Conclusions of the Council and of the Representatives of the Governments of the Member States on a comprehensive approach to the mental health of young people in the European Union
Date: 2023-11-23
Institutions: Council of the European Union, Representatives of the Governments of the Member States
Subjects: disease prevention, health care, health determinant, living conditions, mental health, working conditions, young person, youth policy








C_202301337EN.000101.fmx.xml












Official Journal of the European Union


EN
Series C













C/2023/1337


30.11.2023






Conclusions of the Council and of the Representatives of the Governments of the Member States on a comprehensive approach to the mental health of young people in the European Union
(C/2023/1337)

THE COUNCIL OF THE EUROPEAN UNION AND THE REPRESENTATIVES OF THE GOVERNMENTS OF THE MEMBER STATES MEETING WITHIN THE COUNCIL
RECALLING THAT:

1.   

The right to mental health is linked to the right to human dignity, enshrined in Article 1 of the Charter of Fundamental Rights of the European Union, as well as the right to integrity of the person, including mental integrity, provided for in Article 3, and the right to health care in Article 35 of the Charter. The EU Treaties explicitly confer supporting competences on the EU institutions to address mental health issues, specifically, in Article 168 of the Treaty on the Functioning of the European Union (TFEU), and in Article 3(1) of the Treaty on European Union. In addition, Article 153(1) TFEU confers implied powers on the EU institutions in the field of workers’ health.



2.   

The World Health Organization (WHO) defines mental health as ‘a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community’ (1). Mental health monitoring forms part of the efforts to achieve Sustainable Development Goal 3, Target 3.4 (2).



3.   

The European Youth Goal #5 (3), which is to achieve better mental well-being and end the stigmatisation of mental health issues, thus promoting the social inclusion of all young people, places particular focus on prevention measures, the development of an inclusive intersectional approach and the fight against stigma. In addition, the European Youth Goal #3 promotes the inclusion of all young people in society, while the European Youth Goal #9 seeks to strengthen young people’s democratic participation and autonomy.


ACKNOWLEDGING THAT:

4.   

Our societies have been shaken by the COVID-19 pandemic, Russia’s war of aggression against Ukraine, and the food and energy crisis that it prompted, the inflation crisis and the climate crisis, all of which increased and continue to build up societal stress on young people and have made pre-existing inequalities even more apparent. These successive crises have had an impact on different groups of young people to varying degrees, with groups in vulnerable situations being disproportionately affected. It has also become clear that those young people with fewer opportunities do not have equal access to human rights such as education, employment, housing (4) and healthcare. Factors including mental and physical health, living, working and housing conditions, access to formal, non-formal and informal learning, job opportunities and leisure activities, including physical and sporting activities, and social relationships, are all crucial to young people’s resilience. The past years have taken their toll on the mental health of young people in the EU, thus diminishing their general well-being (5).



5.   

According to estimates published by the Institute for Health Metrics and Evaluation (IHME) (6), more than one out of every six young people in the EU—more than 14 million people—suffered from a mental health disorder in 2019 (17,4 % of people aged between 15 and 29). The proportion of young people reporting symptoms of depression more than doubled in several EU countries during the COVID-19 pandemic, with women and young people from disadvantaged socioeconomic backgrounds being particularly affected.



6.   

The 2022 edition of ‘Health at a Glance: Europe’ (7) states that almost one in two young Europeans (49 %) reported unmet needs for mental health care in 2022 (53 % in 2021), compared with 23 % of the adult population. The report highlights that inequalities in mental health among young people, including by gender, have also persisted – and in some cases widened – during the COVID-19 pandemic. In addition, suicide is currently the second leading cause of death among young people in Europe.



7.   

Data from the Eurofound study ‘Living, Working and COVID-19’ (8) revealed that young people aged 18-29 who perceived their household to have financial difficulties were significantly more likely to be at risk of depression over the course of the pandemic. On average across the EU, two-thirds of young people who reported financial difficulties could be considered to have been at risk of depression during the pandemic (67 %), compared with just under half (45 %) of those who did not report financial difficulties.



