Meeting of Minds input into Green paper on Improving the mental health of the population. Towards a strategy on mental health for the European Union
On 14 October 2005, the Commission adopted a Green paper "Improving the mental health of the population. Towards a strategy on mental health for the EU" (COM(2005) 484 final of 14 October 2005).
The Green paper aims to launch a public consultation on how better to tackle mental illness and promote mental wellbeing in the EU, in line with the mandate for action at Community level. If confirmed, the initiative should lead to the development of a Commission proposal for an EU-strategy on mental health in late 2006. Meeting of Minds has submitted following views and comments on the Green Paper.
COM(2005)484 final
View and Comments of the Meeting of Minds project
Introduction
I. Key message and recommendation for a future EU mental health strategy
II. Specific issues to be considered
III. Final remarks: the role of the EU
Introduction
This contribution is submitted by the King Baudouin Foundation, the European coordinator of the Meeting of Minds project, and voices the views and comments of the European citizens' panel of the Meeting of Minds project in relation to the current Green Paper consultation on a future EU strategy on mental health.
‘Meeting of Minds - European Citizens’ Deliberation on Brain Sciences’ is an initiative of a European group of 12 partner organisations coordinated by the King Baudouin Foundation (B), pooling their respective expertise and experience in public consultation to collaborate on this unique exercise in public engagement with science.
This ambitious and innovative process of citizens’ participation, begun in 2004, featured a European panel of 126 ordinary citizens - from nine countries and with different cultural and linguistic backgrounds – with the overall objective to hold an open, constructive and pro-active public deliberation on the future of brain sciences in the earliest stages before opinions become strongly divided. On 23rd of January 2006 the European Citizens’ panel presented their final assessment report in the European Parliament to high-level European officials, representatives of the European scientific and research community and stakeholders in the field. The comments contained in this submission are based on this report, combined with an analysis of all national citizens’ reports and the synthesis report on the national assessments.
The project, addressing brain sciences in a comprehensive way, has lead to a wealth of information regarding citizen’s views in relation to mental health and the outcome provides some highly relevant inputs into European policy development, such as the current consultation on a future EU strategy on mental health.
I. Key message and recommendation for a future EU mental health strategy
The added value of direct citizens’ consultation
This contribution is unique in that it contains the views of European citizens – which are crucial given the impact of mental health and consequences of mental ill-health to individual citizens and society as a whole.
While Meeting of Minds welcomes the Commission’s intentions to formally involve civil society and stakeholder organizations with the development and implementation of a future mental health strategy, we strongly urge the Commission to also support the direct consultation of citizens and make use of the method of European citizens’ participation, focused on bringing the views of citizens to the fore. This is especially important in the field of mental health given that mental health is central to humankind and affects the daily lives of all citizens. The Meeting of Minds project serves as an excellent example of good practice in this respect.
II. Specific issues to be considered
Meeting of Minds welcomes the Green Paper and what it is aiming to achieve. We fully agree that EU level action would be beneficial, creating a framework for exchange and cooperation between Member States, helping to increase the coherence of actions in different policy sectors and establishing consultative stakeholders and citizens platforms.
Meeting of Minds also welcomes the Commission’s statement that mental health is closely linked to the health and quality of life of citizens, to societal prosperity, to solidarity and to social justice.
Meeting of Minds would like to emphasize the following issues and recommendations as part of a future strategy, in response to the issues raised in chapters 5, 6 and 7 of the Green Paper:
1. The need for more brain research
Increase funding
Mental problems are on the increase in Europe today. People need to have access to a range of high-quality treatments which can be tailored to their individual needs. This will help to enhance their quality of life and preserve their individuality.
Meeting of Minds recommend that basic and fundamental brain research (both on healthy and sick brains) should receive more funding. This funding should be increased through the existing European Community research systems, i.e. part of the 7th EU Framework Programme and it successors. This implies a targeted increase in financial contributions by the national governments to the European Union. The research funding should also be used for communicating the results to the public and this communication should be independent of the control of pharmaceutical companies. Finally, citizens’ participation should be stimulated and put in place to define and monitor the quality of research.
