Debates

Tuesday, 5 September 2006 - Strasbourg

18. Improving the mental health of the population towards a strategy on mental health for the EU (debate)

  President. – The next item is the report by John Bowis, on behalf of the Committee on the Environment, Public Health and Food Safety, on improving the mental health of the population – towards a strategy on mental health for the European Union (2006/2058(INI) (A6-0249/2006).

  Markos Kyprianou, Member of the Commission. Mr President, I very much appreciate Parliament’s active participation in the consultation on the Commission’s Green Paper on mental health. I would like to take this opportunity to thank the rapporteur, Mr Bowis, for his excellent report.

It is almost a year since the Commission presented its Green Paper on improving the mental health of the population. The Green Paper was also a response to the WHO ministerial conference, which involved all EU Member States. In the declaration it adopted, the conference called upon the Commission to support the Green Paper’s implementation.

The Green Paper presented mental health as a central part of overall public health and a key determinant of quality of life in the European Union. It argued that public mental health was also a key factor in the attainment of the EU’s strategic objectives – prosperity, solidarity and social cohesion, as well as justice.

European values and the European social model demand that we give the necessary support to those who suffer from mental disorders and to promote social inclusion. Perhaps this is one of the basic messages to emerge from the consultation process and from the report and resolution, namely that tackling social inclusion and the stigma attached to mental health problems is a key factor in our efforts to deal with this whole question.

Because of the stigma attached, people who suffer from mental health problems do not admit to them, do not seek help. As a result, not only do they not get treatment, but also the reality and effectiveness of the statistical data are distorted, which in turn means that the matter is not always a priority for Member States and governments, since sometimes the figures may appear misleadingly low. Therefore, dealing with this stigma and dealing with social inclusion is not just a human rights issue and not just an obligation, but can also have practical effects in our efforts to give priority and emphasis to actions and activities designed to tackle this problem.

The Green Paper pursued three objectives. One was a broad discussion of the importance of exploring whether a on mental health strategy should be developed at EU level and identifying what the priorities of such a strategy should be. We held a full consultation. We had more than 150 contributions. One of the most important contributions, of course, will be Parliament’s resolution.

The draft report that has been tabled for today’s debate addresses mental health in its full complexity. I welcome the fact that it includes a number of very concrete suggestions. That is very important and helpful to us for the next steps we are to take. I agree with almost all the points contained in the report and the Commission will give due consideration to these proposals when deciding on the next steps to be taken.

We are now in the process of analysing the results of the consultation and as of yesterday, if I am not mistaken, all the contributions are available on our public health website. A document summarising the consultation outcomes will be prepared and published in the autumn. I can say at this stage that the preliminary results of the consultation showed very strong support for the development of an EU mental health strategy.

I hope to present a Commission White Paper on mental health during the first quarter of next year presenting a strategy and proposing a framework for sustainable cooperation between Member States, policy fields and the relevant stakeholders. I am firmly of the opinion that what we need most in order to promote positive mental health in the community and encourage social inclusion is dialogue, consensus-building and more importantly, action. That is extremely important.

Raising awareness and exchanging approaches and good practice are important steps and in the long term can be more powerful than any other initiatives.

I look forward to the debate. Once again, I thank Parliament for this initiative.

  John Bowis (PPE-DE), rapporteur. – Mr President, I thank the Commissioner for his words of welcome on this report.

Colleagues, 450 million people in our world live with a mental disorder. One in four of us will suffer from one during our lifetime; 58 000 people in Europe commit suicide every year and ten times that number try to. More people die needlessly from suicide than from road accidents or Aids. Three in every hundred of us will have depression; one in three of us going to our family doctor will have a mental health problem, but only one in six of us will be diagnosed as such. That does not mean that two out of three of us will have good mental health: it means that we may not need, may not seek, or may not be offered treatment. It may mean that we are given inappropriate treatment with drugs, therapies, institutions and laws that at best may do no harm, and at worst may lead to physical and psychological damage. It almost certainly means that we are labelled, patronised, despised, feared and to a greater or lesser extent segregated in society, within our family, at work, at play and even within our health and social services.

In a perverse reversal, we can hide but we cannot run. We cannot perform, we cannot contribute to society as we would wish, we cannot lead full and fulfilling lives, as we would want. It also means that we have barely scratched the surface of creating a policy to promote mental wellbeing among our citizens from their early years, through the adult years of work and leisure and into old age and the years of increasing frailty.

That is why I welcome what has been achieved, firstly by a sequence of Council Presidencies – starting and culminating now with the Finnish Presidency – and by the Commission, where this Green Paper was drafted and will be driven through to active policy-making in the coming months.

When as a child I first came across mental illness, it was something you did not talk about. When I first came across mental health policy it had not progressed far from the locks, bolts, restraint garments, isolation rooms, powers to detain, forcible administration of drugs and so on – or so it seemed. In fact mental health policy has been on the move since the 1960s, with more humane surroundings, treatments and therapies. Patients have been on the move too, going into community housing or back to their own homes. The public has not always liked that. No longer ‘out of sight, out of mind’, it became ‘out of his or her mind and living next door to me and my children’.

If modern, humane mental health policy is to work, it must have a spectrum of care and a range of health and social services, housing, training, transport and other services working in partnership. It must have trust between professionals, patients and families, and it needs our resources. To get those it needs political awareness, and that needs public consent and professional support. A service that does not gain professional, public and political support fails patients and their families doubly. It fails to treat and care adequately and it prompts a downward spiral of public confidence and so reinforces stigma.

Stigma is rampant in all our countries. It is a human rights abuse. It is unintentional, borne out of fear and ignorance, but just as damaging to the individual as any other form of abuse. We all contribute to the stigmatisation of people who, if they had a physical problem, would receive our sympathy and support. However, with mental illness we so often turn away and hope that someone else will cope. Living with mental illness is tough enough without adding to the burden of illness the pain of rejection and stigma. And so we must listen to patients and service users. They should be our partners and not just our patients. We have legislated against discrimination for people with disabilities. Perhaps we need to do so for people with mental health problems – both those in hospital and those in the community.

My report is about these things. It points the way forward to some of the changes we need. If the public believes, they will put pressure on governments, and those governments will then invest in good services. That makes public belief possible. We know that neuro-psychiatric disorders are responsible for a third of disabilities, 15% of in-patient costs, a quarter of drugs costs, half the caseload of social workers and so forth. I want to be sure that if I, my wife or a member of my family has this problem in due course, as one of us is quite likely to, then I want a system in which they are hugged rather than rejected, loved rather than forgotten; a system in which it is not the case that they do not know people or do not know where they are; a system in which they are not within blank, cold, alien walls. I would want them to have hope and not self-fulfilling despair. If we understand that it could be any of us – and it will be many of us – then we will seek a better service.

In my report I quote those words of Stefan Heym from Alexanderplatz in 1989 East Berlin:

Wir haben in diesen letzten Wochen unsere Sprachlosigkeit überwunden und sind jetzt dabei, den aufrechten Gang zu erlernen. (In these last weeks we have regained our power of speech and learnt once more to walk with our heads held high.)

The stigma of mental health is as repressive a regime as East Germany was. It stills our tongue, makes us hide our head and our task is to make sure that people with mental health disorders will, with our help, find their voices once again, their dignity, their self-respect and walk once more with their heads held high.