8.   

According to the EU Loneliness survey conducted in 2022 (9), young people have a higher incidence of loneliness compared to older generations. Although loneliness amongst young people has increased as a result of the COVID-19 pandemic, the previous Joint Research Centre work indicated that the experience of loneliness among young people aged 18–25 has more than doubled between 2016 and spring 2020.


CONSIDERING THAT:

9.   

The European Commission has adopted a Communication on a comprehensive approach to mental health (10). The Communication calls upon the Member States to foster a comprehensive, prevention-oriented approach that incorporates mental health across EU policies as a public health issue, committing to improving quality of life, addressing determinants and cross-cutting issues to meet the specific needs of different groups in vulnerable situations and specifically addressing the prevalence of mental health issues among these groups, including young people. Several flagship initiatives focus on children’s and young people’s health addressing both mental and physical health comprehensively. According to this Communication, every EU citizen has to have access to adequate and effective prevention. Youth work, in particular, has a significant role on promoting the well-being of young people and in the prevention of mental health issues.



10.   

Determinants of mental health interact with existing inequalities in society, putting some people at a higher risk of poor mental health than others. In addition, violence, hate, as well as discrimination can act as a cause for poor mental health, which makes promoting equality within our societies a crucial preventive measure in addressing these challenges.



11.   

The Eurobarometer on Youth and Democracy in the European Year of Youth 2022 (EYY) (11) stated that young people consider improving mental and physical health and well-being to be the most important priority theme for the EYY, together with climate change (both were voted as the top priority by 34 % of those surveyed). In addition, the Eurobarometer data show that young people’s second most important expectation of the EU, after preserving peace, is increasing job opportunities.



12.   

The EYY, among other topics, focused on re-establishing a positive outlook for young people and included activities supporting their mental health and well-being. During its closing conference, under the theme ‘Claim the Future’, youth participants, policymakers and stakeholders called for greater emphasis on preventive healthcare and on combating mental health issues and loneliness.



13.   

Regular physical exercise and sport activities, as well as participation in cultural activities, can boost the overall health and well-being of young people, having significant short and long-term benefits for mental health. As shown by evidence (12), physical inactivity tends to increase with age, thus becoming increasingly vital that young people possess the basic knowledge and behaviours that enable them to autonomously maintain an active and healthy lifestyle throughout their lives.



14.   

The main concerns expressed by young people in relation to economic instability, job insecurity or growing ecological anxiety are generating mental health issues that cannot be attributed exclusively to pathological processes. 75 % of children and young people are ‘afraid’ of thinking about the future (13) . The COVID-19 pandemic has brought public health to the forefront of the political agenda. A lesson to be learned from the socio-economic and health crisis of recent years is that multidimensional social problems can only be managed by adopting a cross-cutting approach.



15.   

International organisations, such as the Organisation for Economic Co-operation and Development (OECD), highlight the importance of applying a multi-sectoral approach to protecting and caring for the mental health of young people, affirming that ‘many of the protective factors for good mental health go beyond the scope of mental health systems or programmes designed specifically to strengthen or protect mental health. Social, economic and cultural factors, such as employment status, income, physical health, experiences during childhood and adolescence, all have a significant impact upon mental health across the life course’ (14). In addition, the aforementioned Eurofound report (15) of 2021 indicated that the greatest decline in mental well-being (which had reached its lowest level in all age groups since the beginning of the pandemic) was observed among those who had lost their jobs.



16.   

Job insecurity, precarious working conditions and unemployment are important socioeconomic determinants of mental health. Supporting young people in their transition to adulthood, in finding and remaining in employment should be an economic, social and public health policy priority. Employers play an important role in managing psychosocial risks at work to prevent the potential negative impact on the mental health of their employees, including young workers.



17.   

