Years of mental health work led to one stubborn question: why do good programmes fail in practice?

I'm a psychologist by training, with early years split between corporate mental health roles and clinical work, before moving fully into research. That mix is mostly relevant now for one reason: it's where I first noticed the gap between a good policy on paper and what actually happens when it meets a real clinic, a real budget, and one overworked coordinator.

I'm now a PhD researcher at Tallinn University's School of Governance, Law and Society (SOGOLAS). My dissertation is built inside COMBINA/MENTBEST, a Horizon Europe project running the same depression-prevention and mental-health-literacy programme across five countries: Albania, Estonia, Greece, Ireland, and Spain. I lead the Estonian site, Depressioonivaba Tallinn (Depression-Free Tallinn). The research asks a specific question: why does the exact same intervention look completely different once it lands in five different health and social systems, using a case-study design across all five countries, built on tracker data, satisfaction surveys, and interviews with the people who actually ran the programme on the ground. In short: the recipe is only half the battle, because every cook bakes it their own way.

Alongside the PhD, I work as a junior researcher and project manager at ERSI (the Estonian-Swedish Mental Health and Suicidology Institute), where I've managed two other EU-funded mental health projects: EAAD-Best, where I spent four years building the Estonian arm of the European Alliance Against Depression's iFightDepression programme, until it grew strong enough to run without me (which is the best testimonial there is), and MESUR, which supported the mental health of Ukrainian refugees across six countries in the wake of 2022. Between those two projects and MENTBEST, I've now watched the same intervention logic implemented across a genuinely wide range of European systems, plus a long list of local Estonian projects. That's where the Europe-versus-elsewhere comparison in my Fulbright work actually comes from: I've seen the same idea play out completely differently depending on who implements it and where.