
on pay transparency.  

Discrimination on the grounds of sexual orientation, gender identity, gender expression, 
or sex characteristics can also have an impact on mental health, especially for young people. 
Psychological  distress  that  comes  from  experiences  of  marginalisation,  discrimination  and 
stigmatisation  (‘minority  stress’)  increases  the  risk  of  suicidal  behaviour,  self-harm  or 
depression, and will be addressed in line with the LGBTIQ equality strategy 2020-202570. 

The physical and sexual violence and threats experienced by victims of trafficking in human 
beings  results  in  long-term  mental  health  consequences71.  The  Directive  on  preventing  and 
combating  trafficking  in  human  beings  recognises  the  special  needs  of  victims  with  mental 
health  problems  and  provides  specialised  health  services,  and  long-term  recovery  and 
rehabilitation  support.  The  Commission  facilitates  and  promotes  programmes  supporting 
victims  in  their  recovery  and  re-integration72,  such  as  health  and  psychological  services, 
through the Asylum, Migration and Integration Fund73. 

Many  health  issues  can  lead  to  or  exacerbate  mental  health  problems,  for  example  among 
cancer  patients  considering  it  is  the  second  leading  cause  of  death.  Cancer  does  not  just 
affect your body, it also affects your mind and feelings and often leads to depression, anxiety 
and fear. 

Disabilities  can  often  expose  individuals  to  a  higher  risk  of  developing  mental  health 
problems  and  this  may  require  that  approaches  are  adapted  in  line  with  the  strategy  for  the 

66 EUR-Lex - 52022PC0105 - EN - EUR-Lex (europa.eu) 
67 Commission work programme 2023. 
68 https://cordis.europa.eu/project/id/101057390 
69 HappyMums project. 
70 Union of Equality: LGBTIQ Equality Strategy 2020-2025. 
71 Study on the economic, social and human costs of trafficking in human beings within  the EU - Publications 

Office of the EU (europa.eu). 

72 In line with the EU Strategy on Combatting Trafficking in Human Beings (2021-2025).  
73 Asylum, Migration and Integration Fund (2021-2027) (europa.eu). 

13 

 
 
                                                 
rights  of  persons  with  disabilities74,  that  refers  to  actions  particularly  relevant  for  people 
with  mental  and  intellectual  disabilities,  such  as  promoting  that  Member  States  implement 
good practices of deinstitutionalisation in the area of mental health. 

Autonomy,  independence  and  participation  in  society  are  related  to  mental  health,  which  is 
especially  relevant  for  older  people  and  people  with  disabilities.  Therefore,  it  is  crucial  to 
ensure  physical,  social  and  financial  accessibility,  including  by  improving  access  to  labour 
market  and  facilitating  their  return  to  work.  Two  of  the  Disability  Employment  Package 
guidelines  for  employers  are  dedicated  to  working  with  chronic  diseases  and  the  return  to 
work75.  The  Commission  will  also  issue  guidance  to  Member  States  with  regard  to 
independent living and inclusion in the community before the end of 2023, and in 2024, it 
will  present  a  framework  for  Social  Services  of  Excellence  for  persons  with  disabilities, 
including mental health. 

The symptoms of post COVID-19 condition, commonly known as long COVID, have been 
reported to have a negative impact on mental health76 and poor mental health can increase the 
risk  of  developing  long  COVID.  The  Commission  will  set  up  a  network  on  long  COVID 
with Member States’ experts in 2023. 

Refugees  and  displaced  persons,  notably  those  fleeing  from  war;  persecution  or  conflict 
(such as displaced people from Ukraine) are more prone to develop mental health problems77 
and  early  responses  are  needed  to  reduce  distress.  In  this  context,  the  Commission  will 
continue  to  contribute  to  strengthen  psychosocial  support  for  displaced  people  and  in 
particular to the provision of psychological first aid to people affected by the Russian war of 
aggression against Ukraine.78 

The Commission will launch a call for proposals under the Asylum, Migration and Integration 
Fund79 aiming at reducing obstacles for migrants to access health services, including mental 
health services and psychological support.  

Mental ill-health is common among people experiencing homelessness80 and long-term and 
repeated homelessness reinforces mental ill-health and disability. Within the framework of the 
European  platform  on  combating  homelessness  mental  health  challenges  are  being 
addressed.  

74 In 2021, the European Commission adopted the strategy for the rights of persons with disabilities (2021-2030) 
in line with the UN Convention on the Rights of Persons with Disabilities to which the EU and its Member 
States are party. 

75 Disability Employment Package. 
76 Long COVID and mental health correlates: a new chronic condition fits existing patterns - PubMed (nih.gov). 
77  According  to  the  WHO,  an  estimated  1  in  5  people  who  are  now  experiencing  the  ravages  of  war  will  be 
dealing with a mental health condition within the next 10 years, and 1 in 10 will have a severe condition like 
post-traumatic stress disorder or psychosis. 

78 See flagship action on Mental Health support for Ukraine’s displaced and affected people. 
79 Asylum, Migration and Integration Fund (2021-2027) (europa.eu). 
80 Nicholas Pleace (2023) Social and healthcare services for homeless people: a discussion paper forthcoming in 

European Platform on Combatting Homelessness. 