The European Commission adopted the Communication ‘A long-term vision for EU’s Rural Areas – Towards stronger, connected, resilient and prosperous rural areas by 2040’ (16), according to which particular attention should be paid to young people in rural and remote areas, whose mental health conditions and care needs may differ from those of young people in urban areas. Owing to the specific living conditions for young people in rural, remote, peripheral, less-developed areas and outermost regions, for instance due to the precariousness and shortcomings of public services, isolation, scant job opportunities and harsh working conditions (17) which can have a negative impact on their mental health, young people living in these areas require specific measures based on evidential analysis. According to Eurostat (18), the proportion of young people aged 18–24 living in rural areas of the EU who were neither in employment nor in education or training (NEET) was higher than that recorded for young people in urban areas. Added to this degree of precariousness—in itself a cause of mental health issues—is the fact that young people in rural areas are less likely to seek medical attention owing to the long distances they would have to travel (19).



18.   

Although the issue of mental health affects all young people in the EU in a general way, the more disadvantages faced by young people, the greater their vulnerability. In addition to the other many and complex challenges they must overcome, young people at risk of social exclusion or in vulnerable situations, such as, for example, ethnic minorities, LGBTI persons, persons with disabilities, in youth care institutions, without or at risk of losing parental care, or those in disadvantaged socioeconomic situations, are at greater risk of suffering from mental health issues. Exposure to discrimination and inequality is damaging to their mental health, especially when young people are affected by multiple discriminations or disadvantages. The lack of specific attention that these groups of young people sometimes receive for their social development in schools and other educational settings - which can lead to bullying - is also a cause for concern. It is of great importance to enhance mental health and well-being, develop the socio-emotional skills of both young people and their educators and youth workers, and fight bullying, including cyberbullying, sexual harassment and abuse.



19.   

To instil a sense of community in the citizens of a state—a pre-requisite for its stability—it is crucial to implement preventive measures to mitigate problems of loneliness, fear, anxiety, defencelessness and precariousness, to which young people are particularly vulnerable, as well as to promote resilience and well-being protective factors, and thus contribute to the creation of just societies offering equal opportunities for all. It is also essential to involve young people in decision-making of policies that can have an impact on their mental health and take their perspective into consideration.



20.   

According to the report ‘The impact of the COVID 19 pandemic on the mental health of young people: Policy responses in European countries’ (20), by providing opportunities for socialising, sharing experiences and developing a sense of belonging, youth work plays a key role in protecting the mental health of young people.


THE MEMBER STATES, IN THEIR RESPECTIVE AREAS OF COMPETENCE AND AT THE APPROPRIATE LEVELS, ARE INVITED TO:

21.   

Improve the living and working conditions of the young people of their respective countries, promoting a cross-sectorial approach aimed at preventing mental health issues, removing structural barriers to their personal and professional development and creating environments that support their socio-economic and psychological well-being.



22.   

Encourage the improvement of equal and affordable access for young people, especially those in vulnerable situations, to mental health care services that offer prevention, treatment and care, while increasingly working across disciplines and moving towards person-centred and community-based solutions.


THE COMMISSION, PURSUANT TO THE PRINCIPLE OF SUBSIDIARITY, IS INVITED TO:

23.   

Maintain a pro-active approach to mental health, which addresses it from a multi-sectoral perspective that is both preventive and interventionist, paying particular attention to the specificities of young people in the EU, especially those in the most vulnerable situations, and targeting their reintegration and social inclusion.



24.   

Promote actions aimed at improving the mental health of young people in connection with the EU Youth Strategy, considering mental health issues as a consequence of a combination of material and psychosocial factors, including childhood adverse events, precariousness, insecurity, lack of social cohesion, family and social relationships, unequal access to rights and basic social services, vulnerability in educational settings, the role of social media, access to housing, the specific needs of rural youth and, in general, any adverse circumstances that prevent young people from fully enjoying their rights.



25.   

