Mental health policy and practice across Europe: an overview

94 Mental health policy and practice
the MHEEN network in Europe, can help build capacity and fill some of
these gaps. These initiatives may serve to strengthen the case further for
investment.
Of course, on their own, these positive developments will not lead to a
level of funding of mental health consistent with its individual and societal
impact. Effective communication and ongoing engagement are needed with
stakeholders in all sectors, including policy-makers, service users and families,
employers, trade unions and schools. Any discussion of funding must therefore
also consider other sectors, where in comparison with European health care
systems, there may be even greater barriers to access, with higher levels of copayments
and use of income-related means-testing. NGOs and international
donors will also need to continue to play important roles both in funding and
delivering services. The long-term sustainability of effective initiatives needs to
be an important goal.
It is crucial to recognize that it is not just a question of the level of funding for
mental health, but also of the way in which these funds are used. Moving
towards greater reliance on community care requires resources to be shifted
away from institutional care. But as we have seen, there can be many barriers
to achieving this. Financial incentives can be a powerful tool to improve the
flow of funds to and within a mental health system, broadly defined, and to
create incentives and disincentives to better action and performance. Making
decision-makers aware of the cost implications of their decisions can be quite
illuminating; making them financially responsible in a direct way can be
particularly influential in changing behaviour. These incentives can also be used
to empower service users through consumer-directed payment schemes to make
their own decisions on service needs.
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