‘Make mental health a top priority’

There is much to be gained from prevention. The speakers at the mental health gathering were unanimous about this. The symposium ‘Anticipate and Act: Prevention and Strengthening Mental Health in the Netherlands and Beyond’ took place last Thursday at the UMCG. It was a gathering with a wide range of perspectives on (online) depression prevention, the economic potential of mental health, and initiatives from the northern Netherlands.

Psychiatrists are not trained to focus on prevention, said Robert Schoevers during the opening of the event. He is head of the University Center for Psychiatry at the University Medical Center Groningen. At the same time, psychiatrists do have the knowledge to shape prevention efforts, and the topic is increasingly gaining prominence on the agenda, Schoevers continued. This was also confirmed by Wiro Niessen, Dean of the Faculty of Medical Sciences and member of the UMCG Board of Directors. He emphasized that one-third of UMCG’s research focuses on prevention and public health.

Non-consumable interventions

The message: we cannot just stay in our consultation rooms until people are sick enough to come to the hospital. Renowned guest speaker Ricardo Muñoz from San Francisco (US), an expert and pioneer in depression prevention and digital interventions, agreed with this. When Muñoz began his long research career, the prevailing belief was that depression could not be prevented. Over the years, the scientific consensus has changed, he explained. There is scientific evidence that depression is indeed (partly) preventable with the right preventive measures.

The emeritus professor made a plea for non-consumable interventions. Muñoz cited Massive Open Online Interventions, interventions that are accessible online to everyone, as an important example of a non-consumable preventive measure against depression. He emphasized the potential: ‘With this, we can reach two-thirds of the world’s population.’ The researcher urged the well-attended audience to share interventions as widely as possible.

Healthy Economy and Initiatives in the North

Jochen Mierau, Professor of Public Health Economics at the UG, then gave a talk on the economic potential of mental health. Health determines how much time we are able to work, earn money, and thus contribute to the economy, Mierau explained. Mental health issues often arise at a young age, especially compared to other illnesses, and therefore have a strong impact on the workforce. A healthy economy needs healthy employees, the professor emphasized. The paradox is that this same economy often harms health. That is why it is up to policymakers to rein in commercial interests and establish clear frameworks to create a healthy environment.

At the end of the morning program, alderwoman Manouska Molema expressed her support for initiatives in the field of mental health, including the platform Mentaal Gezond Groningen. She pointed out that the definition of what is considered ‘normal’ in our society is becoming increasingly narrow, causing many people to be left out. Afterwards, program director Frederike Jörg spoke about the Mentaal Gezond Groningen platform. Within this initiative, UMCG, Hanze, Accare, and the Municipality of Groningen, together with many others, work to prevent mental health issues in the province and bring knowledge and practice together. Jörg emphasized that mental health problems are a growing concern, especially among young people.

Tip of the iceberg and responsibility

In the afternoon, the participants split into breakout sessions, followed by a panel discussion led by Marie-José van Tol, Professor of Cognitive Neuropsychiatry. The panel included experience expert Monique van den Eijnden, Frederieke Vriends (director of MIND Us), Jochen Mierau, Henk Nijboer (initiator of the Social Agenda from Nij Begun), and Robert Schoevers. Van den Eijnden shared how she experienced a psychosis after the birth of her second child; according to her, prevention is all about how we can prevent this for others. According to Schoevers, the patients in his department at the UMCG are just the tip of the iceberg, and it is extremely important to find ways to help people.

But who holds the responsibility? Van Tol asked. Vriends emphasized the importance of joint effort. She gave an example of a collaboration between MIND Us and telecom company Odido aimed at improving young people’s mental well-being. Collaboration is important, Mierau acknowledged, but at the same time he stressed the importance of ownership. Set health goals, the professor said, and make the Minister of Health, Welfare and Sport accountable for achieving them.

Nijboer countered that concrete goals are no guarantee of success, referring to the climate goals as an example. Above all, funding must be available. And prevention involves long timelines. As initiator of the social agenda, Nijboer is able to serve the public interest, as the Nij Begun program provides both funding and time. ‘That’s a huge help for prevention.’ According to Nijboer, there is a strong sense of pride and community in Groningen and Northern Drenthe, but also a deep mistrust of the government. That’s why he plans to support bottom up initiatives without immediately linking them to policy objectives.

Obstacles and concrete proposals

Van Tol asked what obstacles there are to prevention. The biggest problem is that prevention of ill-health ‘belongs to no one’, Schoevers argued. He called for a different way of dealing with adversity, a more defined care domain and policies that charge companies for the damage done to society. According to Mierau, there is a ‘wrong pocket problem’. That is, the benefits of prevention do not come to the parties who incur the costs. This makes it unattractive to invest. It is therefore important to end the separation between care and prevention, the professor argued.

Finally, the panelists offered concrete proposals. ‘We need to change the narrative,’ Mierau stated. Prevention is often seen as patronizing, while in reality, it’s about protecting health. According to Nijboer, prevention is about the environment, not the individual. ‘We’re only at the beginning when it comes to prevention. There’s a lot to be gained with relatively few resources.’ Vriends argued that mental health must be given higher priority. ‘Make prevention and the strengthening of mental health a top priority.’

As one of the initiators of the event, Frederike Jörg looked back on the gathering at the UMCG with satisfaction. ‘It’s encouraging to see so many people come together today who view the prevention of mental health issues as a top priority. Prevention of mental health issues is highly effective on all fronts: it enhances well-being, helps young people obtain a diploma, enter the labor market successfully, and participate in society. Among young people, we have seen a huge rise in mental health problems over the past decades. That needs to change, because this is our future generation.’ According to Jörg, the day offered a wide range of perspectives on prevention. ‘It’s crucial that we invest in better conditions and work together,’ she concluded.

The event was organized by: UMCG, Aletta Jacobs School of Public Health, Mentaal Gezond Groningen, Nationaal Plan Hoofdzaken, and MIND Us.

Article by Jelle Posthuma