(Applause)

  Kathy Sinnott (IND/DEM), draftsman of the opinion of the Committee on Employment and Social Affairs. – Mr President, Commissioner, I have worked for many years on issues of concern to people with disabilities and those who serve them. Some progress has been made for some people with some disabilities. Sadly, this progress has not for the most part been shared by people who experience mental illness.

Judging from the keen interest in the Committee on Employment and Social Affairs, Members are aware that in our very midst people with mental illness are being subjected to the inhuman abuses of involuntary institutionalisation and hospitalisation, compulsory drugging and other medical treatments, physical restraint and force, while also being subject to discrimination in the workplace, exclusion in the community and suspicion on the part of public services.

Fortunately, there was a real sense in the committee that this must change, that priority must be given to approaches to treatment that enable people to achieve remission and recovery, as well as to inclusion, the prevention of mental illness and the promotion of mental health. Finally, there must be recognition that every human person is valuable and worthy of respect and that this respect demands that we allow people to speak and decide for themselves whenever humanly possible.

As we work through the process of formulating a European mental health strategy, the most important question we should ask ourselves is: will this make someone’s life better? I should like to congratulate Mr Bowis on his report, which contains many good things: an admittance that pharmaceuticals can cause more mental illness than they cure; a recognition of the importance of childhood for mental health with a call for support for families; a recognition that employment can affect mental health for better and for worse; and the need to consult those who have recovered from mental illness to learn how recovery happened. This is a good start but, if we are going to truly help someone with this strategy, then we must take into account the whole person and to do so the strategy will have to include concepts like nutrition and failure, especially student failure, and for this reason I particularly support the amendments by Mrs Breyer.

We also need to look at concepts as yet unmentioned, such as hope and fear, creativity and expression, faith and spirituality. It amazes me that we can write a whole strategy without ever mentioning the words ‘spirit’ or ‘spirituality’. It is important for us to accept that there are moments of crisis, sorrow and strain in all of our lives and that when we experience them we may need support and we may need understanding, but we do not always need a diagnosis and a drug. Getting it right is so important. When we consider suicide, then we see that getting it right can even be a matter of life and death.

  Marta Vincenzi (PSE), draftsman of the opinion of the Committee on Women’s Rights and Gender Equality. – (IT) Mr President, Commissioner, ladies and gentlemen, the Committee on Women’s Rights and Gender Equality has held a passionate debate on the mental health strategy. In the short time allowed to me it is difficult to summarise the richness of the debate, but I am pleased to highlight the unanimous vote, which, extremely briefly, suggests three basic points.

The first point is the strong consensus for the proposal to deinstitutionalise psychiatric services; the aim of abolishing the internment and segregation of the mentally ill is seen by the committee as a step forwards in affirming the dignity of the person and, for that reason as well, Europe is fully entitled to deal with it.

The second point is a strong emphasis on a wide range of approaches with regard to the need for prevention and for users and local services to be actively involved at all levels in the global strategy, and even more so in the area of prevention.

The third point is a call to take the gender dimension into account, which is the most glaring omission in the Green Paper. We claim that the proposed measures need to include systematic research with specific studies on women, since problems such as eating disorders, neurovegetative diseases, schizophrenia, depression and suicide have not yet been studied from a gender perspective and that means that the progress made in prevention and treatment is less significant than is needed. Hopefully, though, we are making headway.

  Françoise Grossetête, on behalf of the PPE-DE Group. – (FR) Commissioner, you will allow me first of all to congratulate my colleague, Mr Bowis, who has done a remarkable piece of work on a particularly important subject that affects us all, since a quarter of all Europeans will have mental health problems during their lives, with all the considerable repercussions that these will involve for those close to them. I fear that this subject in reality affects everyone. Whoever we are, mental health affects us.

For a very long time, we have, however, closed our eyes to these evils. Poor mental health was supposedly just a difficult patch people went through, or not even that. These people felt stigmatised inasmuch as they had to keep their suffering secret. This oppressive silence ought no longer to exist nowadays. To dare to talk about mental health problems is already to have taken action. Talking about these illnesses is a first step towards curing most of them. To isolate people with mental health problems and to discriminate against them is like pointing a loaded pistol at their heads. I am thinking of the young man with a promising future whose life is suddenly turned upside down when, on reaching adulthood, he proves to be schizophrenic. This is distressing not only for him but also for his family. The number of suicide attempts ought to make us reflect on the importance of this problem. Moreover, a certain amount of crime is a result of the increase in certain types of mental health problem.

The ageing of our populations ought also to give us pause for thought as it is, unfortunately, accompanied by an increase in mental illness. We must take this phenomenon into account.

The European Union may develop its measures to prevent poor mental health, but it must also help researchers confront this phenomenon in order better to understand the factors that affect mental health, particularly during early childhood, to manage patients’ progress more effectively, to promote the most suitable medicines available and to support efforts directed at training health care professionals.

An adult is not cared for in the same way as a child or adolescent. We can also reflect on the various possible approaches to be adopted according to whether the patient concerned is a man or a woman. Nor let us forget the crucial role played by the doctor in monitoring the patient. Doctors sometimes feel very alone and ponder the whys and wherefores of forcing patients to take drugs or of locking them away.

Together with my fellow Members, I hope that the Commission will take this approach further and that it will return to us with proposals based on those for which we shall vote tomorrow. It is crucial that full importance be given to mental health in European health policy and that a different view be taken of mental illnesses, with people being accorded the respect and due dignity that any human being should inspire.

  Evangelia Tzampazi, on behalf of the PSE Group. – (EL) Commissioner, the promotion of mental health is an issue that concerns not only mental patients and their families; it basically concerns society because we all at some point face some form of mental illness which may cause significant economic and social problems.

Today's debate on the report by my honourable friend Mr Bowis, whom I should like to congratulate, if I may, on his exceptional work, is extremely important. Thus public consultation is being set in motion in the Union about the introduction of a strategy for mental health. Action needs to be taken for the prevention, timely diagnosis and treatment of the mental illnesses which strike part of the population, in order to limit the personal financial and social consequences.

At the same time, the action in question must target better information and the development of appropriate attitudes and skills, in order to protect mental health and combat the stigma which attaches to mental illness.

At the same time, I should like to highlight the need for continual education of primary health care professionals in mental health issues, as this ensures the best possible response to them.

I also consider it necessary to apply individualised methods for promoting mental health, taking account of the particular needs of target groups, such as people with disabilities. Given the fact that the results are better when people with mental health problems are treated in society, while long-term institutionalisation in mental health hospitals may exacerbate their condition, we need to support their deinstitutionalisation.

  Jolanta Dičkutė, on behalf of the ALDE Group. – (LT) Ladies and gentlemen, as Albert Camus once said: 'Losing your life is not a big deal. But seeing how your life is losing its sense and how your existence is losing its purpose – that is unbearable. It is impossible to live without purpose.'

In this constantly developing world, more and more people become disenchanted with themselves and others, are experiencing stress, see no purpose in life, are unable to face new challenges and solve the problems they face. Now, we are increasingly seeking out the specialists, psychologists and psychiatrists that we avoided a decade ago. There is no shame in admitting the need for help. Unfortunately, people who ask for help are still stigmatised by society.

10 September is World Suicide Prevention Day, and 10 October is World Mental Health Day. Is it not paradoxical that we are forced to draw society’s attention to such painful problems each month?

