Lessons learned in developing community mental health care in Europe

Abstract

This paper summarizes the findings for the European Region of the WPA Task Force on Steps, Obstacles and Mistakes to Avoid in the Implementation of Community Mental Health Care. The article presents a description of the region, an overview of mental health policies and legislation, a summary of relevant research in the region, a precis of community mental health services, a discussion of the key lessons learned, and some recommendations for the future.

The balanced care model for global mental health

“…The Uterature from such middle-income settings, for example many of the countries of Eastern Europe and South America (Knapp et al 2007;Semrau et al 2011;Razzouk et al, in press), indicates that modest levels of resource are usually aUocated for mental health care compared with commurücable and infectious diseases (Razali, 2004;Al-Krenawi, 2005;Furedi et al 2006;Akiyama et al 2008;Janse van Rensburg, 2009;Sharifi, 2009;Rodriguez, 2010). In addition, as resources aUow, the BCM indicates that the five elements of Limited speciaiist staff provision of: 9 training and supervision 9 Talking and psycho-social of primary care staff treatments 9 Pharmacological treatments 9 consultation-liaison for complex cases 9 out-patient and in-patfent assessment 9 treatment for cases which cannot be managed in primary care Out-patient/ambulatory dinics 9 Community mental health teams 9 Talking and psycho-social 9 Acute tn-patient care treatments 9 Pharmacological treatments 9 Long-term community-based residential care 9 Work and occupation > 3.…”

Long-term hospitalizations for schizophrenia in the Czech Republic 1998–2012

“…A call for action has risen globally to promote its better implementation (Maj, 2011;Stuart, 2012) and deinstitutionalization is now the official policy of the World Health Organization in Europe (WHO, 2013). While mental health care systems in the majority of West European countries have undergone deinstitutionalization to some extent (Haug and Rossler, 1999;Novella, 2010;Pijl et al, 2001;Priebe et al, 2005;Saraceno and Tognoni, 1989;Vazquez-Barquero et al, 2001), mental health care in the countries of post-communist Central and Eastern Europe often continue to rely on large psychiatric hospitals (Semrau et al, 2011).…”

Suicides following inpatient psychiatric hospitalization: A nationwide case control study

“…The mental health care system in the Czech Republic on large asylums and a shift of the locus of care towards the community is still in progress (Hoeschl et al, 2012). The shifting of care is similar all over the region of post-communist Central and Eastern Europe (Semrau et al, 2011). The reform proceses should be conducted with caution, substantial effort and investments should be dedicated to increasing capacities for care in the community in order to replicate the Finish success.…”