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Report on Mental health in cities: Beyond traditional healthcare services

This report is part of a Eurocities series on the European Pillar of Social Rights (EPSR), focusing on mental health (Principle 16: Access to Health). It highlights how cities are creating policies and services that not only target mental health but also address the social factors, such as housing, employment and social inclusion, that greatly impact citizens’ wellbeing. The report underlines the need for a citywide approach, where mental health is integrated into all urban policy areas, from transport and urban design to culture, environment and social services.

Urban environments, characterised by density, diversity and complex living conditions, bring both risks and opportunities in addressing mental health. With their proximity to citizens and local expertise, cities are uniquely positioned to shape interventions that address the mental health risks including not only healthcare needs but also the primary social, economic and environmental factors that contribute to poor mental health.

However, as mental health disorders now affect around 84 million people in the EU, costing more than €600 billion per year (European Commission, 2018), it is clear that cities cannot tackle this issue in isolation. The report identifies critical gaps in funding, coordination and data collection, which limit the effectiveness of city-level interventions. It also stresses the need for enhanced cooperation between cities, national governments and EU institutions to build a more resilient mental health infrastructure that addresses both acute needs and long-term prevention.

Key findings

  • While healthcare is primarily a national responsibility, cities play an important role in addressing everyday mental health risk factors, such as poverty, social isolation and financial or housing insecurity.
  • Cities are uniquely positioned to develop integrated, place-based solutions that directly tackle these risk factors and actively promote mental wellbeing. They can provide alternative treatments and fill gaps often caused by inaccessible and under-resourced national mental health services.
  • Coordinated involvement of multiple city departments is needed. Mental health is linked with various city services and sectors, including social care, education, housing, culture and urban design. Green spaces, accessible transport and safe public areas all contribute to reducing anxiety and stress.
  • Cities face significant barriers in addressing mental health, ranging from limited statutory competencies, financial resources, human capacity shortages and gaps in data, which are limiting the effectiveness of local measures.
  • Cities successfully pioneer mental health interventions, often going beyond their remit. These include the implementation of municipal strategies, collaboration with local partners, community engagement and innovative service delivery approaches to promote the wellbeing and mental health of their citizens.
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Michaela Lednova Senior Policy Advisor
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