Elevating Public Health through European Elections: A Call to Action.

"KlugeHans HenriWHO/Europe Regional Director: The vital importance of mental health and psychosocial support in conflict settings: Feeling safe is the foundation of well-being for individuals; peace is the foundation of flourishing communities. Violence of any kind—experienced directly or indirectly—profoundly disrupts these equilibriums, inevitably leading to suffering.: The WHO European Region is in the midst of, or reeling from, the impact of multiple armed conflicts—the war in Ukraine, the Karabakh crisis and most recently the conflict in Israel and the occupied Palestinian territory—causing suffering for millions of people. Facing the horrors of war, danger and human misery are emotionally taxing in the extreme, and it is common for people affected to experience feelings of intense anxiety, sadness, despair and hopelessness. : With the right support, however, most people will be able to process and integrate these experiences, regaining their foothold in their daily life, and building resilience. It is important to note that not everyone exposed to such extreme distress will develop a mental health condition such as depression or post-traumatic stress disorder (PTSD). According to the latest available data, about 1 in 5 (22.1%) people living in areas affected by a conflict in the previous 10 years will have a mental health condition (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30934-1/fulltext). The longer a conflict progresses and the less access people have to the support they need, the higher the likelihood of long-term negative consequences for their mental health and overall well-being.: Delivering effective mental health and psychosocial support (MHPSS) early on in emergency situations is one of the most important means of mitigating lasting suffering. MHPSS refers to any type of local or outside support focused on protecting or promoting psychosocial well-being and preventing or treating mental health conditions. It is a crucial, cross-cutting area of any emergency response.: For the last two decades, the World Health Organization (WHO) has been a key actor, together with other United Nations agencies and international organizations, in developing international standards and resources for MHPSS, culminating in the MHPSS Minimum Service Package (https://www.mhpssmsp.org/en). According to these standards, effective MHPSS interventions are well-coordinated among responding agencies and across different sectors, informed by rapid, iterative assessments of needs and available resources. In essence, there is no one-size-fits-all approach with MHPSS—customized interventions must be delivered based on the needs of the affected communities.: To ensure such a needs-driven approach, a strong, well-staffed, national mental health system must be in place before the emergency. This system should also incorporate MHPSS into the national emergency response and recovery plan, which should flexibly respond to the changing needs of affected populations over time.: A sufficient number of qualified mental health professionals must also be in place, which is why reports from across the WHO European Region, indicating a shortage of such professionals, are concerning, particularly in the realm of child and adolescent mental health.: In situations of intense distress, the first source of support for most people is from their community members. For that reason, community engagement must be actively enabled, including the creation of community referral networks to ensure that people are able to access the support that they need. Responding agencies, however, tend to prioritize allocating resources to the treatment of mental health conditions and less to the strengthening of community-based support which can foster resilience and social cohesion.: Support for those involved in the response—health care professionals, first responders and volunteers—must not be forgotten. Helpers are often exposed to distressing events, widespread suffering, long working hours, overwhelming workloads and security threats, which can drastically affect their mental health and lead to burnout. Diverse interventions to protect and promote mental health and psychosocial well-being should be available to helpers ‘during and after crises’, at both the individual and group level.: Wanting to forget atrocities is a typical human response in order to return as quickly as possible to normalcy after a crisis ends. However, it is essential that the recovery process be planned for and supported in the aftermath of a crisis to actually allow healing at the individual and collective level. Otherwise, there is a very real risk that unresolved trauma may form the foundation for the next conflict.: Globally, roughly 80% of WHO’s humanitarian work takes place in fragile, conflict-affected and vulnerable settings.: That’s widely known to those who work in public health. Also widely acknowledged is how health and peace are interlinked; how physical and mental health are the number one condition for peace and vice-versa and how fighting health inequity is crucial to building and strengthening peace. This is why mental health and psychosocial support is increasingly an integral element of peacebuilding as well.: Awareness of the dividends, intricacies and impacts on individuals and societies alike should urge us to make mental health and psychosocial support an even greater priority—integral to our work within public health. This is clearly laid out in the European Programme of Work, committed to by every single Member State in this WHO European Region encompassing 53 countries across Europe and Central Asia. And this lies at the heart of the agenda of a WHO/Europe flagship initiative under our European Programme of Work: the Pan-European Mental Health Coalition, launched in 2020 to promote mental health as a critical priority for public health as a whole.: Because to help heal the impacts of conflicts around us, we ultimately have to heal the conflicts within."