It is hard to admit that the number of people suffering from mental illness is increasing even at a time when mental healthcare is seemingly improving. The increase in the number of suicides is catastrophic. Every 40 seconds, someone in the world commits suicide, and every 3 seconds someone attempts to commit suicide. Lithuania, my country, loses more than 1 500 people each year to suicide, and sadly this ranks us first in all of Europe, leaving behind even Russia and other post-Soviet countries.

We obviously cannot disregard the current situation. Immediately after the Ministerial Conference in Helsinki, Lithuania started drafting its national mental health policy, which will be soon approved by Parliament. Furthermore, mental health has been established as a priority within national policy. It is one of four areas that will receive Structural Funds for the health sector. We realise that we must develop community-based services as an alternative to permanent care institutions, thus solving the issues of human rights in a modern way.

It is impossible to suffer in silence, alone with one's own grief; that is why we need to rally our efforts to solve the problems of mental health. I believe that the EU’s Green Paper 'Improving the mental health of the population' is the first important step in pursuing a common solution. It is not only treatment that matters. For the first time we are speaking about the promotion of mental health, illness prevention and recovery. We must also share information and best practices with our colleagues from other countries and develop information exchange networks.

We have finally realised that solving these problems is not merely the province of specialists. Society and every one of us individually must take responsibility. 'With understanding, new hope', the slogan of World Suicide Prevention Day, embodies the hope of those who are not indifferent to the suffering of others and the hope that society will come to the aid of those in distress.

  Hiltrud Breyer, on behalf of the Verts/ALE Group. – (DE) Mr President, ladies and gentlemen, I hope that this Green Paper sends out a signal, at long last, in favour of improving mental health in the EU. Increased political awareness of the mental wellbeing of European citizens is long overdue. In my view, however, it is a serious omission that neither the report of the Committee on the Environment, Public Health and Food Safety nor the Commission proposal contains a comprehensive causal analysis.

We know that environmental pollution, poor diet and food allergies have an effect on both physical and mental wellbeing. The effects of toxic chemicals on hormonal balance are evident. There is a pressing need for an analysis to be carried out at long last of neurological disturbances resulting from environmental toxins and pesticides, and of the connection between attention deficit disorder and food intolerances.

We also know that highly gifted children and young people, for example, often wrongly end up receiving psychiatric treatment owing to a failure to recognise them as such. There must be greater readiness to deal with this issue, too. This is also the reason for my concern about the risk of the pharmaceutical industry jumping on the bandwagon and promoting medicines as the only solution.

We need to tackle the issue of the need to perform a comprehensive approach involving analysis and treatment instead of further medicalising and pathologising life cycles. After all, it is unacceptable that healthy, lively children, children who had previously been considered perfectly healthy, should now be diagnosed with attention deficit disorder or attention deficit hyperactivity disorder and be prescribed medication, and it is also unacceptable that young people should be exposed to high levels of violence in the media and then labelled as psychologically ill and prescribed medication.

We must also ask ourselves whether there can ever be a guarantee of happiness in our consumer society, and therefore whether it sends out the wrong signal to automatically treat people with antidepressants every time they are grieving or in a bad mood – things that we all have to go through.

My concern, therefore, is that we may be setting the wrong course with this Green Paper, and also with a White Paper. We should carry out a causal analysis and should not rely solely on prescribing medication. Parliament’s call for medicines to be used as a last resort, once the causes of the psychological illness have been sufficiently explained, should be central, and we cannot let ourselves become the lackeys of the pharmaceutical industry and dedicate ourselves to further pathologising and medicalising life cycles and processes.

  Roberto Musacchio, on behalf of the GUE/NGL Group. – (IT) Mr President, ladies and gentlemen, this report, for which I sincerely thank Mr Bowis, can make a significant contribution to a better Europe, one that respects the dignity of psychiatric patients, assists them and helps them back into society, while putting an end to unacceptable practices such as segregation in mental institutions. In short it will be a better Europe, since a civilisation is judged very much on how it behaves in these situations in relation to the weakest individuals and those most at risk.

A year ago, a group of people who are commonly termed ‘mad’ came here to Strasbourg from Rome in a coach, together with mental health workers and family members. They had come to talk to us about the situation in Italy: a law named after a psychiatrist, Franco Basaglia, who is unfortunately no longer among us, who fought with them – ‘mad’ men and women – for patient dignity, shut down mental institutions and set up an alternative, local assistance and rehabilitation scheme, because of which people in Italy are now in a better position. These ‘mad’ men and women came to ask us to roll out the scheme in Europe, because they would thus feel more like citizens of this Europe, in which all too often they have been, and still are, discriminated against and deprived of their rights.

With this report today, we are beginning to respond to that demand, and we can tell them, ‘You are citizens like everyone else’. But for that to happen completely, this work, which we have done with all our hearts, and the work contained in the Green Paper through positive collaboration between Parliament and the Commission, needs to be turned into something significant that will also provide the various countries with guidance: in other words, a genuine directive for a Europe without mental institutions that restores dignity to all psychiatric patients.

(Applause)

  Urszula Krupa, on behalf of the IND/DEM Group. – (PL) Mr President, it is rare for the issue of rights and ethical standards to be brought up in a debate on mental health. Some people even view immoral behaviour as a symptom of modernity. However, that kind of lifestyle leads to disorders and inhibits personal development. A person is then driven by biological stimuli from the subcortex region of the brain that are not checked or controlled by the cortex, where the higher emotions are based.

In these individuals, the thought process and intelligence are governed by instincts which correspond to underdeveloped higher moral and aesthetic emotions and an inability to share social or patriotic bonds. In this way, disturbed personal and emotional development may affect not only individuals, but whole groups and communities. This goes hand in hand with a rise in psychopathic tendencies in society which further corrupt it, leading to an increase in mental disorders and a deterioration of the personality.

Another problem facing modern medicine, in relation to the treatment of mental disorders, is that symptomatic treatment merely eliminates the symptoms but fails to provide an effective cure.

  Irena Belohorská (NI). – (SK) The issue of mental health is not a new phenomenon, but it has been discussed a lot lately in Europe and the United States. I would like to examine this issue from the perspective of the work environment, which is one of the contributing factors in the worsening of mental health. The effort to improve the economy and prosperity of our regions has brought about a change in working conditions. Teleworking, the more intensive use of communications technologies, changes in working habits, increased mobility – all these have had an effect on the mental health of workers. Job requirements related to flexibility, education and skills have been getting tougher, with the result that middle-aged and older employees are unable to adapt to the changing conditions. The constant stress may lead to mental problems.

In addition to the medical dimension of the issue, it is necessary to recognise the economic consequences of the population’s deteriorating mental health. Stress triggers poorer work attendance, inferior work performance or commitment, and problems among colleagues at work.

Since public health is on the national agendas of the Member States, and since the European Union has limited powers in this area, we must turn our attention to those countries that encounter greater problems and have less funds available for their remedy.

In spite of the large number of suicides in Northern Europe and the United Kingdom, I believe that we should draw our attention primarily to the new Member States, five of which rank among the countries with the highest suicide rates in the EU. Countries in Central and Eastern Europe, including Slovakia, have undergone significant changes, and their citizens have had to adapt to a changing working environment, acquiring new skills and habits in line with those of Western Europe. They have had to re-qualify and manage new, more sophisticated procedures very rapidly, which has had a negative impact mainly on middle-aged and older employees. In addition to that, the above-mentioned countries suffer from high unemployment, which also contributes to the worsening of mental health.