14 

 
 
                                                 
Roma may be at a higher risk for mental health problems, given their often difficult situation 
arising  from  poor  socio-economic  income,  circumstances  and  exclusion,  lack  of  access  to 
education  and  employment,  inadequate  housing,  segregation,  exclusion  and  discrimination, 
including in health-related aspects. The EU Roma strategic framework for equality, inclusion 
and participation includes the sectorial objective of improving Roma health and increasing the 
effective equal access to quality healthcare and social services.81 

Victims  of  crimes,  in  particular  those  who  have  suffered  considerable  harm  due  to  the 
severity of the crime or because of their personal characteristics, such as victims of terrorism, 
victims  of  trafficking,  victims  of  hate  crime,  child  victims  or  any  other  victim  in  need  of 
psychological aid, should have access to such aid free of charge and for as long as necessary.  
Within  the  upcoming  revision  of  the  Victims’  Rights  Directive82,  the  Commission  is 
working  on  strengthening  victims’  access  to  psychological  aid,  notably  by  making 
psychological aid free of charge for as long as necessary for all victims in need of such help.  

.  

People  living  in  rural  or  remote  areas,  such  as  farmers,  have  particular  mental  health 
challenges  associated  with  the  risk  of  disconnection  and  lack  of  access  to  mental  health 
services.  Suicide  rates  among  farmers  are  20%  higher  than  the  national  average  in  certain 
Member  States83,  which  is  why  support  will  be  offered  to  strengthen  their  resilience.  CAP 
funds  can  support  awareness  raising  activities  including  in  the  area  of  mental  health  for 
example via farm advisory services. In addition, other funds could also be mobilised, such as 
the European Social Fund+ or the European Fund for Regional Development, to enhance the 
investments into the social support services in rural and remote areas and thus guarantee that 
they  are  accessible  to  farmers  and  agriculture  workers  in  need,  regardless  of  their  place  of 
residence. 

81 https://commission.europa.eu/system/files/2021-

01/eu_roma_strategic_framework_for_equality_inclusion_and_participation_for_2020_-_2030_0.pdf. 
82 Directive 2012/29/EU of the European Parliament and of the Council of 25 October 2012 establishing 
minimum standards on the rights, support and protection of victims of crime, and replacing Council 
Framework Decision 2001/220/JHA, OJ L 315, 14.11.2012, p. 57 – 73. 

83 2018 report by Public Health France 

15 

 
 
 
                                                 
FLAGSHIP INITIATIVES 

11. PROTECTING VICTIMS OF CRIME 

  By  Q2  of  2023,  the  Commission  will  seek  to  improve  the  access  of  crime  victims  to 
psychological  and  mental  health  support  by  revising  the  Directive  establishing 
minimum standards on the rights, support and protection of victims of crime. 

12. CANCER MISSION: PLATFORM FOR YOUNG CANCER SURVIVORS 

  The Commission will provide young cancer survivors with a platform to help them to 

boost their mental health, via the Horizon Europe Cancer Mission84. 

  The  Commission  will  support  collaborative  work  between  Member  States  to  provide 
psychological support to cancer patients, their carers and families (EUR 8 million)85. 

The  Commission  encourages  Member  States  to  improve  access  to  digital  tools  with  proven 
usability  for older  people  to  improve  their mental  health  and help  them  participate  in  social 
life.  Member  States  are  encouraged  to  collect  data  on  the  mental  health  status  of  people  in 
vulnerable  situations,  including  homeless  people,  and  on  accessibility  of  services  in 
marginalised and remote and disadvantaged areas. The Commission urges Member States to 
ensure equal access without barriers to quality and affordable healthcare and social services, 
especially for those groups most at risk or those living in marginalised or remote localities86 
and to address the specific situation for Roma, by improving access to mental health services 
and  primary  prevention  measures,  for  example  through  awareness  raising  campaigns.  In 
addition,  the  Commission  urges  Member  States  to  implement  good  practices  for  de-
institutionalisation,  including  for  children,  and  to  strengthen  the  transition  to  community-
based services. 

e.  Tackling psychosocial risks at work 

People spend a significant part of their time at work and a good work environment is crucial 
for  health.  Stress  and  psychosocial  risks  at  work  can  impact  mental  health  and  lead  to 
decreased  job  satisfaction,  conflict,  lower  productivity,  burnout,  absenteeism,  and  turnover. 
Mental  health  is  a  precondition  for  work  ability,  competence  and  productivity.  However, 
around  half  of  European  workers  consider  stress  to  be  common  in  their  workplace  and  it 
contributes to around half of all lost working days.  At the same time, psychosocial risks and 
work-related stress are among the most challenging issues in occupational safety and health. 

84 EU Mission: Cancer (europa.eu). 
85  Financial  support  under  EU4Health  2023  work  programme:  CR-g-23-19.01  action  grants  on  mental  health 

challenges for cancer patients and survivors. 

86 For example, as set out in the Council Recommendation on Roma equality, inclusion and participation. 

16 

 
 
 
 
 
 
 
                                                 
New  forms  of  work  brought  by  digitalisation  and  accelerated  by  the  Covid-19  pandemic 
(such  as  platform  and  remote  work)  have  affected  workers’  mental  health,  even  if  the 
flexibility  of  such  forms  of  work  could  also  prove  beneficial.  Essential  workers,  and  in 
particular health and social care workers, appeared to be the most at risk of being exposed to 
work-related psychosocial risks in the post-pandemic context87. 

Employers  have  a  key  role  in  ensuring  the  safety  and  health  of  workers  as  defined  in  EU 
Occupational  Safety  and  Health  (OSH)  legislation88.  The  Commission  has  addressed 
psychosocial  risks  and  mental  health  at  work  over  the  years  in  its  OSH  strategic 
frameworks89.  There  is  a  particular  focus  on  mental  health  and  psychosocial  risks  in  the 
Communication on an “EU strategic framework on health and safety at work 2021-2027”90.  

