Male suicide has recently made headlines for its alarming status as the unappreciated threat to under 45s in the UK. Its status has prompted a new consideration of the socioeconomic and cultural stereotypes that both create and perpetuate gender inequality. Within the post-recession Europe, this presents a pertinent question of what is being done to address the regional disparities with regards to administration of treatment and approach to combating mental health issues.
Mental health in Europe has been subject to an increased focus as an area for direct policy and action by cross-border research. The complexity of mental health and its treatment has been acknowledged in the policy of both Europe-wide and national institutions. Mental health was a key point for the Liberal Democrat party in the last UK election, and, despite their absolute decimation, the increase in focus has triggered a conversation regarding mental health and its conceptualisation in treatment, as well as in the public imagination. In 2016, there is an increasing awareness of the cultural formations of gender manifest in different mental illnesses. In fact, the World Health Organization’s European Regional Office almost explicitly states this, albeit with regard to pointing out the conflation between gender and mental health, and women’s issues. Since the late 2000s, there has been an EU-funded initiative regarding the mental health of the population of Europe, one that resulted in the 2013 Joint Action Mental Health and Well-being project.
It highlights one of the ways in which government policy directly impacts on a system of constructed gender expectations; in one of the reports publishers hypothesised that the “betrayal” many men felt as their capability to maintain their role as breadwinner was undermined by state action.
So what is the nature of the political analysis of regional health? In January 2016, an EU-funded conference has demarcated a new arena for approaching mental health in the political sphere, including a recognition of mental health as more than a health, or public health issue. Indeed, the framework resulting from the Joint Action research and analysis directly links the need for health equity more generally across the region, acknowledging that this would only come from a broader set of policy recommendations that tackle social and economic factors impacting on health. These include a recognition of the different challenges faced by different demographics, one in which gender plays an influential part. This is recognised by the World Health Organisation, who state their approach to gender when concerning mental health, “It determines the power and control men and women have over the socioeconomic determinants of their mental health and lives, their social position, status, and treatment in society.” A more specific recognition of how mental health issues manifest along gender lines cites the prevalence of internalising disorders in women – anxiety and depression, for example – compared to the externalising of those in men, which tended towards substance abuse.
Whilst these are positive steps in how mental health is conceived and approached, it comes at a time of alarming insight into the human effect of fiscal policy since 2008. In a study published in October last year, Dr Nikolaos Antonakakis and Professor Alan Collins presented a damning case for the effects of austerity on the mental health of the male European population. Reported on by several news outlets, it directly links the governmental policies of austerity, enforced by the monetary powers of Europe, to the mental health of the men of the countries in which they were implemented; Greece, of course, being the predominant example of austere policy. What they found was that policies of cuts to wages and welfare correlated with the almost proportional increase in male suicide rates per percentage loss in GDP, or percentage increase in unemployment. These figures were not mirrored for women. It highlights one of the ways in which government policy directly impacts on a system of constructed gender expectations; in one of the reports publishers hypothesised that the “betrayal” many men felt as their capability to maintain their role as breadwinner was undermined by state action.
Indeed the depth and length of the 2008 financial crisis has now been recognised as sparking a wider health issue across the European region, and one that has raised profound questions about how Europe responds to the fallout from the severity of economic policy following the 2008 crash. The concerns regarding the rising inequity of health since 2008 have been raised before, as well as the need for increased involvement of health professionals in the debate regarding economic policy. In a report on the social determinants of health published in 2013, also commissioned by WHO, it states, “In the short to medium term, the priority is to address the health effects of the current economic crisis. Recognition of the health and social consequences of economic austerity packages must be a priority in further shaping economic and fiscal policy in European countries. The views of ministers responsible for health and social affairs must be heard in the negotiations about such austerity packages.” What the 2015 report highlights is the impact of governmental policy in a tangible and heartbreaking manifestation. It demonstrates not only a failure of our approach to mental illness, and the continuing rigidity of our conceptualisation of it within gender norms, but a failure of government and financial institution policy to sympathise with a population.
These damning statistics and correlations do not, ultimately, paint a necessarily morbid future for the mental health of populations in Europe if the proposed policies are able to align with fiscal and social initiatives both nationally and across borders. Yet the sadness is for those individuals for whom it is already too late. It is a stark reminder of the humanitarian impact of policies of austerity, but also of the importance of addressing the gender imbalance for both men and women. The importance to invest in research and implementation of policies to improve the understanding of mental health and well-being, and to study the grave impacts of detaching economic, social, and health policies.