It has been suggested that a new agency should be set up to tackle this problem. I do not agree with this point of view. I believe that it would be far more efficient to restructure the existing agencies, including those agencies that deal directly with issues related to mental health.

  Avril Doyle (PPE-DE). – Mr President, I should like to thank both the Commissioner, for an excellent Green Paper, and Mr Bowis for his report, which has added even more to what was an excellent standing start. Thank you, John. Your particular interest and feeling for this subject is inspirational to many of us here.

Health services and healthcare are individual Member State competences, but under Article 152, we in Europe have a mandate as regards promotion, prevention and the dissemination of information. That is exactly what this debate on the Green Paper can do: ensure that we open up this whole area, focus on the major problems of stigma and discrimination and exchange best practice and epidemiological figures on this area.

Commissioner, you mentioned that the figures do not show the real burden of the disease of mental health. Because of the stigma and discrimination, many do not access treatment and help. I would fully agree with you. In fact, I would seriously question our data. I would say that they reflect probably half – being generous – of what the real burden of the disease could actually be. Most employees with acute or chronic depression, for example, hide it from their employers for fear of the adverse impact on their careers. Therefore, raising awareness, changing attitudes and, above all, exchanging best practice is an enormous contribution we can make here to this most important area.

The figures are startling: 18 million people across the EU suffer from severe depression; 58 000 of our citizens commit suicide every year – roughly equivalent to two or three small towns in any rural area being obliterated every year. Ten times that number attempt suicide. One in four of us is likely to experience mental health problems at some point in our lives and over 27% of adults in Europe are affected by mental health problems every year. Depression and anxiety disorders, including stress and eating disorders, are the most common mental health problems experienced. Studies estimate, frighteningly, that by 2020 neuro-psychiatric disorders, with depression at the top of the list, will be the highest-ranking cause of illness in the developed world. A major portion of that will be caused by the ageing of Europe, which will pose a particular challenge.

Mental ill health is preventable and treatable. We need to encourage early intervention and ensure that, if possible, as was suggested by my colleague Mr Bowis, we look again at legislation on discrimination to see if we can include discrimination against those with mental health problems as part of that package. We need to do all we can with the competence we have. Unfortunately, with the European Constitutional Treaty not moving as some of us would have hoped, our competence is fairly limited. However, that does not stop us joining up the dots in the relevant areas of European law that exist at the moment. Above all we must open up this subject and be inclusive to those who are suffering in this particular area.

Ignoring this problem and not providing the facilities and treatment that are needed costs Europe three to four per cent of our GDP per year.

Thank you, Commissioner, for your work and, above all, thanks to my colleague Mr Bowis for his excellent report.

IN THE CHAIR: MR MAURO
Vice-President

  Dorette Corbey (PSE). – (NL) Mr President, Commissioner, ladies and gentlemen, Europe has few powers in the field of public health, and that is how it should stay, for health is primarily a responsibility of the Member States.

Europe does have a very important complementary role to play: common research policy where health occupies an important place and a public health action programme that aims to improve the quality of care and treatment methods by exchanging data, by bundling expertise and by allowing countries to learn from one another.

Since this approach is particularly promising in the area of mental health, Commissioner, I welcome the Green Paper. I am also indebted to Mr Bowis for his commitment and involvement in this. He has written an excellent report.

It has been said several times this evening that one in four Europeans, or one hundred million of us, experience a bout of serious illness at least once in their lives. That is tragic and also accounts for 3 to 4% of the Gross Domestic Product.

Mental health problems cover a multitude of things and can range from eating disorders in girls or young women, alcoholism, drug addiction, through to behavioural problems, depression, as well as other psychiatric illnesses. It is difficult to develop successful treatment methods for those illnesses. Take drug addiction. What is the best way of overcoming addiction? Is it medicines, methadone, talking therapy, or a Narconon programme that involves saunas and vitamins? A serious comparison of the success of the different recovery methods would be useful. Or take eating disorders and depression: there are success stories, but just as many failures.

What matters is that expertise is combined, that practitioners learn from one another, that patients or addicts gain awareness of successful treatment methods. In this sense, it is also useful to set up a European coordination-expertise group, in which patients, addicts and care institutions should all be involved. This should be turned into a kind of help desk with a website where one in four Europeans and their families can seek help when they suffer from mental health problems. That is when European cooperation comes into its own.

  Marios Matsakis (ALDE). – Mr President, Commissioner, firstly I wish to express my sincere congratulations to the rapporteur for his excellent work. Mr Bowis has thoroughly and successfully addressed all the important issues concerning a strategy for mental health in the EU and my group fully endorses his report.

As regards the amendments tabled, the ALDE Group will support the two PSE Amendments 11 and 12, but with the following proposed oral amendment to each. In both amendments, the words ‘some of’ should be inserted after the word ‘in’ so that the text reads: ‘in some of the new Member States’. This is necessary because what is referred to in the amendments does not apply to all new Member States and it would be inappropriate and erroneous not to make this clear. I am sure this small alteration will be agreed by all concerned.

On the main substance of the report, I only wish to re-emphasise a couple of points. Firstly, the fact that mental ill health is extremely common. It is estimated that approximately 100 million EU citizens will be affected by it during their lifetime. It does not appear to be so common in everyday life, because most people choose to hide it away. The time has now come to bring the issue of mental illness out of the closet of denial and shame and deal with it openly, rationally and effectively.

Secondly, there is the fact that mental illness is unfortunately subject to stigmatisation in our societies. In my view, this stems from our limited comprehension of the function of one of our most important vital organs, the brain. The brain, like other vital organs such as the heart and the lungs, is susceptible to disease, which results in malfunction. A malfunctioning heart will give rise to cardiac disease. In the same way a malfunctioning brain will give rise to mental disease. The main difference in my view is that we may not yet be able to identify the exact anatomical and/or histological and/or biochemical anomaly giving rise to the particular brain malfunction. I am sure we will be able to do this in the future, as our scientific knowledge of neurology and neuroscience progresses. So mental illness should be nothing to be ashamed of. The mentally-ill patient is no different to a cardiac patient or any other patient.

In conclusion, I very much wish and hope that this report will mark the end of the dark ages approach to mental disorders and the beginning of a new era of understanding in dealing with both the treatment and prevention of mental ill health.

  Jean Lambert (Verts/ALE). – Mr President, I too should like to congratulate Mr Bowis on his excellent report. I should also like to say that it is not just a gender issue: there is certainly a very strong racial perspective as well that is attached to mental health and mental illness. At least we are past the age where sexual orientation was seen as a mental disorder, but there is still, as others have said, a tremendous amount of work to be done. As Mr Bowis himself pointed out, we have only just begun to scratch the surface in terms of what we would call promoting mental wellbeing. The World Health Organisation describes mental health as a state of wellbeing in which the individual realises his or her abilities, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to his or her community.

That has enormous implications for the social inclusion policies that we pursue and, as a Member of the Committee on Employment and Social Affairs, I want to pick up – as others have done – on the world of work, focusing in particular on paragraph 27 of the report. It is not just about the influence of mental health on employment, but the effect of employment on mental health. As others have said, stress is potentially the largest cause of time off work. The Bilbao Agency has done a lot of work on that. Self-reported work-related stress, depression or anxiety accounted in the UK recently for nearly 13 million lost working days in one year. If that had been the result of physical injury at the workplace there would have been an enormous outcry.