Encourage studies on the impact of mental health issues on young people in the EU. In addition to age, these studies might consider using data disaggregated by other key elements that affect young people’s lives. These studies will help to better guide actions and investment of resources. Foster the dissemination of these studies as part of awareness-raising efforts to combat the ongoing stigma attached to mental health issues and support the transfer of evidence-based best practices on mental health across Member States.


THE MEMBER STATES AND THE COMMISSION, IN THEIR RESPECTIVE AREAS OF COMPETENCE AND AT THE APPROPRIATE LEVELS, PURSUANT TO THE PRINCIPLE OF SUBSIDIARITY, ARE INVITED TO:

26.   

Coordinate efforts to reduce the incidence and prevalence rates of mental health issues among young people by listening to the specific needs and challenges of young people, as well as their suggested solutions, and taking actions forward.



27.   

Take into account the prevalence of mental health issues on young people in the EU when developing policies that are commensurate with the scale of the problem, with a special emphasis on preventive measures. Ensure that the measures proposed are comprehensive and evidence-based and that policy development goes hand in hand with the latest scientific evidence, recommendations and studies on mental health conducted in the EU and in each Member State.



28.   

Encourage actions to destigmatise mental health issues and raise awareness by promoting messages inviting young people to adopt behaviours that improve their mental well-being and to seek help from professionals in psychological risk-prevention structures to alleviate their suffering and to prevent suicides.



29.   

Foster the eradication of messages of hate, violence and abuse in the media, including social media, targeting groups of young people in the most vulnerable situations, defending their human rights and fundamental freedoms and thus contributing to their psychological and emotional well-being.



30.   

Support the implementation of the 20 flagship initiatives and other actions of the Communication on a comprehensive approach to mental health (21), from a wide range of areas essential to addressing mental health challenges across the EU and at national level, including the preparation of guidelines and transfer of best practices and innovative approaches to address the issue of young people’s mental health.



31.   

Create ways, as well as make good use of the already available tools such as the EU Youth Dialogue, the European Youth Portal and Youth Voices (22), for young people to raise awareness on the mental health issues that they want to highlight and to express their views and concerns regarding their mental health and the approaches to tackle their mental health issues. Ensure that young people are aware of the importance of their involvement in ensuring the effectiveness and relevance of the measures to be adopted, using, for instance, youth-friendly and accessible communication.



32.   

Ensure that young people in vulnerable situations are represented in the development of public policy programmes on mental health in order for them to not solely take into account the interests of young people with easier access to institutional participation channels, but also consider the interests of those who find it much harder to make themselves heard. Support the promotion of channels for young people in vulnerable situations to voice their concerns.



33.   

Continue to support youth work so that it can fully play its role in protecting young people’s mental health by enabling young people to participate in activities which are largely based on the relationships and trust between youth and youth workers and developing their capacity to seek help when they are facing emotional and psychological difficulties.



34.   

Support youth work, youth organisations and other relevant experts and stakeholders in their role as providers of information to young people and enable them to disseminate quality information on strengthening young people’s mental health and wellbeing and addressing mental health issues if needed.



35.   

Promote a safer and healthier digital space for young people, in line with the European declaration on digital rights and principles (23). This includes encouraging awareness raising and training in media and information literacy and in the responsible use of social media with safeguards against risks such as cyberbullying, hate speech, grooming and excessive screen time, as well as providing protection and information about aggressive online marketing of products such as unhealthy food and drinks, alcohol, tobacco and similar products.




(1)  World Health Organization, WHO Fact Sheets, ‘Mental health: strengthening our response’, 2022.

(2)  United Nations, Sustainable Developments Goals (SDG), SDG3, Target 3.4: ‘By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being’.

(3)  Resolution of the Council of the European Union and the Representatives of the Governments of the Member States meeting within the Council on a framework for European cooperation in the youth field: The European Union Youth Strategy 2019-2027, OJ C 456, 18.12.2018, p. 1.

(4)  As indicated by Eurostat in 2020 figures, all EU Member States showed a higher rate of severe housing deprivation among young people than among the population as a whole.