Moreover, the need to reflect  on the way forward as regards the  right to disconnect, as an 
integral  part  of  reducing  work-related  stress  and  promoting  a  better  work-life  balance,  the 
right  to  return  to  work  after  mental  illness  as  well  as  a  psychologically  safe  working 
environment  are  both  crucial  to  promoting  mental  health  and  to  creating  a  more  inclusive 
society.  

The Commission welcomes the 2022-2024 work programme of the European cross-industry 
social partners and the ongoing negotiation of a new agreement on teleworking and the right 
to  disconnect,  intended  to  be  put  forward  for  adoption  in  the  form  of  a  legally  binding 
agreement  implemented  via  a  Directive.  The  Commission  will  continue  to  support  social 
partners  in  their  endeavour  to  negotiate  a  new  agreement  on  telework  and  the  right  to 
disconnect,  facilitating  discussions  and  the  identification  of  best  practices,  and  by  assessing 
existing  practices  and  rules  related  to  the  right  to  disconnect.  The  on-going  negotiations  of 
social partners are linked to the resolution of the European Parliament of January 2021 on the 
right to disconnect on which the Commission is committed to follow-up. 

The  Commission  will  ensure  that  EU-OSHA91  finalises  the  overview  on  OSH  and 
digitalisation  which  covers  mental  health  at  work  and  implements  an  OSH  overview  on 
psychosocial and mental health at work, including information on good practices on returning 
to work and working with mental health conditions and of an overview on OSH in the Health 
and Care sectors. The Commission will ensure that EU-OSHA provides updated guidance as a 
follow-up to the 2018 publication “Healthy workers, thriving companies - a practical guide to 
well-being  at  work”92,  and  that  it  carries  out  a  project  on  good  practices  on  supporting 

87 See  https://osha.europa.eu/en/publications/osh-pulse-occupational-safety-and-health-post-pandemic-

workplaces. 

88 Safety and health legislation | Safety and health at work EU-OSHA (europa.eu). The OSH framework directive 
(89/391/EEC) lays down the employer obligation to evaluate the safety and health risks of workers, including 
psychosocial  risks,  and  to  put  in  place  protective  measures.  The  display  screen  equipment  Directive 
(90/270/EEC), the workplace  directive (89/654/EEC), and the  directive on prevention from sharp  injuries in 
the hospital and healthcare sector (2010/32/EU) also address aspects of work relevant to psychosocial risks. 

89 For example COM(2002) 118; COM(2007) 62; COM/2014/0332. 
90 COM(2021) 323 final. 
91 European Agency for Safety & Health at Work (europa.eu). 
92 Healthy workers, thriving companies – a practical guide to wellbeing at work. 

17 

 
 
                                                 
workers  with  a  work-  or  non-work-related  mental  health  condition  to  stay  in  work  or 
successfully return to work following a sickness absence, with a report by 2024. 

The occupational safety and health (OSH) Summit, held on 15-16 May 2023 by the Swedish 
Presidency and the European Commission, identified psychosocial risks and mental health at 
work as growing OSH issues that need intensified further consideration93.  The Commission 
will follow up on these conclusions of the Summit to improve mental health at work in full 
respect  of  the  tripartism  principle.  It  will  also  continue  the  work  of  the  review  of  the 
Directive  on  the  workplace  (89/654/EEC)94    and  the  Directive  on  work  with  display  screen 
equipment  (90/270/EEC)95.  Finally,  the  Commission  will  support  the  implementation  of  the 
European Care Strategy96 with actions that contribute to the mental well-being of carers and 
those being cared for. 

FLAGSHIP INITIATIVES97 

13. EU-LEVEL INITIATIVE ON THE PSYCHOSOCIAL RISKS 

  The  Commission  will  conduct  a  peer  review  on  legislative  and  enforcement 
approaches to address psychosocial risks at work in the Member States with a view, 
and  subject  to  its  outcomes  and  the  input  of  social  partners,  to  present  an  EU-level 
initiative on the psychosocial risks in the medium term. 

14. EU WORK PLACE CAMPAIGNS 

  EU-wide  EU-OSHA  Healthy  Workplaces  Campaign  -  Safe  and healthy  work in 

the digital age, including a focus on mental health at work (2023-2025); 

  EU-wide  EU-OSHA  Healthy  Workplaces  Campaign  on  psychosocial  risks  and 
mental  health  at  work  with  a  focus  on  new  and  overlooked  occupational  sectors, 
including  agriculture  and  construction,  and  groups  including  low  skilled,  migrant  or 
young workers (2026-2027/28). 

Member States are encouraged to  raise awareness  of the mental health issues of  farmers 
and  populations  in  rural  areas  with  support  from  the  common  agriculture  policy  and 
develop  and  implement  policies  and  best  practices  to  help  focus  on  prevention  and 
strengthen  the  resilience  of  essential  workers,  including  health  professionals,  teachers  and 
farmers.  To  help  Member  States,  the  Commission  will  ensure  that  EU  OSHA  produces  a 
report that addresses psychosocial risks in the agricultural sector. 

