Mental health policy and practice across Europe: an overview

Foreword
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Institute on promoting the rights of people with mental health problems and
intellectual disabilities throughout central and eastern Europe and the former
Soviet Union. Our work is focused on providing technical and financial support
to organizations that provide community-based alternatives to institutionalization,
as well as promoting the social inclusion of people with mental health
problems and intellectual disabilities through advocating for policy changes
and public awareness campaigns. Through my work with the Open Society
Mental Health Initiative, I have had the opportunity to collaborate with many
of the contributors to this book. Their commitment to developing mental
health policies that promote the rights of people with mental health problems is
demonstrated by the pockets of good practice in the region in which we work.
It says much that the Open Society Institute has been the only donor to
address on a sustained basis the issue of mental health across central and eastern
Europe and the former Soviet Union. Mental health issues remain a low priority
among international donors as well as policy-makers. A poignant example of
this is that new residential institutions for people with mental health problems
and intellectual disabilities are still being built in the new central and eastern
European member states of the European Union, despite the fact that some of
their governments have stated their intent, over time, to close such institutions.
In the former Soviet Union, the transition from state-dominated societies has
created conditions that spell untold suffering for people with mental health
problems and intellectual disabilities. Pervasive fiscal crises and cuts to government
health and social welfare budgets have resulted in the further deterioration
of conditions for people in long-term institutions and increased the
isolation of those kept at home.
There is a great need for advocacy in mental health from a variety of angles,
including the crucial work to address issues of social exclusion. In addition to
promoting quality health care and social support, mental health policies must
protect the human rights of people with mental health problems in terms of
access to education, housing, employment, and leisure and cultural activities.
Policies that support the development of community-based alternatives to institutional
care are also essential to ensuring the full and equal participation of
people with mental health problems in society. In many parts of Europe, however,
community-based alternatives remain severely underdeveloped. To move
forward, as a first step, governments must recognize the rights of people with
mental health problems by elaborating policies that comply with international
human rights standards and implementing financing mechanisms that make
the shift of resources from institution to community realistic and possible.
Perhaps most importantly, people who use mental health services and their
families must have a voice in the planning, implementation and review of new
policies.
Judith Klein
Director, Mental Health Initiative, Open Society Institute