Increase research on prevention and alternative treatments
Meeting of Minds recommends that a part of all brain research funding, both public and private, is earmarked for research on the interaction between neurological causes and causes from the social and cultural environment in order to try to prevent brain related disorders. In addition, more research should be conducted on alternative treatment techniques.
Stimulate pharmaceutical research with low profit-potential
Meeting of Minds recommends examining ways of encouraging pharmaceutical companies to undertake brain research with low profit-potential as well as research into long-term consequences of medication and other treatments. For instance, patent rules must be revised and linked to the turnover generated by a given drug. Thus, the length of a patent may be significantly extended in the case of a rare condition, whereas in other cases it may even be reduced.
Make better use of existing knowledge – in care and education
Finally, Meeting of Minds makes a plea for bridging the gap between existing new knowledge of the brain on the one hand side and the knowledge which reaches the target groups in the health care systems on the other. The gap between scientific knowledge on the ways the brain learns and how it is used in practice in the education system also needs to be addressed.
2. Equal access to treatment should become a reality
All individuals suffering from mental problems should have easy and equal access to appropriate treatment. While this principle is generally accepted in theory, the reality leaves much to be desired. The causes of this inequality (e.g. lack of information, income, social exclusion) should be identified and addressed, both by policymakers as well as by health professionals.
Ensuring dignity and quality of life for chronically ill patients
Meeting of Minds emphasizes that long-term patients are often not given the best possible treatment, including the most up-to-date medicines. Expensive treatments for chronic disease are under pressure because of the increasingly limited coverage by health insurances. This affects our societies as a whole. Therefore, we strongly believe there should be no discrimination between acute and chronic phases.
Meeting of Minds recommends that the EU should put in place practical exchanges of experience and good practice between Member States in this area, with a view to establishing future guidelines for national-level medical assistance to ensure dignity of life for chronically ill patients.
This exchange and future guidelines should pay particular attention to improving care levels in hospitals but also minimum standards for non medical treatment. It should establish a quality control system for medical and non medical treatment within the national health care systems.
New treatments should be available
In many instances, (long-term) patients do not have access to the best possible treatments, including the most innovative medicines. When deciding on treatments and assessing benefits in relation to cost, the benefit to the individual in need of treatment should be considered in its totality; the social benefits for patient, family, and community must be an integral part of the assessment.
New treatments and technologies need to be objectively assessed with respect to their effectiveness. These assessments should be communicated widely in order to inform patients as rapidly and comprehensively as possible about their existence and effect.
3. Avoid medicalisation of society
Meeting of Minds focuses on the acceptance of diversity in order to prevent stigmatisation. Diversity is a basic prerequisite for democracy. It is therefore a fundamental concern for us as citizens. While rigid definitions of what constitutes abnormal behaviour can lead to instances where inappropriate treatment is instigated, clarification of what is considered ‘normal’ and what should be interpreted as a ‘real’ disease is needed in order to avoid unnecessary treatment and ‘medicalisation’ of society.
III. Final remarks: the role of the EU
Since mental health is an issue for all Member States, Meeting of Minds would like to underline the obvious added value of addressing this area at EU level. The EU can be of great assistance in addressing mental health and improving services in a coherent way across Europe, facilitating the exchange of good (and bad) practice between Member States, and setting up pan-European advisory committees, e.g. on research. It can also take a lead in actively and directly involving citizens, setting a good example for Member States to follow.
Putting in place a pan-European ethical and legal advisory committee could stimulate debate and lay down guidelines for brain sciences. It should integrate existing European agreements and include representatives of national ethical committees and relevant European stakeholders’ organisations.
Lastly, Meeting of Minds welcomes the setting up of the EU’s Fundamental Rights Agency, becoming operational by 1 January 2007, which will take into account the issues of mental health through promoting rights and protection of people with mental health conditions.