Member States are also encouraged to further promote the use of SLIC Guide98 with regard to 
prevention of psychosocial risks for increasing effective monitoring and inspections of OSH 

93 https://ec.europa.eu/social/main.jsp?langId=en&catId=89&furtherNews=yes&newsId=10582#navItem-1  
94 Council directive concerning the minimum safety and health requirements for the workplace. 
95 Council directive on work with display screen equipment. 
96 European Care Strategy. 
97 Financial support provided by EU-OSHA budget. 
98 https://osha.europa.eu/en/legislation/guidelines/labour-inspectors-guide-assessing-quality-risk-assessments-

and-risk-management-measures-regard-prevention-msds 

18 

 
 
 
 
 
 
                                                 
obligations  in  this  regard,  as  well  as  to  participate  in  SLIC  training  events  for  labour 
inspectors.  

f.  Reinforcing mental health systems and improving access to treatment 

and care 

Health  systems  need  to  reinforce  their  capacity  to  lead  action  on  mental  health,  from 
prevention, to early intervention, to diagnosis, treatment and management of care and support 
to  the  reintegration  of  patients.  Reinforcing  mental  health  systems  and  improving  access  to 
treatment and care is therefore a key objective. 

The  right  of  everyone  to  timely  access  to  affordable,  preventive  and  curative  care  of  good 
quality is one of the key principles of the European Pillar of Social Rights. People suffering 
from  mental  health  problems  in  the  EU  do  not  often  have  easy  and  equal  access  to  support 
and  it  often  entails  costs  that  are  not  bearable  for  many.  There  are  disparities  between  and 
within Member States as regards the capacity of health systems to meet the needs of people 
with  mental  ill-health99.  Inequalities  related  to  gender,  ethnicity,  geographical  location, 
including  the  urban-rural  divide,  education,  age  and  sexual  orientation,  gender  identity  or 
expression and sex characteristics have an important impact on the population’s mental health 
and their access to adequate care. 

It is essential to identify best practices and innovative solutions to improve the availability, 
quality, accessibility and affordability of mental health care. To address inequalities, tailored 
care  should  be  provided  to  people  in  vulnerable  situations,  including  displaced  people, 
refugees,  migrants,  persons with  disabilities and  LGBTIQ people. The special care needs of 
people with comorbidities should also be addressed to facilitate access to effective treatments, 
in  particular  for  people  with  drug-use  disorders,  in  line  with  the  EU  Drugs  Strategy  2021-
2025 and the related Action Plan. 

Reinforcing  the  training  of  the  health  workforce  will  be  essential  to  continue  to  improve 
skills and the quality of care but also to reduce stigma and discrimination and to increase the 
resilience  of  one  of  the  most  pressured  sectors  of  the  working  population.  The  EU  Year  of 
Skills  offers  a  unique  opportunity  for  stakeholders  to  boost  training  of  professionals  in  the 
mental health area. 

The  use  of  digital  tools  (e.g.  telemedicine,  advice  hotlines)  should  be  explored  for  those 
people requiring better information and care, including in rural areas. 

Social  prescribing  is  an  innovative  approach  to  improve  well-being  and  health,  including 
mental  health.  At  the  individual  level,  social  prescribing  gives  a  person  the  knowledge, 
motivation and confidence to better manage and improve their own health and well-being 100. 
This  approach  can  be  applied  in  the  primary  care  setting,  where  doctors  or  other  health 

99 Health at a Glance: Europe 2022 report (see footnote 37 on page 8). 
100 Global developments in social prescribing - PubMed (nih.gov). 

19 

 
 
                                                 
professionals can prescribe activities that match with the person’s needs and interests, such as 
spending time in nature, sports, yoga or social and cultural activities101.  

The  Commission  will  continue  to  develop  actions  to  support  Member  States  in  addressing 
unmet  needs  for  medicines  and  will  review  the  potential  of  telemedicine  for  improving 
access  to  mental  health  services102.    A  mental  health  section  will  be  included  in  the  2023 
country  health  profiles,  under  the  State  of  Health  in  the  EU  project.  In  addition,  the 
Commission will launch a voluntary collaboration process with Member States (via the Open 
Method of Coordination), to strengthen linkages between culture and mental health. Finally, 
the potential of new technologies for the prevention and treatment of mental ill-health will 
be explored via the Expert Group on Health Systems Performance Assessment103. 

Data  collection  and  monitoring  needs  to  be  strengthened  to  facilitate  informed  decision-
making.  New  statistics  and  indicators  should  be  developed  and  gradually  embedded  into 
policymaking  to  reflect  issues  such  as  inequalities,  physical  and  mental  health  and  nature’s 
value to people and to assess the impact of actions and funding. This will help to monitor the 
progress  towards  well-being,  facilitate  the  communication  of  political  challenges  and  the 
options to address them in a people- and planet-centred manner104.  

Member  States  already  signalled  strong  need  for  support  in  the  areas  of  mental  health 
workforce  planning  and/or  capacity  building,  monitoring  and  evaluation  of  mental  health 
policy, and mental health promotion and prevention (Figure 1)105.  

Figure 1 – Priority needs of Member States for capacity building (27 EU Member States, Norway and 
Iceland) 

101 Systematic review of social prescribing and older adults: where to from here? - PubMed (nih.gov). 
102 EUR-Lex - 52012SC0414 - EN - EUR-Lex (europa.eu). 
103  The  expert  group’s  report  “Mapping  metrics  of  health  promotion  and  disease  prevention  for  health  system 
performance assessment” includes a case study on mental health and best practices on social prescribing 

104 Strategic foresight (europa.eu). 
105  To  support  investments  and  reforms  in  Member  States  through  targeted  capacity-building,  a  survey  was 
carried  out  in  April  2023,  through  collaborative  work  between  the  Commission,  the  WHO  and  the 
Organisation  for  Economic  Co-operation  and  Development  (OECD),  to  provide  a  snapshot  of  mental  health 
policies in the Member States. 

