Summit on COVID-19 impacts on mental health

Statement by Dr Hans Henri P. Kluge, WHO Regional Director for Europe (Athens, Greece, 22 July 2021)

Your excellencies,

Prime Minister of Greece, Mr Mitsotakis,

First Vice President of the Hellenic Parliament, Mr Kaklamanis,

Vice President of the European Commission, Mr Schinas,

Minister Kikilias, excellencies, ministers of health, Madame Messimeri, Father representing His Beatitude, friends and colleagues,

“Kathe nossos ksekina apo tin psyche” (“Κάθε νόσος ξεκινά από την ψυχή”) – “Every disease starts from the soul,” said Hippocrates, 2500 years ago.

The father of medicine, he was the first to introduce to the world, a holistic approach to health, highlighting the important link between body and soul. This approach was also adopted by the World Health Organization in 1948, when health was defined as: “A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity,” in its constitution.

With more than 1.2 million registered deaths in the WHO European Region, countless livelihoods ruined, families and communities driven apart, opportunities lost and businesses bankrupted, COVID-19 has shaken us all. This pandemic came to disrupt our lives and our health, both physical and mental. Our “psyche”, defined as our soul and mind; our deepest feelings, emotions, thoughts, attitudes and relationships were hit hard. This “psyche”, that Hippocrates made the epicentre of human well-being, is the focus of our discussion for the next 2 days. For the “psyches” of almost 1 billion people living in the 53 countries for which we are responsible as WHO/Europe and for the actions required to address the impacts of the COVID-19 pandemic on mental health and service delivery systems, to protect our “psyche” in the harsh times of this pandemic and to be prepared for similar catastrophic events in the future.

Events that shake us to the core, profoundly and collectively change us. Among those ongoing changes, is the general perception of mental health and what it means – a question which, now due to COVID-19, has become a top priority.

This pandemic provides an opportunity to rethink services, heal the fractures in society that have been exposed and the gaps that have been magnified. This is an opportunity no country can squander – and today marks a turning point in our effort.

Hosted by the Hellenic Republic, today we are here to discuss what’s needed to address the impact of COVID-19 on mental health and service delivery in the WHO European Region.

I am very much pleased that we are having this conference in Athens, following the successful completion of the joint rapid review assessment of mental health, conducted by WHO and the Greek Ministry of Health. This review produced a series of recommendations, which will soon materialize into the National Action Plan for Mental Health, here in Greece, as an example for the rest of the WHO European Region. I believe this is a great example of how we can make the best of the opportunity presented by this pandemic, in order to promote meaningful reforms in mental health, and for this, I would like to personally thank the Prime Minister of Greece, Mr Mitsotakis, the Minister of Health, Dr Vasilis Kikilias, and the Deputy Minister responsible for Mental Health, Ms Zoe Rapti, for not allowing the challenge of the pandemic to stand in the way of your reform-oriented approach to mental health and for continuing to place mental health at the top of your agenda, before, during and after the pandemic.

During my campaign for the post of the Regional Director for Europe – prior to the pandemic, I already identified mental health as a priority. It is a flagship of our European Programme of Work, endorsed by the Regional Committee a year ago.

Back then, after listening carefully to all 53 Member States, I recognized the importance of mental health for multiple reasons. Among those reasons, a critical one is that challenges related to mental health are the largest contributor to disability in our region. Every single day, millions are subjected to stigma and discrimination due to mental health. Yet, reforms to services remain far too slow and fragmented and the quality of care often remains insufficient.

This begs two questions:

One: If this is so evident, why haven’t we been able to bring about the desired change before?

And two: what must we do differently now?

To understand the scale of the impact of COVID-19 on mental health, WHO/Europe established a Technical Advisory Group, composed of professionals and advocates from across the Region. The wealth of evidence and the complexity of their recommendations is the basis of our work today and tomorrow.

The European Mental Health Coalition that’s being launched in September – together with the Queen of all Belgians, Queen Mathilde – is another important vehicle for change. The Coalition will seek to:

• address stigma and discrimination;
• build accessible, multidisciplinary mental health services in the community;
• revamp primary health care;
• strengthen investment for a fit-for-purpose mental health workforce;
• address structural and environmental determinants of poor mental health.

Here we cannot underestimate the quality of mental health services. I would like to express my deep appreciation to the Government of Greece once again for the unique opportunity through the new WHO Athens Office on Quality of Care, which will help all countries. Our agenda is a very ambitious one. WHO will rely on its trusted, resourceful expert partners, established as champions of mental health across the Region; partners like all of you, sitting here with us today, physically or virtually. But we also wish to bring on board those who never realized that they too can and should contribute: employers, trade unions, cultural and sports organizations, players who have not been utilized to the maximum before, but who have a lot to contribute to this effort.

The sheer fact that so many health leaders from the Region are gathered today – among them the Vice-President of the European Commission, the Regional Director of UNICEF, the OECD, gives me hope and signals a commitment, backed by action and investment. The presence of all of you, bringing experience, expertise, leadership and resources – to produce policies and legislation, trigger action and invest in better services – signals a change in tide.

Today, we are taking stock and shaping an opportunity in societies that are increasingly aware of mental health and well-being. Aware of how vital it is to foster resilience, preparing for future health emergencies, for the future of our children.

Mental health and well-being should be seen as a fundamental human right, as a fight in which, if we succeed, everyone wins. Not only do we mitigate the impact of COVID-19 – we also contribute to the economic recovery, and to the achievement of universal health coverage and the Sustainable Development Goals.

As health leaders, the responsibility is ours. I trust in your participation today being a manifestation of a long-term commitment to go beyond catchwords – and grasp the unique opportunity to do better. We owe it to ourselves and, most importantly, we owe it to the people we serve.

My thanks to our host, the Greek government and the Ministry of Health for staunchly advocating for mental health with WHO/Europe.

Although it is the right thing to do, it will still take a lot of courage and steadfastness to continue to put mental health at the top of the reform agenda – before, during and after the pandemic. I now ask all of you to do the same and all together approve the Athens Summit Declaration later on this morning, which will be presented in the opening plenary – to give mental health prominence, and invest in reformed, accessible, community-based and qualitative services. I urge you to rise to the challenge, mobilize your networks and start building the future we want.

Thank you.