Many companies do not have a policy for dealing with stress. Many managers cannot recognise it in themselves and cannot manage it in others. So we need to develop training there, and we need to have a culture at work where you can admit to stress, have it dealt with seriously and work with working practices that promote mental wellbeing.

  Jiří Maštálka (GUE/NGL). – (CS) We all naturally agree that mental health is a prerequisite for intellectual and emotional fulfilment and for integrating people into society. In recent years, however, mental health has not received sufficient attention compared to other areas. The Commission’s Green Paper, and in particular the outstanding report by Mr Bowis, plug that gap, putting forwards a great many proposals, not only for the Commission, but also for doctors and the general public.

The report before us identifies the main problems in the area of mental health which form part of the broader context, offering food for thought on such hotly debated issues as the stigmatisation of the mentally ill, methods of treating patients and the gender differences which are so prevalent in mental health.

First, I should like to highlight the call from Mr Bowis and the Commission’s Green Paper for prevention as the most effective way of combating the growing incidence of mental illness. This ought to be one of the priorities in our proactive approach. It is precisely the influence of environment, employment and the family that should form the focus of our attention and our action plans, as these are the areas affecting mental health where prevention can work.

I also very much welcome the important reference to gender difference in the area of mental health, which was not sufficiently addressed in the Commission's Green Paper. Women are more likely to seek healthcare, and to take more pharmaceutical products, which they are less able to tolerate. They are also often subject to undesirable pressure from their peers, which may lead to mental breakdown.

One area that certainly deserves attention in the future, not only from doctors and politicians, but also from the general public, is the stigmatisation of the mentally ill. The emphasis attached to this issue in the report is an indication of the seriousness of the situation. I welcome all of the comments and proposals made by the rapporteur. Although I consider the proposals for best practice to be very positive, and believe that they will lead to higher standards – speaking as a doctor I very much support these proposals – it is unfortunately the fact that in my country the programmes in question are extremely expensive and thus far sadly not priority areas. The possibility of joint EU programmes in this area could help resolve this dilemma.

  Jan Tadeusz Masiel (NI). – (PL) Mr President, I would like to congratulate Mr Bowis on an excellent report which helps us to realise how important mental health is not only in the life of an individual but also for society.

The prevention of mental disorders, psychotherapy for children, adults and families, the treatment of nervous disorders and the promotion of mental hygiene are all the more important since we know that real mental disorders such as psychoses can be treated but not cured. It is worth remembering that, in the field of psychiatry, there are no medicines that can cure in the strictest sense of the word and that those that do exist were discovered by accident.

In Western civilisation, there is a persistent tendency to suppress and to block out of our consciousness the existence of any weakness, especially mental weakness. Only somatic illnesses are tolerated. However, if we dedicated more funds to the work of psychologists and psychotherapy, we could save money on medical consultations for treating the body and on healthcare spending as a whole.

  Antonios Trakatellis (PPE-DE). – (EL) Mr President, according to the World Health Organisation, mental health is necessary to the wellbeing of individuals, societies and countries and must be addressed globally on a new basis, from a new point of view which creates new hope. In this report, we are guided by the data of the World Health Organisation and are, for the first time, inaugurating a systematic effort to promote mental health.

The families of sufferers, which provide material and moral support to their members suffering from mental health problems, fall victim, together with the persons in question, to the negative consequences of the stigma and of the discrimination which accompanies these illnesses. Consequently, support for them by professionals in order to meet their obvious needs, together with information and a systematic fight against the stigma are necessary components when addressing mental illnesses.

I consider it equally necessary to investigate the mechanisms and causes of these illnesses and to improve the corresponding treatment, including the development of new treatment methods. Here I should like to emphasise that the most important difference between these patients and most other serious conditions which may even lead to death is that they upset the functioning of the brain, such as for example memory functions, cognitive functions and the conscience, in other words the functions which are inextricably bound up with the personality of the human being. This personality is eroded and may ultimately be destroyed by many of these conditions.

Consequently, if the objective of prevention and cure of human illness is a very serious priority, then the corresponding objective relating to neuro-psychological illnesses is the top priority if we wish to prevent the quintessence of European society from being eroded and breaking up, especially as this society includes in its composition many elderly people who, as we know, are vulnerable to neuro-degenerative illnesses.

To close, I wish to say that, bearing firmly in mind that prevention, timely recognition and correct treatment significantly limit the personal, economic and social consequences, I believe that, in voting for the excellent report by my honourable friend, Mr Bowis, we are inaugurating a course that will give mental illnesses the serious priority they warrant and result in more effective action against this modern scourge.

  Justas Vincas Paleckis (PSE). – (LT) Mr President, please accept my cordial welcome for such an unusually sincere and personal presentation of the draft report. This report and the debates that followed are an important step by the European Parliament in support of the development of the new mental health policy by the Commission, which is especially important to the new EU Member States. Poor mental health indicators, such as high suicide rates and numerous cases of violence and abuse, especially alcohol abuse, are not unusual in such countries. The new Member States have inherited inefficient mental healthcare systems based on large psychiatric institutions that just serve to perpetuate social exclusion and stigma. Presently, even these institutions are poorly financed, and thus, floundering and failing to perform their already limited functions.

There is obviously a lack in the community-based services that should be a part of healthcare and social infrastructure. We can usually only report isolated cases of success in care homes for mental health patients, while home healthcare and community-based services are actually much more humanistic, better compatible with human rights and more cost-effective. We have no tradition of home healthcare that would be supported by society; therefore, the old system is resisting giving up its positions.

The increasing number of children, who are growing up in state institutions, is particularly disturbing. This is further proof of the lack of an alternative system that would help parents in high-risk groups to properly raise and educate their children.

Some new Member States have already taken the first steps towards implementing provisions that are compliant with EU principles. Lithuania has drafted a mental health policy that will be presented to Parliament for approval this year. Lithuania has also initiated the project 'Child and adolescent mental health in an enlarged European Union: development of effective policies and practices'. This project was supported by the Commission and has attracted 18 participant countries and 34 associate partners.

  Marian Harkin (ALDE). – Mr President, I am pleased to speak on this timely and well-considered report and I congratulate the rapporteur.

Firstly, I agree that the added value of a Community strategy on mental health is primarily in the field of prevention and awareness-raising and that any proposals from the Commission should involve partnership and consultation with all relevant parties.

An essential element of any strategy will be to eliminate the stigma associated with mental illness and this will require a multifaceted approach, including information, education, anti-discrimination legislation, community-based approaches and responsible reporting by the media.

I fully support the proposal in the report that Member States should work together to implement effective strategies to reduce suicide, because this is not only a national or European issue but also a global one.

In Ireland, suicide is the most common cause of death in 18-24 year olds. Unfortunately, it is the highest within this age group in the EU. Such deaths devastate families and tear the heart out of communities. A recent survey conducted in my own area of North Leitrim and West Cavan entitled ‘Men on the Border’, painted a distressing picture of the reality of life for many single, older men, with 56% or respondents saying that they knew somebody who had committed suicide. Given that I always like to link what we do here with what is happening in our constituencies, I am pleased to say that this survey was partly funded by the EU and I hope that its recommendations will help to improve the situation.