20 

 
 
 
 
 
 
 
 
 
 
                                                 
To  address  these  needs,  financial  support  at  EU  level  will  be  mobilised  to  allow  Member 
States  to  strengthen  their  capacity  to  act.  This  will  include  more  and  better  trained 
professionals  to  deal  with  mental  health  problems.  It  will  also  imply  a  shift  from 
institutionalised to community-based care. 

Several Member States have included under their Recovery and Resilience Plans measures 
to  strengthen  mental  healthcare  for  their  population.  This  is  in  line  with  Country-Specific 
Recommendations  adopted  under  the  2020  European  Semester  calling  on  all  Member 
States  to  boost  the  resilience  of  their  health  systems.  In  the  spring  2023,  the  Commission 
proposed Country Specific Recommendations  advocating healthcare reform  for six Member 
States. The country reports for an additional six Member States recognized the need to further 
improve healthcare system to complement the Recovery and Resilience Plans. Moreover, all 
country  reports  adopted  under  the  European  Semester  contain  a  thematic  section  covering 
population health and health systems in Member States, highlighting in selected cases mental 
health  challenges  and  planned  reforms.  The  European  Semester  will  continue  to  monitor 
developments in healthcare at national level.  

FLAGSHIP INITIATIVES 

15. INITIATIVE FOR MORE AND BETTER TRAINED PROFESSIONALS IN THE EU 

  As  of  2023  the  Commission  will  strengthen  training  for  healthcare  and  other 
professionals,  such  as  teachers  and  social  workers.  A  new  cross  border  exchange 
programme  for  mental  health  professionals  will  also  be  launched  through  dedicated 
funding support under the EU4Health programme (EUR 9 million). This should allow 
to have around 2000 professionals trained across the EU by 2026 and on average 100 
exchanges per year.  

16.TECHNICAL SUPPORT FOR MENTAL HEALTH REFORMS ACROSS SEVERAL SECTORS 

21 

 
 
 
 
 
 
 
The Commission will: 

 

In 2024, increase the availability and affordability of mental health services for people 
by  offering,  upon  demand,  technical  support  to  Member  States  to  design  and 
implement  reforms  to  improve  the  availability  of  integrated  cross-sectoral  mental 
health services through the technical support instrument106. 

17. GATHERING DATA ON MENTAL HEALTH 

  As  of  2025,  the  Commission  will  ensure  that  the  European  Health  Interview  Survey 
(EHIS)  includes  additional  data  on  mental  health  to  ensure  strong  monitoring  and 
assessment of progress on mental health across the EU. 

The Commission encourages Member States to ensure access to affordable mental healthcare, 
including  by  telemedicine  means  and  in  cross-border  settings.  National  authorities  should 
collaborate on developing and implementing projects  to  improve mental health services and 
community-based  care  and  de-institutionalisation107  and  are  invited  to  develop  referral 
pathways  to  mental  health  professionals,  also  taking  into  account  the  work  of  other  service 
providers.  

g.  Breaking through stigma 

Stigma  and  discrimination  exacerbate  the  personal  and  economic  impacts  of  mental  ill-
health. Discrimination towards people with mental health problems is common, especially in 
social media but also in workplaces with 50% of workers considering that disclosing a mental 
health condition would have a negative impact on their career108. 

The  principles  of  re-integration  and  social  inclusion  of  those  affected  by  mental  health 
problems have to guide our action. Investing in improving awareness and understanding of 
mental health, including mental health and empathy training in  school  curricula are  key to 
improving the situation, with the involvement of all stakeholders. 

The annual  European  Mental Health Week (taking place in  May) and World Mental Health 
Day109 (10 October) are occasions to specifically address stigma at EU level.  

Arts  and  culture  are  important  in  promoting  the  positive  mental  health  and  well-being  of 
individuals and society in general by supporting social inclusion and reducing mental health 
stigma110.  They  may  complement  more  traditional  support  for  mental  health  problems  and 

106 TSI 2024 Flagship - Mental health: Fostering well-being and mental health (europa.eu) 
107 In line with the United Nations – Convention on the Rights of Persons with Disabilities (UNCRPD). 
108 OSH Pulse (flash Eurobarometer survey, 2022): ’Occupational safety and health in post-pandemic 

workplaces’. The report includes the results of questions on psychosocial risks and individual country 
factsheets and a follow-up expert article on mental health and the impact of the COVID-19 pandemic. 

109World Mental Health Day (who.int).  
110 C4H_SummaryReport_V11LP_shortsmall.pdf (cultureforhealth.eu). 

22 

 
 
 
 
 
                                                 
may contribute to the prevention of mental health problems and to addressing mental health 
stigma. The Commission  will support the Member States to  raise awareness  on the positive 
role of cultural  and artistic activities  in improving mental  health and overall well-being,  for 
example,  through  a  dedicated  event  showcasing  arts  and  culture  as  new  instruments  for 
well-being and mental health. 

FLAGSHIP INITIATIVES 

18. TACKLING STIGMA AND DISCRIMINATION 
The Commission will allocate EUR 18 million to111: 

 

 improve  the  quality  of  life  of  patients,  their  families  and  (in)formal  carers, 
including  cancer  patients,  with  a  particular  focus  on  addressing  stigma  and 
discrimination  by  supporting  Member  States  to  identify  and  implement  best 
practices; 

  with the same objective it will support stakeholders to implement projects, such as 
awareness-raising activities to break through stigma and address discrimination, 
ensure  social  inclusion,  protect  the  rights  of  patients,  focusing  on  vulnerable 
groups;  

  develop EU guidance on breaking through stigma and tackling discrimination 
with the Member States under the Expert Group on Public Health and stakeholder 
groups; 
introduce  communication  activities  to  promote  awareness  in  the  fight  against 
stigma. 