(5)  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, COM(2023) 298 final.

(6)  The Institute for Health Metrics and Evaluation (IHME) Global Health Data Exchange (GHDx), 2020.

(7)  OECD and European Union, ‘Health at a Glance: Europe 2022, State of Health in the EU Cycle’, OECD Publishing, Paris, 2022.

(8)  Eurofound, ‘Living, working and COVID-19 dataset’, 2021.

(9)  Casabianca, E.J., Nurminen, M., Interventions to reduce loneliness among youth, Publications Office of the European Union, Luxembourg, 2022, doi:10.2760/793941, JRC129905.

(10)  See footnote 5.

(11)  Flash Eurobarometer [2282 / FL502], Youth and Democracy in the European Year of Youth, May 2022.

(12)  Special Eurobarometer 525, Sport and Physical Activity, September 2022.

(13)  Caroline Hickman, Elizabeth Marks, Panu Pihkala, Susan Clayton, R Eric Lewandowski, Elouise E Mayall, Britt Wray, Catriona Mellor, Lise van Susteren, Climate anxiety in children and young people and their beliefs about government responses to climate change: a global survey, The Lancet Planetary Health, Volume 5, Issue 12, December 2021, pages e863-e873.

(14)  OECD, A New Benchmark for Mental Health Systems: Tackling the Social and Economic Costs of Mental Ill-Health, OECD Publishing, Paris, p. 162, 2021.

(15)  Eurofound, Living, working and COVID-19 dataset, 2021.

(16)  Communication from the European Commission, ‘A long-term vision for the EU's Rural Areas: Towards stronger, connected, resilient and prosperous rural areas by 2040’, COM/2021/345 final.

(17)  See footnote 15.

(18)  Eurostat (2023). Statistics of young people neither in employment nor in education and training by sex, age and degree of urbanisation (NEET rates), May 2023.

(19)  Eurostat Regional Yearbook, 2017.

(20)  European Commission, European Education and Culture Executive Agency, ‘The impact of the COVID-19 pandemic on the mental health of young people: Policy responses in European countries’, Luxembourg: Publications Office of the European Union, 2022.

(21)  See footnote 5.

(22)  Youth Voices is a voice recording platform of the European Commission launched during the European Year of Youth 2022 that allows young people to express their insights, concerns and proposals.

(23)  European Parliament, Council and Commission, European Declaration on Digital Rights and Principles for the Digital Decade, 2023/C 23/01.




ANNEX
References:
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, COM(2023) 298 final.
European Commission, European Education and Culture Executive Agency, ‘The impact of the COVID-19 pandemic on the mental health of young people: Policy responses in European countries’, Luxembourg: Publications Office of the European Union, 2022.
Communication from the European Commission, ‘A long-term vision for the EU's Rural Areas: Towards rural stronger, connected rural areas by 2040’, COM/2021/345 final.
European Economic and Social Committee, ‘The long-lasting legacy of the European Year of Youth: youth mainstreaming and empowerment’, 2022.
World Health Organization, WHO Fact Sheets, ‘Mental health: strengthening our response’, 2022.
OECD and European Union, ‘Health at a Glance: Europe 2022, State of Health in the EU Cycle’, OECD Publishing, Paris, 2022.
Casabianca, E.J., Nurminen, M., Interventions to reduce loneliness among youth, Publications Office of the European Union, Luxembourg, 2022, doi:10.2760/793941, JRC129905.
Caroline Hickman, Elizabeth Marks, Panu Pihkala, Susan Clayton, R Eric Lewandowski, Elouise E Mayall, Britt Wray, Catriona Mellor, Lise van Susteren, Climate anxiety in children and young people and their beliefs about government responses to climate change: a global survey, The Lancet Planetary Health, Volume 5, Issue 12, December 2021, pages e863-e873.



ELI: http://data.europa.eu/eli/C/2023/1337/oj
ISSN 1977-091X (electronic edition)