Finally, while expenditure on mental health is a national competence, I believe that we need to highlight the sizable differences in mental health expenditure in individual Member States and I am not proud to say that our own levels in Ireland are inadequate. I agree with the rapporteur that public pressure is needed to ensure adequate expenditure to promote mental health and to prevent mental illness.

  Jean-Claude Martinez (NI). – (FR) Mr President, a tsunami is sweeping the European economy and European societies, a giant wave that is known as mental illness but that I prefer to call neurological illness to prevent its being stigmatised. The number of patients is continuously increasing, the wave replenished by the obvious ageing of the population and by the sacred cow of ultraliberal economics, which is itself a form of neurosis. No doubt the European Commission has something to say about this, as does the rapporteur, in paragraph 24, who talks of rural isolation, working conditions, job insecurity and unemployment. What, however, has led to rural isolation if not the destruction of the common agricultural policy, and that in the name of free trade? What has led to unemployment if not the political choice in favour of free trade? What causes stress in the working environment, if not the ideology of competitiveness or competition?

What are needed in order to treat these neurological illnesses are what Mr Bowis calls for: hospitals, individual care, specialised services and a variety of health care personnel – in other words, investment, which is something prohibited by the budgetary austerity pact in the name, of course, of the ideology of competitiveness and free trade.

That is the point at which we go round in circles because what brings on illness is a mistaken philosophy of economic competition and what is required to treat it is investment, which is something prevented by this same philosophy. Although it may well require an agency responsible for exploring the continent of the mind, the solution probably consists mainly in curing our leaders. I have just one more thing to say. Of Don Quixote of la Mancha it was said that he had read so many books on chivalry that his brain had dried up. In the case of our leaders, they have read so much Adam Smith and David Ricardo that they have gone mad.

  Christa Klaß (PPE-DE). – (DE) Mr President, Commissioner, ladies and gentlemen, our greatest asset is indisputably our health – physical, but also mental.

All too often, health policy in the past and present has focused exclusively on considerations of physical health. This is tangible, often even visible, and is often easier to treat. In addition, even maintaining physical health is very cost intensive and, unfortunately, it is often the case that not all the available possibilities are still affordable today. Our healthcare network, from prevention to aftercare, is bankrupting the public coffers.

It is not the intention of this report, on which I should like to congratulate Mr Bowis, that the EU play an active part in the health field. That is the responsibility of the Member States and should remain so. Nevertheless, we are in favour of the issuing of this Commission Green Paper to stimulate discussion of the importance of mental health in the EU, of the necessity of having a strategy, and of any priorities. We now know that good mental health is also a precondition for good economic performance.

We need to ask ourselves questions and seek answers, however. To begin with: who are we referring to when we speak of those with ‘mental ill health’? Why are 13% of Europeans seeking professional help in this field? Why do so many people in the EU commit suicide? We have heard the figures; at the hearing a figure of 58 000 each year was mentioned. Why is society so ill? What are the causes? Are the demands of our society perhaps too great in general? Then there is the big question: what happens to these disadvantaged members of society?

These issues need to be discussed in order to raise awareness. One thing is certain: social changes are also needed in order to prevent these illnesses. As we know, it is difficult to tackle the harshness and competitiveness of people’s working lives. Many things are easier to bear, however, if people have a haven, or a chance to withdraw. I am thinking here mainly of the family, which gives people the opportunity to rest and recharge their batteries. Nevertheless, families need help and support in order to fulfil all their important social functions.

One thing is certain: it is not possible to control human beings by law, but it is possible and indeed necessary to create the conditions in which they and their health can grow – mind, body and soul. Let us support the family, therefore, and if that is one of the intentions of the report, that is a step in the right direction.

  Bogusław Sonik (PPE-DE). – (PL) Mr President, for many years the issue of mental health has been an embarrassing topic and is still overshadowed by other diseases affecting our society. However, the scale of the phenomenon today means we cannot ignore the dangers associated with mental disorders.

We cannot discuss health in the European Union without taking these dangers into account. The statistics reflect the cruel truth. On average, 58 000 people commit suicide each year. This figure is higher than the number of those who die in car accidents, are murdered or die of AIDS. Depression is currently the most serious problem affecting our society. It is a problem that affects a growing number of people, particularly the young and, to an increasing extent, ethnic minorities.

Economic analysts estimate that poor mental health costs the citizens of the European Union around three to four per cent of GDP, mainly as a result of falling productivity and early retirement.

That is why it is vital to draw up and adopt, as a matter of urgency, a directive on mental health and the protection of the civil and fundamental rights of people suffering from mental health problems. Implementing the principles of the directive will establish the practical framework for implementing the Community programme. Preventative healthcare which takes into account different age groups should play an important role in the mental health strategy, according to the motto ‘prevention is better than cure’. The pilot programme of the European Association against Depression has already achieved a 25% decrease in the number of suicides and suicide attempts by young people. That is why we need to think about the matter seriously and to take appropriate action to prevent dependence on modern technologies.

Today, we revel in the fact that we have access to all kinds of technology, that everything is possible, that we have thousands of gadgets at our disposal. But at what price? The price is that young people in particular are addicted to their screens and refuse to accept any reasons for turning away from them. This is the challenge of our age and we have to meet this challenge. Adopting a single, coordinated European Union policy in the field of mental health will allow us to create the appropriate conditions for the harmonious development of public mental health. It will help people to learn to cope with difficult situations, conflict or stressful conditions and to form better interpersonal relations.

  Richard Seeber (PPE-DE). – (DE) Mr President, Commissioner, this afternoon we discussed a smoke-free Europe. Action by the Commission and the whole of Europe on mental health is even more vital, however. In this connection, I am obliged to the Commissioner for attending to this issue, and also to our rapporteur, Mr Bowis, for dealing with the issue and delivering an excellent report.

One of the main problems regarding mental health is that it is taboo in all societies, and we should ask ourselves why this is the case. Many reasons can be identified, but I shall select just a few of them. Firstly, no doubt we all have a fear of ending up in a similar situation ourselves one day – particularly when we think of the old age lying before us.

Secondly, mind and soul lie at the heart of our humanity; they are something that defines the essence of humanity.

Thirdly, there is no recourse to our beloved mechanistic interpretation of our environment in this field, as this does not function here. This is a phenomenon that causes great suffering not only for the individual, but also for society as a whole.

I have picked out a couple of figures, which make very alarming reading. According to a study by Deutsche Angestellten-Krankenkasse, a German social security institution, there was a 70% increase in the number of psychological conditions in the workplace between 1997 and 2004. Against the trend of falling figures for sick leave over the same period, the number of cases of absence owing to mental ill health shot up by more than two-thirds. Psychological stress now accounts for 10% of all days of absence in the European economy.

The World Health Organization (WHO) states that, whereas in 1990 the three leading causes of global disease burden were pneumonia, diarrhoeal diseases and perinatal conditions, by 2020 the leading causes will be ischaemic heart disease, depression, anxiety disorders and traffic accidents. If we look at the loss of productivity, we can see that this amounts to billions of euros. Studies carried out for the EU-15 – the old Member States – have put losses at EUR 265 billion, or approximately 3–4% of Community gross domestic product.

Europe as a whole is therefore perfectly entitled to ask itself what we can do about this together. Of course, we must bear in mind that Member States are very suspicious of Europe’s powers and responsibilities. Nevertheless, I believe that the added value of European action is extremely important. Mr Bowis detailed that very well in his report. Let us not forget the best practice model, or the more extensive figures, or the enhanced research and development. Our thinking should be oriented mainly towards target groups, to enable us to arrive at a solution and thus prevent the European engine grinding to a halt and the plug being pulled.