 

The  Commission  encourages  Member  States  to  develop  communication  campaigns  to 
demystify  and  break  through  stigma,  and  to  develop  measures  to  counteract  stigma  and 
discrimination by  helping individuals reintegrate into employment,  empowering patients  to 
access  the  services  that  best  meet  their  needs  and  disseminating  information  on  the  use  of 
legal  instruments  to  tackle  discrimination.  Awareness  should  be  raised  (decision  makers, 
employers, health care professionals, other professionals and the general public and healthcare 
professionals on mental health and stigma, especially of people in vulnerable situations) and 
community activities (sports, the arts, nature) should be supported that help to break through 
stigma  and  support  mental  health  rehabilitation.  Member  States  should  support  policies 
encouraging the integration of people with mental health in the community and on the labour 
market, including by social economy activities. 

111 Funded under the EU4Health programme (EUR 18.36 million: budget under work programme 2023 dedicated 

to mental health activities). 

23 

 
 
  
 
 
                                                 
h.  Fostering mental health globally 

Safeguarding and promoting mental health is not just a priority for the EU, it is also a global 
issue  and  one  where  the  EU  can  lead  by  example,  making  targeted  contributions  at 
international level and fostering convergence where appropriate. 

At  the  EU-US  Trade  and  Technology  Council  of  30  and  31  May  2023,  the  EU  and  the 
United  States  expressed  the  shared  view  that  online  platforms  should  exercise  greater 
responsibility in ensuring that their services contribute to an online environment that protects, 
empowers and respects children and youth and take responsible actions to address the impact 
of their services on children and youths’ mental health and development.112 

The EU Global Health Strategy113 provides global, national and regional actions intended to 
facilitate  achievement  of  the  health-related  UN  SDGs,  with  a  focus  on  three  interrelated 
priorities:  (1)  deliver  better  health  and  well-being  of  people  across  the  life  course;  (2) 
strengthen health systems and advance universal health coverage; and (3) ensure public health 
security,  including  mental  health  and  psycho-social  support.  The  focus  should  be  on 
strengthening primary health care where the availability of mental health services is essential.  

The Youth Action Plan in EU external action (2022-2027)114, recognises health and well-
being  as  a  prerequisite  for  young  people  to  realise  their  full  potential  and  participate  in 
society.  It  puts  forward  health,  mental  and  physical  well-being  at  the  core  of  its  “empower 
pillar”. In parallel, mental health and psychosocial support (MHPSS) should be an integral 
part  of  measures  to  strengthen  national  health  systems  in  partner  countries,  if  appropriate, 
supporting  global  public  health  interventions  e.g.  the  Global  Fund  to  fight  AIDS, 
Tuberculosis  and  Malaria115,  the  Spotlight  Initiative  on  Gender-Based  Violence116  or  in  the 
context of EU humanitarian aid. According to the WHO, more than one in five people in post-
conflict settings suffers from depression, anxiety or post-traumatic stress disorder117. Mental 
health needs also arise in situations of displacement and natural disasters. Therefore, MHPSS 
is  an  essential  element  of  a  comprehensive  crisis  response,  integrated  in  the  EU  funded 
humanitarian aid operations with EUR 111 million dedicated to this priority since 2019.  

The EU also spurs others to action by mobilising and raising the awareness of donors and 
partners  on  the  importance  of  providing  quality  MHPSS  in  humanitarian  emergencies. 
Following the successful engagement in the Middle East and North African region, outreach 
and  capacity  building  sessions  will  be  organised  in  other  regions,  starting  with  Latin 
American and Caribbean, before the end of 2023. 

112 Joint Statement for the EU-US Trade and Technology Council of 30 and 31 May 2023. 
113 EU Global Health Strategy to improve global health security and deliver better health for all (europa.eu). 
114 Youth Action Plan (europa.eu). 
115 Home - The Global Fund to Fight AIDS, Tuberculosis and Malaria. 
116 The Spotlight Initiative | What we do: Ending violence against women and girls | UN Women – Headquarters. 
117 New WHO prevalence estimates of mental disorders in conflict settings: a systematic review and meta-

analysis - The Lancet. 

24 

 
 
                                                 
Furthermore,  the  Commission  is  building  the  capacity  of  stakeholders  through  training  and 
dissemination of the Interagency Standing Committee (IASC) Minimum Service Package on 
MHPSS118. This key reference tool was developed by the humanitarian community to set the 
minimum  quality  and  facilitate  the  roll  out  of  impactful  and  timely  mental  health 
interventions in crisis situations. 

In  Ukraine119,  the  Commission  already  supports  community  centres  for  displaced  children 
and their caregivers, and also children in institutions, to help them re-establish some level of 
normality and routine. However, the long duration of the aggression and its devastating effect 
is  accelerating  mental  health  impacts  for  people  fleeing  the  war  in  the  EU  and  for  those 
displaced within Ukraine, which calls for determined and ambitious support.  

Ukrainian  children  are  currently  subject  to  the  trauma  of  war,  often  leaving  them  with 
profound  psychological  scars.  The  Commission  will,  together  with  Ukraine,  establish  a 
specialised e-learning program for paediatricians and primary care medical staff. Through this 
initiative,  healthcare  professionals  will  get  equipped  with  the  necessary  skills  to  provide 
trauma  care  and  improve  children’s  mental  health  conditions.  Specialised  rehabilitation 
services will also be offered to distressed children in both Ukraine and the EU. 

