Evidence is scarce in terms of tracking the progress of implementation of mental healthcare plans and policies (MHPPs) in Europe, we aimed to map and analyze the content of MHPPs across the WHO European region.

We collected data from the WHO Mental Health Atlas 2011, 2017 and 2020 to map the development of MHPPs in the region. We contacted 53 key informants from each country in the European region to triangulate the data from WHO Mental Health Atlases and to obtain access to the national mental health plans and policies. We analyzed the content of MHPPs against the four major objectives of the WHO Comprehensive Mental Health Action Plan, and we also focused on the specificity and measurability of their targets.

The number and proportion of countries which have their own MHPPs has increased from 30 (52%) to 43 (91%) between 2011 and 2020. MHPPs are generally in line with the WHO policy, aiming to strengthen care in the community, expand mental health promotion and illness prevention activities, improve quality of care, increase intersectoral collaboration, build workforce and system capacity, and improve adherence to human rights. However, specific, and measurable targets as well as a description of concrete steps, responsibilities and funding sources are mostly missing. They often contain very little information systems, evidence and research, and mostly lack information on evaluating the implementation of MHPPs.

Progress has been made in terms of the development of MHPPs in the WHO Europe. However, MHPPs are often lacking operationalization and appropriate data collection for evaluation. This is then reflected in missing evaluation plans, which in turn leads to lessons not being learned. To enhance the potential for knowledge generation and demonstration of impact, MHPPs should be more specific and contain measurable targets with allocated responsibilities and funding as well as evaluation plans.

Globally, mental disorders account for almost 20% of disease burden and there is growing evidence that mental disorders are socially determined. Tackling the United Nations Sustainable Development Goals (UN SDGs), which address social determinants of mental disorders, may be an effective way to reduce the global burden of mental disorders. We conducted a systematic review of reviews to examine the evidence base for interventions that map onto the UN SDGs and seek to improve mental health through targeting known social determinants of mental disorders. We included 101 reviews in the final review, covering demographic, economic, environmental events, neighborhood, and sociocultural domains. This review presents interventions with the strongest evidence base for the prevention of mental disorders and highlights synergies where addressing the UN SDGs can be beneficial for mental health.

Crises such as the corona pandemic, but also climate change associated events such as extreme weather events are major stressors for people on an individual, but also on a population level. Such crises often lead to highly burdened individuals with reduced quality of life, decreased well-being, mental health problems and an accumulation of psychiatric illnesses, especially in vulnerable population groups. These create a high demand and need for low intensive (psychosocial) support and primary and clinical care that can often no longer be adequately met by the existing infrastructure. However, good mental health and mental health care is a necessary prerequisite for people to lead fulfilling and productive lives and for communities and their settings (such as families, schools and workplaces, etc.) to function well. Therefore efficient supporting (public mental health) approaches are urgently needed. This presentation will introduce and discuss public mental health approaches and their effectiveness with a focus on mental health promotion and prevention. The implementation and dissemination of these approaches may help to further strengthen psychological resilience in communities to be better prepared for coping with acute crises and long-term stressors.

The rise in domestic violence and abuse has been dubbed a ‘pandemic within a pandemic’. Individuals known to mental health services are particularly vulnerable. Yet despite challenges to mitigating domestic violence and abuse in this group, the COVID-19 pandemic has provided opportunities to develop new interventions to support those affected.

Mental health issues are fast becoming one of society’s greatest health challenges with evidence of higher levels of illness and strain on psychiatric services. The reasons for this trend of increasing mental health problems across the population are complex and there is an urgent need to research and deliver effective public mental health strategies. In this perspective piece we argue that psychiatrists and public health physicians have unique knowledge and perspectives on population mental health. The development of interdisciplinary initiatives and training posts would result in clinicians with expertise to drive forward public mental health strategies. Focused and sustained advocacy and collaboration are necessary for prioritisation of public mental health on policymakers’ agendas.

Besides addressing the increased prevalence of psychiatric disorders, social challenges, and building community resilience during the crisis, mental health professionals (MHPs) are in a unique position to assist the vaccination drive against coronavirus disease-2019 (COVID-19) in various nations. Vaccination programs are adversely affected by misinformation, fake news and vaccine hesitancy fuelled by social media. MHPs can enable this vital public health strategy by prioritizing vaccination for individuals with severe mental illness (SMI) and substance use disorders, promote awareness and public education, debunk misinformation and integrate psychosocial care into the vaccination drives. In order to target the health inequity and discrimination faced by people with SMI coupled with their additional risks, the authors urge the global mental health fraternity to tailor these crucial roles with respect to COVID-19 vaccination based on the regional needs and contexts.

The past 20 years have seen the disappearance and degradation of biodiversity on earth at unprecedented rates. This phenomenon shares similar drivers to those behind climate change yet requires its own solutions. The twin catastrophes of climate change and biodiversity loss demonstrate how our health is bound up in the vitality of this planet. There has been an increasing effort on the part of healthcare professionals to appreciate this relationship, as evidenced by the growing influence of planetary health as a discipline. However, the health impacts of biodiversity loss have been less focused on than those brought on by climate change. Psychiatry's appreciation of the interface between environments and our health, alongside the evidence for the connection between nature and mental health specifically, prompt psychiatrists to ensure that the institution of healthcare throws its influence equally behind solutions to climate change as well as biodiversity loss.

COVID-19 has presented society with a public health threat greater than any in living memory, leaving us to question almost every aspect of our society. An ever increasing concern is how we protect the global population from mental illness and whether public mental health policies can achieve this. In this article I reflect on the history of mental health service development, and furthermore on how COVID-19 might impact on the delivery of public mental health strategies into the future.

The coronavirus disease (COVID-19) pandemic continues to be a devastating chapter in history. The consequences of the pandemic unfold daily and they extend beyond physical health. Current research suggests that it is a public mental health crisis. With regard to the physical effects of COVID-19, policy-makers have drawn from past experiences, such as the severe acute respiratory syndrome (SARS) outbreak of 2003, to craft unique responses. A similar approach must be taken to address the mental health effects of the pandemic. Because COVID-19 can fit the definitions of a mental health disaster, it can be addressed using the principles of disaster mental health management. This letter to the editor presents arguments for defining COVID-19 as a mental health disaster, the challenges facing policy-makers in addressing it as such, and calls upon researchers to fill this gap in the literature.

Recently, mental health and ill health have been reframed to be seen as a continuum from health to ill health, through the stages of being asymptomatic ‘at risk’, to experiencing ‘mental distress’, ‘sub-syndromal symptoms’ and finally ‘mental disorders’. This new conceptualisation emphasised the importance of mental health promotion and prevention interventions, aimed at reducing the likelihood of future disorders with the general population or with people who are identified as being at risk of a disorder. This concept generated discussion on the distinction between prevention and treatment interventions, especially for those mental health conditions which lie between psychological distress and a formal psychiatric diagnosis. The present editorial aims to clarify the definition of promotion, prevention and treatment interventions delivered through a task-shifting approach according to a global mental health perspective.