Mental Health Policy And Practice Across Europe

This book maps the current state of policy, service provision and funding for mental health care across Europe, taking into account the differing historical contexts that have shaped both the development and the delivery of services.

This WHO report co-funded by the European Commission gives an overview of policies and practices for mental health in 42 Member States of the European Region. A large majority of countries have made significant progress over the past few years, and several are world leaders in mental health promotion, mental disorder prevention activities, service reform and human rights. Nevertheless, this report also identifies weaknesses in Europe, some systematic, such as a lack of consensus on definitions, and of compatible data collection, and others such as the need for development and investment across several areas. It identifies gaps in information where further work must be done, and is a baseline against which progress can be measured towards the vision and the milestones of the Mental Health Declaration for Europe. The data were obtained from the ministries of health of 42 European Member States. Over 150 figures and tables in the report demonstrate the diversity across the European Region, and allow country to country comparisons of indicators such as numbers of psychiatrists, financing, community services, training of the workforce, the prescription of anti-depressants and representation of users and carers.

Worldwide, mental health problems are set to become the second greatest threat to health by the end of the next decade. The European Union has identified mental health problems as a growing concern, although there is great variation within EU countries with respect to patient numbers and the range of facilities available to them. Historically, EU mental healthcare services have been analysed using measurable aspects of care provisions such as throughput, costs and outcome measures. Little is known of the experiences, perceptions, beliefs and values of those accessing and providing services. This enlightening new book adopts a very different approach. With a particular focus on nursing, it examines and critiques the state of specialist mental health services in nine EU countries - Czech Republic, Finland, Ireland, Greece, Luxembourg, Netherlands, Germany, United Kingdom and Portugal. Each chapter focuses on a single country and ascertains existing services, their development, the treatments and care provided, factors preventing better service delivery, and suggestions for improvement. A rich pattern of differences emerge and comparisons can then be drawn. It also explores the emergence of an EU mental health identity in regards to selection of mental health personnel, their training and education, and the range of services they provide. Healthcare professionals and students with a particular interest in mental health issues (especially those with an interest in international approaches) will welcome the fresh analysis. It provides vital new information for European policy makers and shapers, voluntary sector personnel, and service users and the organisations representing them.

Policy determines much of what nurses actually do on a daily basis, which means it is essential for nurses to engage with policy if they are to understand their own practice. Mental health nursing in particular has been shaped by a variety of policy factors in the past fifty years. In this new textbook, edited by the mental health advisor to the Royal College of Nursing, a range of experts in their field introduce the essential elements of mental health policy to students and experienced practitioners. The book covers a broad range of areas, including settings for care and the historical context, policy affecting various diagnoses and service user groups, and how policy is translated into action. Clinical examples are drawn on throughout, to help students think about the real-life context of what can be a difficult subject. It will be essential reading for pre-registration mental health nursing students, and valuable to those working in practice who want to gain an understanding of policy.

This international book aims to bring to life the mental health dimension of health promotion. It describes the concepts relating to promotion of mental health, the emerging evidence for the effectiveness of interventions, and the public health policy and practice implications. The book includes evidence on the relationship between social and cultural factors and the mental health of individuals and communities. It reviews the available evidence from a range of countries and cultures. It documents how actions such as advocacy, policy and project development, legislative and regulatory reform,

There are wide inconsistencies between, and even within, countries in how community-orientated care is defined and interpreted. The analysis presented in this book take as a starting point an evidence-based balanced care model in which services are provided in community settings close to the populations served, with hospital stays being reduced as far as possible, usually located in acute wards in general hospitals. The surprising conclusion from the research is that the same problems arise in all countries, regardless of resource status, and thus the recommendations of this book apply to mental health provision everywhere. This book reviews the implementation of community-orientated care using the balanced care model. It summarizes the steps, obstacles and mistakes that have been encountered in the implementation of community mental health care worldwide and presents guidelines on how to avoid them. It proposes realistic and achievable recommendations for the development and implementation of community-orientated mental health care over the next ten years. These guidelines will be of practical use to psychiatrists and other mental health and public health practitioners at all levels worldwide, including policy makers, commissioners, funders, non-governmental organisations, service users and carers. A core message of the book is that the mental health sector will more powerfully advocate for better services in future through strong and unified alliances, especially with powerful representation from consumer/service user and carer groups. Community-orientated care draws on a wide range of practitioners, providers, care and support systems (both professional and non-professional), though particular components may play a larger or lesser role in different settings depending on the local context and the available resources, especially trained staff. Research by a WPA task force has demonstrated that most of the challenges are common and global, but with local variations. The book is therefore relevant to psychiatrists and mental health workers in developed countries who are trying to deliver better health care on reduced budgets and for those in the developing economies who are in the position to modernise their mental health care. It provides clear, concise guidance on policy and practice decisions, learning from what has and has not worked in regions in the world. The book contains many tables documenting the evidence, supported by an essential reference list, and a Key Points summary for each chapter. Highly Commended in the Psychiatry section of the 2012 BMA Book Awards.