European Mental Health Awareness Week: discover how the EU-funded Joint Action ImpleMENTAL is promoting and improving mental health in Europe by implementing best practic

According to the recent Eurobarometer survey,  almost nine out of ten respondents (89%) consider mental health promotion as important as physical health promotion. This highlights the importance of mental health as an integral part of health and the need to focus on early diagnosis and prevention of mental health issues as well as on the provision of care and services for those in need.

As the European Mental Health Week continues, HaDEA spoke with Vasileia Konte, MD, the coordinator of the Joint Action ImpleMENTAL from NPHO in Greece.

Shortly present ImpleMENTAL and its relevance in the field of mental health 

ImpleMENTAL is the Joint Action (JA) on implementation of best practices in the area of mental mealth, co-funded by the European Union Third health programme. The Joint Action comprises a strong network of 39 organisations from 21 countries, with more than 180 people working in collaboration. 

ImpleMENTAL has been working to support the transfer and pilot implementation of two national best practices in other countries: 

• The Belgian best practice on community mental health system reform aims to improve the quality of care and quality of life of patients. Among its main objectives is the limitation of treatment in health care facilities to those who really need it and the shortening of hospital stays. Pilots are being implemented in 11 countries.
• The Austrian best practice on suicide prevention (SUPRA) focuses on establishing a multi-level suicide prevention strategy that integrates universal, selective and indicated prevention interventions, based on the local implementation context and building upon existing resources and initiatives. Pilots are being implemented in 14 countries.

JA ImpleMENTAL also aims to support EU countries to improve & promote mental health through capacity-building and training, which: 

• Address system transformation and increase its efficiency; 
• Promote citizen-centered & integrated approaches to mental health;
• Put an emphasis on participation of individuals and their families;
• Help to build and maintain healthy alliances.

The project helps to enhance the reform of the national mental health systems. A strong involvement of national and regional governmental actors is envisaged and implemented, and there is a sustained cooperation and involvement of a wide variety of key stakeholders both at national and European level.

Improving mental health is a team effort and synergies across EU countries and their key stakeholders are necessary and JA ImpleMENTAL is a very good example of that. JA ImpleMENTAL has two advisory bodies: a stakeholder forum with 10 key European organisations in the area of mental health and 2 international organisations, the World Health Organisation (WHO) Europe and the Organisation for Economic Co-operation and Development (OECD), and a member state policy committee forum with all representatives of the 21 EU countries taking part in the JA. 

ImpleMENTAL is currently in its final implementation phase, which focuses on the actual implementation of the best practices. This has been preceded by assimilation of the best practices, adaptation to the local context and formulation of the pilot and its assessment, while keeping in mind its long-standing sustainability. 

How has the JA contributed to the wider adoption of mental health prevention measures and suicide prevention strategies in European countries? 

Within JA ImpleMENTAL we are implementing 25 pilots for the two best practices mentioned above: 

• 11 countries are implementing the Belgian model, from a total of 163 activities implemented across 5 strategic areas, 43 are focusing on developing new or transforming existing mental health services. Measures include defining care pathways for people at risk of mental illness or mental health challenges and the development of individual service plans.
• 14 countries are implementing the SUPRA pilot action plans, entailing prioritised measures based on country needs. The areas covered comprise support and treatment for risk groups, assessing restrictions to means, conducting activities raising awareness and countering stigma, improving quality of data, integrating suicide prevention programmes into other health promotion activities. A total of 142 measures under this best practice are currently implemented across Europe. By using the Austrian best practice, 14 new or updated suicide prevention plans across Europe will be formulated.

Our activities have shown that stakeholders wish to collaborate effectively with one another, to share experiences and be empowered as well as they support the establishment of mental health networks. While transforming mental healthcare systems toward social inclusion and a recovery-oriented approach is a long process, the implementation of pilots may provide an effective example and leverage resources to improve mental health care.

Have you encountered any significant challenges in implementing this JA, for instance in shifting the implementation of mental health services from institutionalised mental health care towards community-based local networks? If yes, could you briefly expand on this?

Different challenges were encountered in different phases of the JA. During the transfer and pilot implementation process, for instance, the key challenges were the resistance to change and the engagement of stakeholders, but also the availability of reliable data and the shortage of mental health staff.  

As a result of its efforts, though, the project has managed to improve collaboration with stakeholders. The management tools and methods that have been provided can be transferred to other regions and sites, ensuring that these are scaled up. The key lessons learned were shared in the network across countries, allowing for their inclusion in national strategies.

An important lesson learnt from the implementation phase is that customisation of the measures to local needs is crucial for their successful implementation, as well as inter-professional and intersectoral collaboration. A realistic action plan must be designed, based on activities which are focused, feasible and practical. Time and consistency are also important elements to be considered for implementation.  

How important is the support of EU funding for IMPLEMENTAL? What are the expected future outcomes of this JA?

Both EU funding and the prioritisation of mental health in the EU Commission agenda, especially in the aftermath of the pandemic, have been instrumental for promoting mental health and eliciting changes in the mental heath care systems in countries participating in JA ImpleMENTAL.

The support of EU funding has allowed JA ImpleMENTAL to achieve very successful results, including the organisation of events and the development of trainings in collaboration with WHO Europe. Thanks to the involvement of experts in the field, we have delivered trainings to representatives from 16 countries, with the aim to improve the quality of care in mental health and related services and to promote the human rights of people with psychosocial, intellectual and cognitive disabilities.

The JA has a clear sustainability roadmap. A lot of its activities have already been integrated in national action plans. A good example of this is the area of suicide prevention, for which countries have been drafting an original or revised action plan. Many countries have revised their information systems, enhanced user participation in the delivery of services, and mobilised community resources. Many professionals have received training in a wide range of topics for community mental health care and suicide prevention. 

These changes, the knowledge, the collaborations are the heritage of the JA. The network, the consortium are the biggest asset of this Joint Action and its shared vision. Its short term outcomes will be disseminated through different scientific and non-scientific channels, the outcomes will inform policy recommendations and be used to raise awareness. 

Its long term outcome will include its substantial contribution to bringing mental health to the forefront and changing the culture of services towards a recovery-oriented, human rights-based approach. The JA will eventually contribute to reductions in suicides and better quality of care and life for people with mental health challenges. 

We can be proud of what has been achieved in the past 3 years. 

“It is important to remember that we can succeed, if we join forces together. This needs to be a collective effort. We have to make people's lives better. And we must be able to say that it is ok not to be ok - you are not alone, and you should seek help.” 

Background

Background

EU4Health is the fourth and largest of the EU health programmes. The EU4Health programme goes beyond an ambitious response to the COVID-19 crisis to address the resilience of European healthcare systems. The programme provides funding to national authorities, health organisations and other bodies through grants and public procurement, contributing to a healthier Europe.

HaDEA manages the vast majority of the total EU4Health budget and implements the programme by managing calls for proposals and tenders from 2021 to 2027.