On 7 June 2023, the European Commission put forward a Communication laying out a comprehensive approach to mental health, aimed at helping Member States and stakeholders take swift action to deal with mental health challenges. The Communication features 20 European flagships and identifies financing opportunities worth EUR 1.23 billion.
ERGO Network’s research report Roma access to healthcare and long-term care (2022) includes a dedicated chapter on Roma mental health. Our findings show that the Roma experience a higher risk of being in poor mental health, however, most of them cannot access much-need care and support due to unavailability of services in communities, high costs of consultations, antigypsyism and stigma, and lack of trust in the healthcare system overall. See below for a summary of our analysis of the EC Communication from this perspective.
- Read our full response to the Communication here!
We warmly welcome that the Roma are explicitly mentioned in the Communication, with statements closely aligned with our own findings. We also particularly appreciate the social determinants of health perspective, looking at poverty, discrimination, and poor access to quality housing, education, and employment. The text also features clear links with the EU Roma Strategic Framework for Equality, Inclusion and Participation, which is mentioned twice, as well as with the Council Recommendation on Roma Equality, Participation and Inclusion. We are equally happy to see that the Communication mentions ethnic minorities, underlining that inequalities based on ethnicity have an important impact both on mental health as well as on access to adequate care. Last but not least, discrimination is comprehensively mentioned throughout the document, including explicit references to the discrimination faced by the Roma.
However, antigypsyism as such is not mentioned, nor is there any reference to racism or the EU Anti-Racism Action Plan. While comprehensive efforts and funds are dedicated to combatting the stigma and discrimination associated with mental health, which is very welcome, no similar efforts are foreseen to combat discrimination on other grounds (such as ethnic or racial background), despite it being acknowledged as a determinant of poor mental health. The sections on the prevention of psycho-social risks at work and on reinforcing mental health systems and improving access to treatment and care fail to mention discrimination in the workplace, or when seeking support services. It is a missed opportunity to not have included requirements for anti-bias training for mental health professionals and for Member States to promote the hiring of minority mental health workers and mental health mediators.
An encouraging flagship initiative is aimed at improving data collection through the European Health Interview Survey (EHIS), where we hope that data will also be broken down by ethnic background, to have a complete picture of the state of Roma mental health and of their access to and take-up of corresponding support services. Part of the EUR 28 million that the European Commission pledges in order to provide psychological first aid to people fleeing the war in Ukraine and their children must be dedicated to combatting racism and antigypsyism, given overwhelming evidence from the ground that Roma families escaping the war have been severely discriminated in host countries, often being turned away, not believed, denied help, or persecuted because of their ethnicity.
Overall, we broadly welcome the European Commission’s comprehensive approach to mental health, as a very important first step in improving mental health in Europe. However, the Communication falls short of being a strategy with targets and monitored objectives, and many of the initiatives and funds are not new. Disappointingly, the main social and material determinants of mental health – poverty and discrimination – are correctly identified, but not sufficiently addressed. Lastly, stakeholders (including civil society) are only mentioned once in a general sentence, while nothing is said about giving ownership to the affected communities and individuals themselves, as they should be closely associated to the design, implementation, and monitoring of policies affecting their lives and wellbeing.
ERGO Network hopes that the gaps identified above will be remedied through implementation and through subsequent EU policy measures, and we stand ready to support these efforts at both EU and national level.
`
For more information about our work on Roma mental health, please contact Amana Ferro (a.ferro@ergonetwork.org), Senior Policy Adviser in the ERGO Network staff