The  Commission  also  supports  humanitarian  partners  to  increase  their  capacity  to  address 
the  mental  health  needs  of  conflict-affected  populations,  including  in  the  Zaporizhzhia, 
Kharkiv,  Dnipro  and  Mykolaiv  oblasts.  Under  the  EU4Health  programme,  in  2022  a 
contribution  agreement  of EUR 28.4 million  with the  International  Federation of Red Cross 
Societies was allocated to provide psychological first aid, and four projects120 (total of EUR 3 
million) are being carried out by stakeholders implementing best practices to improve mental 
health  and  psychosocial  wellbeing  in  migrant  and  refugee  populations.  For  2023,  over 
EUR 10.6 million is programmed under EU4Health to improve access to health care and for 
the  prevention  of  non-communicable  diseases,  in  particular  mental  health  issues.  The 
Commission will also support Member States and stakeholders in the implementation of the 
best practice iFightDepression121 which includes an online self-management programme that 
can help displaced people, including those from Ukraine, to self-manage their symptoms. 

As  humanitarian  assistance  alone  cannot  meet  the  potential  long-term  needs  of  forcibly 
displaced  people,  including  healthcare,  the  Commission  supports  its  partner  countries  to 
integrated forcibly displaced communities into existing national service delivery structures. 
This integration is done in a way that ensures equal and fair access of refugees to the services 
addressing  their  needs,  including  on  mental  health,  post-traumatic-stress,  and  gender-based 
violence.  The  EU’s  substantial  assistance  to  address  the  needs  of  migrants  also  includes 
psycho-social support, particularly for the most vulnerable, including children, victims of war, 
trafficking, stranded migrants and returnees. 

118 IASC Minimum Service Package: Mental Health and Psychosocial Support. 
119 Financial support provided under NDICI Eastern Partnership Regional Programme to provide psychological 

support in Ukraine.  

120 EU4Health projects to provide mental health support to Ukrainian refugees.  
121 https://ifightdepression.com/en/: available in Ukrainian, and culturally adapted. 

25 

 
 
                                                 
The  Commission  supports  a  comprehensive  approach  to  the  promotion  and  protection  of 
mental  health  and  psychosocial  well-being  of  learners,  and  their  teachers  and  caregivers 
through education actions. The Commission is a main donor of Education Cannot Wait that 
considers MHPSS a key priority of its work and of the  Global  Partnership for Education 
that invests in strengthening links between the health and education sectors. 

The  Commission  will  continue  to  mainstream  mental  health  in  measures  to  strengthen 
health systems at regional, national and global level, in line with efforts towards localisation 
and the triple humanitarian-development-peace nexus, and ensure that refugees, people on the 
move and displaced people in  post-emergency situations  in  partner countries have access  to 
MHPSS at the same level as the host communities.  

FLAGSHIP INITIATIVES 

19. MENTAL HEALTH SUPPORT FOR UKRAINE’ DISPLACED AND AFFECTED PEOPLE 

  The Commission will contribute to the provision of psychological first aid to people 
affected  by  the  Russian  war  of  aggression  against  Ukraine  deepening  the 
collaborative  work with  the  International  Federation  of Red Cross  and Red Crescent 
Societies122  (EUR  28  million).  The  Commission  will  seek  to  reinforce  its  financial 
support to strengthen psychosocial support for displaced people from the war. Options 
for training (online) of first responders, teachers, and social workers in psychological 
first  aid  and psychosocial  support will also  be  explored to  better  help  those in  need. 
An additional EUR 0.5 million will be allocated to strengthen psychosocial support for 
affected people in emergency settings.  

  The  Commission  will,  together  with  Ukraine,  establish  a  specialised  e-learning 
program  for  paediatricians  and  primary  care  medical  staff  to  support  Ukrainian 
children suffering from stress and anxiety because of the war. Through this initiative 
healthcare professionals will get equipped with the necessary skills to provide trauma 
care and improve children’s mental health conditions.  

  The  Commission  will  work  with  Member  States  to  offer  provision  of  affordable 
psychosocial  support  available  to  the  people  who  fled  the  war,  to  complement  the 
healthcare already offered under the temporary protection directive. 

20. SUPPORTING  THE  DISSEMINATION  OF  THE INTER AGENCY STANDING COMMITTEE123124 
MINIMUM SERVICE PACKAGE ON MHPSS: 

  The  Commission  will  continue  to  support  the  dissemination  of  a  Minimum  Service 
Package  intended  to  support  humanitarian  actors  to  deliver  quality  care  in 
humanitarian  emergencies.  It  provides  guidelines  on  how  to  integrate  timely, 
coordinated  and  evidence-based  mental  health  services  into  overall  humanitarian 
response. 

122 Budget: EUR 28.4 million mobilised under EU4Health 2022 work programme.  
123 Budget: 750 000 EUR funded under the Enhanced Response Capacity Programme. 
124 WHO, UNICEF, UNHCR and UNFPA https://mhpssmsp.org/en. 

26 

 
 
 
 
 
 
                                                 
EU funding for mental health 

Budget  to  support  mental  health  should  match  the  magnitude  of  the  challenge.  EU  and  MS 
need  to  devote  adequate  resources  to  ensure  people  in  need  are  helped,  as  a  social  and 
economic imperative.  

The Commission is mobilising all relevant financial instruments of the EU budget under the 
2021-2027 Multiannual Financial Framework (MFF) to address key mental health challenges 
and  to  support  the  flagships  and  actions  identified  in  this  Communication.  Furthermore, 
Member  States  may  benefit  from  the  funds  available  through  the  Recovery  and  Resilience 
Facility125 to finance reforms and investments on health, including mental health. 

