Concluding Remarks

J.M. Caldas de Almeida*, #
Department of Psychiatry and Mental Health, Nova University of Lisbon, Portugal

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© JM Caldas de Almeida; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo dos Mártires da Pátria 130, 1169- 056 – Lisboa – Portugal; Tel: +351 21 8803000; Fax: +351 218803006; E-mail:
# Coordinator of the EU Joint Action on Mental Health and Well-being

Mental disorders are highly prevalent in Europe and are a major burden on society. Age, gender and various social factors can influence the incidence of mental disorders; however no group is immune. Mental disorders can alter the lives of children as well as adults, causing enormous suffering and disability.

In fact, there is increasing evidence on the frequent onset of mental disorders during childhood, as well as on the significant impact these disorders can have on the physical and mental disorders in later periods of the life course.

There is also increasing data proving that positive mental health and well-being is a key factor for social cohesion, economic progress and sustainable development in the EU. Mental health is a human right and a key resource for the success of the EU as a knowledge-based society and the accomplishment of the objectives of the Lisbon strategy.

Significant efforts were made by EU and MS to tackle these challenges, which resulted in the creation of indicators and data bases, development of guidelines and other tools for the improvement of mental health interventions, and creation of networks supporting research, care and policy development. Yet, despite all these efforts, a lot remains to be done. A significant proportion of the general European population, including children and adolescents, has unmet need for mental health care. In promotion and prevention there is also a huge gap: the majority of the populations don’t benefit from the interventions that have proved to be effective in these domains.

There is evidence showing that poor implementation of recommended mental health actions in the past is associated to lack of commitment of policy makers and other stakeholders, insufficient resources allocated to mental health, resistance to innovation, and insufficient integration of mental health in other policies. These and other barriers to be identified must be addressed in order to make possible the realization of the Europe 2020- strategy for smart, sustainable and inclusive growth, which requires actions to prevent and treat mental disorders, and to promote positive mental health in the population.

It was in this context that the European Pact for Mental Health and Well-being, launched in June 2008, agreed that “there is a need for a decisive political step to make mental health and well-being a key priority” and that “the mental health and well-being of citizens and groups, including all age groups, different genders, ethnic origins and socio-economic groups, needs to be promoted based on targeted interventions that take into account and are sensitive to the diversity of the European population”.

To attain these objectives, a Joint Action on Mental Health and Well-being, including working group on mental health and wellbeing of children and adolescents in the school setting was created in 2012. This working group has reviewed the available knowledge and resources resulting from other mental health projects in Europe, has analyzed previous initiatives in order to better identify the ingredients that should be taken into consideration to improve the effectiveness and sustainability of future initiatives, and has been developing recommendations for action at EU and MS level to improve the effectiveness of mental health policies implementation.

This report, presenting an important part of this work, confirms that children and adolescents mental health is indeed an important public health issue in Europe. It also offers an excellent review of the available evidence on the effectiveness of prevention and promotion programs, confirming that school-based programs can have a major role in the improvement of mental health and well-being of children and adolescents. The promising findings found on the effectiveness of programs aimed at promoting general health and wellbeing in the school, programs designed to promote the integration of adolescents with specific problems, and interventions to prevent major problems such as bullying, obesity and alcohol and drugs consumption among children and adolescents, show that, despite the increasing attention most countries have dedicated to this issue, much more can be done in the future. The information gathered in this Report has important policy implications and certainly will be an excellent inspiration for the framework for action that European countries will adopt in the future.