  Frieda Brepoels (PPE-DE). – (NL) Mr President, Commissioner, ladies and gentlemen, first of all, I have nothing but gratitude for the Commissioner for the Green Paper, and even more so for Mr Bowis for the important work he has done.

It has indeed turned out to be a very balanced report. After all, not for nothing was it almost unanimously supported in the Committee on the Environment, Public Health and Food Safety, and we are therefore hopeful that this report will be carried by an overwhelming majority in this House tomorrow, and will bring the necessary pressure to bear on the Commission so that it can take the necessary initiatives in line with its competences, because, clearly, much can be improved in the area of metal health care in the European Union.

Patients still have no say. Cooperation between the different care institutions is still lacking, and the sector is facing a serious lack of funding. The added value of policy at EU level which we need to pursue is mainly in the area of promoting exchange and cooperation between Member States. We must, above all, be able to improve the connection between the various and different measures at Member State level, both nationally and regionally.

Commissioner, ladies and gentlemen, the Commission’s Green Paper has not only cranked up a debate here in Parliament, national and regional governments have also been encouraged to make more funds available. When in my country, in Flanders, the national health survey showed that as many as one in five Flemings experience psychological problems and one in eight even serious problems, the Flemish Welfare Minister promptly decided to considerably reinforce the mental health centres, particularly those for the target groups that suffer the most, namely children and young people.

Patient organisations followed suit. They asked representatives of ADHD Europe, for example, to home in on the living conditions of ADHD patients, since originally, the Green Paper did not even make a mention of this developmental illness in children, which, if left untreated, can do so much damage and cause so much distress, not only to the patient, but also in the form of costs to the health care system, the school system and the economic system.

I am therefore delighted that our rapporteur was prepared to approve a few important additions in this respect. I would also thank the fellow Members for their support. I am now hopeful that the Commission, on the basis of the above, will be able to present a proposal for an EU mental health strategy by the end of this year. I wish the Commissioner every success in this.

  Péter Olajos (PPE-DE). – (HU) First of all I, too, would like to thank Mr Bowis for the opportunity to speak on this very important topic. Everyone is afraid of illness, and the most terrifying illnesses are undoubtedly those which threaten mental health.

For a long time, medical science and society were equally helpless in the face of these problems, and reacted by sweeping the subject under the carpet or by isolating the victims. Fortunately, today we know that children who have learning difficulties are not bad kids, that those suffering from depression cannot be expected simply to pull themselves together, but that with adequate care even individuals with mental disabilities are capable of significant development. At the same time, we must face the fact that just as desk jobs are bad for the back, or the use of chemicals increases the incidence of allergies, so stress, the information overload and the lack of stable reference points in our society make it more difficult to preserve mental health. While most people today consciously strive to maintain the health of their bodies, the protection of our mental health receives considerably less attention.

For this reason I welcome the fact that the Commission has taken the first steps towards a Community strategy for improving mental health. This is particularly important from the perspective of the new Member States, including Hungary, since the shock provoked by sudden economic and social transformations has given rise to problems that our outmoded institutional systems, serious underfunding and fossilised attitudes are unable adequately to address. To these must be added the problems traditionally characteristic of the region, such as the high suicide rate.

In my country, Hungary, at the peak of the suicide wave twenty years ago more than 45 out of every 100 000 people died by their own hand, a statistic with which we shocked the world. According to the figures of the World Health Organisation, in 2000 the worldwide suicide rate was 16 out of 100 000, which represented a rising trend over the last half-century. There were years, not that long ago, when there were fewer fatalities in Europe caused by road traffic accidents than by suicide, as some of my colleagues have already mentioned. But we should not think that this is true only of Europe. In the United States as well, suicide is often ahead of homicide among the causes of death – in 1997, for instance, there were one and a half times as many suicides registered as murders.

The long period of neglect of our region has meant that in our country, consulting a psychologist is still considered something to be kept secret, and it is not unusual for children from disadvantaged backgrounds to be considered mentally disabled. Many families are left to their own devices, without effective outside help, when one of their members faces serious problems. This situation must be changed, and it is for this reason that I am in support of all those amendments which explicitly state that specific attention needs to be paid to the mental health-related problems in the new Member States.

  Eija-Riitta Korhola (PPE-DE). – (FI) Mr President, first of all I should thank my colleague, Mr Bowis, for the work he has done. Furthermore, I am not just referring to this report, but to all his input and the vigour with which he has spoken on behalf of mental health work in Europe. I have been a Member of Parliament for seven years, and in all this time John Bowis has consistently kept this subject on the agenda. For me he is a heartening example of a politician who realises his vision of a better world with determination and steadfastness. It is only in this way that things change: when one does not yield to arbitrary political whims and trends but knows oneself what one is striving for and does it.

Mental health problems are something which it is easy to keep quiet about. There is a strong stigma attached to such types of disorder, and there may even be discrimination, which in the worst case scenario might prevent someone from seeking care. Proper information, openness and the sort of mental health campaigns proposed in the report will help to dispel this pointless stigma. The path to maturity is stonier than ever. Growth seems hampered by society’s increased uncertainty. It is good that the report should demonstrate awareness of the need for early intervention and the importance of prevention. To prevent mental health problems in children and young people in particular, we need to invest more time and money in preventive measures in day-care centres, schools, children’s clinics and school healthcare. A young person in need of help might be inclined to let things continue as they are simply because he or she does not know where to turn to for help. The role of the child’s background, and above all the family, is therefore of major importance.

With the right resources, school healthcare units and children’s clinics are in an excellent position to identify problems in children and young people and provide help at an early stage. While, for example, in my country mental health problems have become more common in young people, statistics show that the parents of one in five children work untypical hours. Schoolchildren suffering from anxiety can be given significant help at school in the shape of group-based support, but it is absolutely essential to provide families with support on weekdays. Support for a child from parents and the family creates a basis for good mental health. Treating the problems of the young with drugs should be the last resort. The main focus should be on identifying and eliminating the social and environmental factors that are causing the harm.

The problems will not go away by keeping silent about them. Depression has been called the new European disease. Very few people under the age of 30 took antidepressants 20 years ago, but now they take them as much as the older generations do. If there is no intervention in young people’s mental health problems immediately, and if no attention is paid to easing the situation regarding access to help, the price paid will be just too high. The fine words and good intentions in the Commission’s Green Paper must be turned into effective legislation as soon as possible, and we in Parliament expect to receive a proposal for a directive to debate on soon.

  Thomas Ulmer (PPE-DE). – (DE) Mr President, ladies and gentlemen, I should like to join the chorus of good wishes to Mr Bowis, who has proved once more that, for him, health policy is a passion rather than a duty.

Successful policy and successful psychotherapy have one thing in common: both require a great deal of openness, honesty, patience and commitment. We are discussing here an issue that is interesting and widespread yet largely neglected in the European Community: mental health.

The WHO defines health as a state of complete physical, mental and social wellbeing. It is also realistic to achieve these three objectives in this order. When dealing with mental health, we note a dramatic increase in psychological illnesses in the Union. There is a wide palette of symptoms, causes, diagnoses and therapies in terms of both pathogenicity and molecular biology: depression, schizophrenia, borderline psychosis, bulimia, anorexia, phobias, neuroses and mania, to name but a few.