In total, EUR 1.23 billion of EU support to mental health activities have been identified and 
are  available  to  finance  activities  directly  or  indirectly  promoting  mental  health,  from 
research to awareness campaigns, from capacity building and transfer of health best practices 
to  psychological  support  to  cancer  patients  and  Ukrainian  refugees.  The  impact  of  these 
projects and programmes will be regularly monitored. This not only requires having reliable, 
comparable and recent data but also indicators, monitoring and evaluation systems, to ensure 
follow-up and accountability. 

For  2022  and  2023,  EUR  69,7  million  has  been  allocated  through  the  EU4Health 
Programme126 ) for actions that promote good mental health. This includes EUR 51.4 million 
under the 2022 work programme127, to support capacity-building initiatives in Member States 
and  address  the  mental  health  of  vulnerable  groups  and  the  EUR  18.3  million  under  the 
EU4Health 2023 work programme to support collaborative work between the Member States 
and to provide psychological support to cancer patients, their carers and families128.  

Funding of EUR 765 million in funding is mobilised through the Horizon 2020 and Horizon 
Europe129 programme to support research and innovation projects on mental health.  

National,  regional  and  local  authorities  can  also  make  use  of  cohesion  policy  funding,  in 
particular  the  European  Social  Fund  Plus  (ESF+)  and  the  European  Regional  Development 
Fund (ERDF), to strengthen equal access to health care by investing, for example, in relevant 
infrastructure and equipment, personal assistants, mobile teams, help lines, social workers130 
The Technical Support Instrument (TSI) is available to provide technical support to Member 
States  for  projects  on  mental  health  (EUR  2  million  in  2023).  In  2024,  the  Commission 
intends  to  mobilise  further  resources  from  the  TSI  to  support  capacity  building  for  mental 
health on a demand driven basis in the Member States. 

125 Recovery and Resilience Facility (europa.eu). 
126 Regulation (EU) 2021/522 on the EU4Health Programme. 
127 com_2022-5436_annex2_en.pdf (europa.eu) 
128 wp2023_annex_en.pdf (europa.eu). 
129 Horizon Europe (europa.eu). 
130 An overall budget of EUR 7.2 billion is available under ERDF for health infrastructure and equipment, which 

may include measures for mental health and social inclusion.  

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Funding  (EUR  3.3  million)  has  been  made  available  under  the  EU’s  “Creative  Europe 
programme”  for projects on culture,  well-being  and  mental  health,  and EUR  28 million  has 
been mobilised to support mental health and psychosocial support activities in emergency and 
humanitarian  settings  (European  Civil  Protection  and  Humanitarian  Aid  Operations).  The 
Citizenship,  Equality,  Rights  and  Value  Programme131  (2023-2024)  also  provides  funding 
opportunities132  for  actions  on  the  mental  health  of  children  and  of  victims  of  gender-based 
violence133.  To  help  tackle  mental  health  in  the  workplace,  funding  will  be  made  available 
under the EU-OSHA. 

Conclusion and next steps 

Today’s challenges on mental health can affect everybody and require concerted actions and 
the  full  commitment  of  all  actors  involved.  Mental  health  is  an  integral  part  of  people’s 
health. It enables individual to realise their own abilities, to cope with the stresses of life, to 
socialise, work and contribute to community life 

All institutions and levels of government can, and should, play their part to overcome barriers 
to good mental health. Coordinated efforts, with and beyond the health system, are required to 
mobilise society as a whole and take a life-course approach with the emphasis on equality and 
non-discrimination.  

The  Commission  calls  on  the  European  Parliament  and  Member  States  to  work  together  in 
taking  forward  the  initiatives  put  forward  in  this  strategic  Communication,  which  lay  the 
foundations  for  sustained  action  at  national  and  EU  level  for  a  comprehensive,  prevention-
oriented  and  multistakeholder  approach  to  mental  health.  They  promote  the  universality  of 
health care for people suffering from mental health in the EU and beyond.  

The  prevention  of  mental  health  problems,  access  to  help  and  reintegration  in  society  are 
integral  to  the  right  to  healthcare  and  through  this  initiative  the  EU  sets  a  high  ambition  to 
help  the  most  fragile  and  vulnerable  in  our  societies,  in  line  with  the  European  way  of  life 
where each person counts and should have a prosperous life prospect. 

This Communication is the beginning of a new strategic approach to put mental health on par 
with physical health. It adds another pillar to the architecture of the European Health Union 
by both reinforcing ongoing work and opening new workstreams, developed with all partners 
and including implementing actions. These will be closely monitored with the Member States 
under  the  Expert  Group  on  Public  Health  and  in  particular  its  sub-group  on  mental  health. 
Stakeholders will have the opportunity to collaborate and coordinate their joint input for the 
development  and  implementation  of  the  actions  set  out  through  the  EU  Health  Policy 

131 Citizens, Equality, Rights and Values (CERV) (europa.eu). 
132 Daphne and rights of the child: c_2022_8588_1_en_annexe_acte_autonome_cp_part1_v2.pdf (europa.eu). 
133  EUR  22.9  million  under  the  2024  Daphne  call  for  preventing  and  combating  gender-based  violence  and 
violence  against  children  to  finance  actions  specifically  supporting  victims  and  survivors  and  further 
developing integrated child protection systems .   

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Platform. These concerted efforts will be the path to develop and implement a new ambitious 
approach on mental health for a more resilient society that puts people first. 

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