I do not wish to go into detail on toxicological and environmental causes here – that would be a whole dossier in itself. I would like to show some possible ways in which we, the European Union, could help in the field of prevention, ways in which we could reduce the burden of suffering of those with mental ill health, could recognise the early stages of the illness in time and could thus prevent the onset.

I should like to give just a few statistics. One in four will fall ill; there are 58 000 suicides and ten times as many attempted suicides each year. We see suicide as something difficult, demonic, impossible to grasp, and feel obliged to prevent it.

Suffering from a psychological disorder means being stigmatised, whilst psychological illness often involves feelings of inferiority, and the history of Europe has often seen psychiatric institutions misused for political purposes. We have the opportunity to call on our national governments to do more than before. This call does not mean we are interfering in subsidiarity, but that we want to suggest action points and demonstrate a pan-European approach for enhancing human dignity and reducing discrimination, for example healthy families within which children can grow up and equal opportunities throughout the Union, both within Europe and within the Member States.

Our strategy must comprise comprehensive treatment close to patients’ home areas. The treatment must be holistic: that is, must involve both body, mind and social environment. Compulsory treatment can be considered only as a last resort, and abuse of alcohol and both legal and illegal drugs is to be validated and included in this global approach. The focus here is on prevention.

Today, with this report, we are opening a new chapter, and it is to be hoped that it will soon be enlarged upon in a White Paper.

  Rodi Kratsa-Tsagaropoulou (PPE-DE). – (EL) Mr President, Commissioner, allow me too to congratulate the rapporteur, John Bowis, because with his systematic work and the results of it, as contained in this report, he has highlighted the importance of mental health and the policies which we must apply.

Clearly the public health strategy must also include mental health, both for reasons of personal wellbeing and for reasons of social cohesion and social peace and progress.

'A healthy mind in a healthy body' was what the ancient Greeks said in order to demonstrate that both mental and physical health are an integral component of human health. This saying is just as topical and important in modern times. Numerous Members have already referred to various forms of modern mental illnesses.

Within this framework, I should like to emphasise that particular account must be taken of the gender dimension, both in research and in preventing and addressing psychoses. Research has even shown that various particular biological conditions and, more importantly, social circumstances affect women.

The gender dimension must be also taken into account in the education of and information for nursing staff. Generally speaking, society and the families of people suffering from mental illnesses suffer because, in many cases, women with psychological problems are dealt with as people who are over-sensitive and not as sufferers needing special care and attention.

In other words, we must also protect sufferers and their environment, because that will also make the environment more suitable and more trustworthy in the role that it is called on to play in addressing the problems of the people within it.

To close, allow me to mention war victims. The serious psychological problems they face must qualify for both our development and our humanitarian aid and, in general terms, aid to reconstruct areas, because the reconstruction of areas requires above all reconstruction of the human psyche.

  Markos Kyprianou, Member of the Commission. Mr President, I should like to thank all the honourable Members for the very interesting and useful debate. I shall be brief.

The best conclusion one could draw from the debate today is that here, as well as in the rest of the consultation process, there is broad support for the establishment of a new strategy on mental health. This is a very positive signal for the Commission going forward, because throughout the general consultation process, the parliamentary process and the process of consulting the Member States, similar levels of support have been expressed for these efforts. The truth is that there is added value for an initiative and strategy at European level and that is why we intend to come forward with a strategy very soon.

Amongst other things, it is very important that we promote cooperation on mental health between Member States, between stakeholders and between different sectors. Involving all relevant sectors in the effort to provide better public health is an important aspect of the new strategy. As I said at the beginning, we intend to place mental health at the core of our health strategy and the public health initiatives.

Schools and workplaces have a greater influence on mental well-being than the actual health sector. Teaching parenting skills is also important. Older people must have opportunities to participate actively in social life.

Many very interesting issues have been raised and we will take them into account when we draft the strategy. We will look into prevention and, as you know from previous debates, it is my basic important commitment and the basis of my strategy for this term to promote prevention and not just treatment.

Gender aspects will be taken into account. When we had a similar debate here on the gender aspects of health, I said that our policies from then on would take into account the gender aspects in all our health initiatives and in the various areas of research, promotion, prevention, care, treatment and rehabilitation. They will all take gender into account. It will be reflected in the strategy document that the Commission will prepare. As I said, we will be looking into prevention and some of the causes, not all of which are avoidable, of course – such as ageing, for example.

Ageing is a reality and a fact. We have an ageing population. The point is to make ageing healthy. We are living longer and we need to be healthy in our old age, and mental health is a very important aspect of that.

I should like to finish by saying, in the light of all the numbers and statistics that have been mentioned here, that this is just the tip of the iceberg. It is not only those who suffer from mental health who are affected: there are also the families, friends, employers, employees and colleagues. The truth is that the whole of society suffers as a result of mental health problems. That is why perhaps the best achievement of this whole process, including the strategy, would be to make mental health a priority, not only for the European Union – I believe we in the Commission and in the European Parliament have already done that – but also for each Member State separately and the Community as a whole.

  President. – The debate is closed.

The vote will take place on Wednesday at 12 noon.

Written statements (Rule 142)

  Filip Kaczmarek (PPE-DE). – (PL) Mr President, I would like to thank John Bowis for his very comprehensive and detailed report on improving the mental health of our citizens, that is, the European Union’s mental health strategy.

Mental health problems know no national boundaries, which is why we can speak of a mental health strategy for the whole Union. In any case, establishing a common strategy, creating a framework for cooperation between different institutions and monitoring its implementation could facilitate the introduction and provision of services for people with intellectual disabilities and those affected by mental disorders at the national level,

Throughout the ages, many measures of humanity have been developed. One of these is our attitude to people affected by mental disorders. In my view the demands for de-stigmatising the problem, eliminating prejudice, and changing attitutdes and stereotypes relating to psychological disorders are very important. Meanwhile, whenever a politician in Poland wants to insult another politician, he says, or implies, that the other is mentally ill or psychologically disturbed. Unfortunately, even some Members of the European Parliament indulge in this kind of behaviour. However, we should all remember that people who suffer from mental disorders deserve to be cared for and treated in a dignified and humane manner.

In countries with a high unemployment rate, this problem particularly affects disabled people. That is why I strongly support initiatives to ensure non-discrimination in the treatment of those affected by mental illness and the social integration of people with mental disorders. These actions are particularly important because good working conditions have a positive influence on mental health.

  Jules Maaten (ALDE). – (NL) Europe is facing major threats to public health: cancer, heart and vascular diseases, diabetes, asthma ... Mental illness also belongs to this list, though. After all, why do people suffering from a mental illness get treated differently from people with a heart disease, AIDS or cancer? At a time when patients are increasingly seen as consumers, are better informed and are more involved in decision-making, the attitude towards mental health should change to match this trend.

At the moment, the EU shares the responsibility for public health and health care with the Member States. The Member States are responsible for national health services and systems. The EU only has a secondary role in this. I would argue in favour of the EU being given a bigger role in public health matters, precisely because these are so important to the public.

In order to promote and support cooperation between the Member States in the area of mental health, and to remove inequalities between Member States, it is a good thing for the Union to be taking action in this area by, for example, joining forces, promoting coherence and creating a platform. In that way, the EU can mean something to the citizen and change the negative image of bureaucracy and unnecessary red-tape which many citizens have.