Mental health policy and practice across Europe: an overview

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248 Mental health policy and practice strategies can also contribute to a reduction in other problems such as youth delinquency, child abuse, dropping out of school and work days lost to illness. Stigma plays a negative role in the recovery process and the effectiveness of psychosocial rehabilitation. The stigma attached to mental illnesses creates social isolation, an inability to work, alcohol or drug abuse, homelessness, or excessive institutionalization, which decreases a person’s chance of recovery and their quality of life (WHO 2001b). Note 1 Names in use include consumers, users, survivors of psychiatry, psychiatric survivors, clients, victims of psychiatry, ex-users, ex-patients, ex-inmates, lunatics ... References Becker, T. and Vázquez-Barquero, J.L. (2001) The European perspective of psychiatric reform, Acta Psychiatrica Scandinavica, 104 (Suppl. 410): 8–14. Becker, T., Hülsmann, S., Knudsen, H.C., Martiny, K., Amaddeo, F., Herran, A., Knapp, M., Schene, A.H., Tansella, M., Thornicroft, G., Vázquez-Barquero, J.L., EPSILON Study Group (2002) Provision of services for people with schizophrenia in five European regions, Social Psychiatry and Psychiatric Epidemiology, 37(10): 465–74. Brand, U. (2001a) Mental health care in Germany: carers’ perspectives, Acta Psychiatrica Scandinavica, 104 (Suppl. 410): 35–40. Brand, U. (2001b) European perspectives: a carer’s view, Acta Psychiatrica Scandinavica, 104 (Suppl. 410): 96–101. Buetow, S.A. and Roland, M.O. (1999) Clinical governance: bridging gap between managerial and clinical approaches to quality of care, Quality in Health Care, 8(3): 184–90. Burti, L. (2001) Italian psychiatric reform 20 plus years after, Acta Psychiatrica Scandinavica, 104 (Suppl. 410): 41–6. Burti, L., Amaddeo, F., Ambrosi, M., Bonetto, C., Cristofalo, D., Ruggeri, M. and Tansella, M. (2005) Does additional care provided by a consumer self-help group improve psychiatric outcome? A study in an Italian community-based psychiatric service, south Verona (submitted). Available from the authors. Chamberlin, J. (2005) User/consumer involvement in mental health service delivery, Epidemiologia e Psichiatria Sociale, 14(1): 10–14. Corrigan, P.W., Calabrese, J.D., Diwan, S.E., Keogh, C.B., Keck, L. and Mussey, C. (2002) Some recovery processes in mutual-help groups for persons with mental illness; I: qualitative analysis of program materials and testimonies, Community Mental Health Journal, 38(4): 287–301. Department of Health (1998) A First Class Service: Quality in the New NHS. London: Department of Health. Dressing, H. and Salize, H.J. (2004) Compulsory admission of mentally ill patients in European Union Member States, Social Psychiatry and Psychiatric Epidemiology, 39(10): 797–803. Ferrari, G., Fioritti, A., Piazza, A. and Pileggi, F. (1986) Legge e salute mentale: rassegna delle legislazioni psichiatriche nel mondo, Formazione Psichiatrica, VII(2): 29–54. Fioritti, A. (2002) Leggi e Salute Mentale: Panorama Europeo delle Legislazioni di Interesse Psichiatrico. Torino: Centro Scientifico Editore. Geller, J.L. (2002) Does ‘in the community’ mean anything any more? Psychiatric Services, 53(10): 1201.
Reforms in community care 249 Goldberg, D. (1997) Community psychiatry in Europe, Epidemiologia e Psichiatria Sociale, 6 (Suppl. 1): 217–27. Hölling, I. (2001) About the impossibility of a single (ex-) user and survivor of psychiatry position, Acta Psychiatrica Scandinavica, 104 (Suppl. 410): 102–6. Johnson, S., Zinkler, M. and Priebe, S. (2001) Mental health service provision in England, Acta Psychiatrica Scandinavica, 104 (Suppl. 410): 47–55. Knapp, M., Beecham, J., Koutsogeorgopoulou, V., Hallam, A., Fenyo, A., Marks, I.M., Connolly, J., Audini, B. and Muijen, M. (1994) Service use and costs of home-based versus hospital-based care for people with serious mental illness, British Journal of Psychiatry, 166: 120–2. Leff, J. (2001) Why is care in the community perceived as a failure? British Journal of Psychiatry, 179: 381–3. Marshall, M., Crowther, R., Almaraz-Serrano, A., Creed, F., Sledge, W., Kluiter, H., Roberts, C., Hill, E., Wiersma, D., Bond, G.R., Huxley, P. and Tyrer, P. (2001) Systematic reviews of the effectiveness of day care for people with severe mental disorders; 1) Acute day hospital versus admission; 2) Vocational rehabilitation; 3) Day hospital versus outpatient care, Health Technology Assessment, 5(21): 1–75. Merson, S., Tyrer, P., Carlen, D. and Johnson, T. (1996) The cost of treatment of psychiatric emergencies: a comparison of hospital and community services, Psychological Medicine, 26 (4): 727–34. Murray, C.J.L. and Lopez, A.D. (1997) Regional patterns of disability-free life expectancy and disability-adjusted life-expectancy: Global Burden of Disease Study, The Lancet, 349: 1347–52. Salize, H.J. and Dressing, H. (2004) Epidemiology of involuntary placement of mentally ill people across the European Union, British Journal of Psychiatry, 184: 163–8. Saraceno, B. (2002) Prefazione, in A. Fioritti (ed.) Leggi e Salute Mentale. Panorama Europeo delle Legislazioni di Interesse Psichiatrico. Torino: Centro Scientifico Editore. Schene, A. and Faber, A.M.E. (2001) Mental health care in the Netherlands, Acta Psychiatrica Scandinavica, 104 (Suppl. 410): 74–81. Souetre, F. (1994) Economic evaluation in mental disorders: community versus institutional care, Pharmachoeconomics, 6(4): 330–6. Tarricone, R., Gerzeli, S., Montanelli, R., Frattura, L., Percudani, M. and Racagni, G. (2000) Direct and indirect costs of schizophrenia in community psychiatric services in Italy. The GISIES study, Health Policy, 51: 1–18. Thornicroft, G. and Tansella, M. (2004) Components of a modern mental health service: a pragmatic balance of community and hospital care – overview of systematic evidence, British Journal of Psychiatry, 185: 283–90. Thornicroft, G. and Tansella, M. (2005) Growing recognition of the importance of service user involvement in mental health planning and evaluation, Epidemiologia e Psichiatria Sociale, 14 (1): 1–3. United Nations (1991) The Protection of Persons with Mental Illness and the Improvement of Mental Health Care. UN General Assembly resolution A/RES/46.119 (available at:http:/ /www.un.org/ga/documents/gadocs.htm). Warner, R. (1994) Recovery from Schizophrenia, 2nd edn. London: Routledge. World Health Organization (2001a) Atlas: Country profiles. Geneva: World Health Organization. World Health Organization (2001b) The World Health Report 2001, Mental Health: New Understanding, New Hope. Geneva: World Health Organization. World Health Organization (2001c) Mental Health Policy Project: Policy and Service Guidance Package, Executive Summary. Geneva: World Health Organization. World Health Organization (2001d) Mental Health Resources in the World: Initial Results of Project Atlas. Geneva: World Health Organization.
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European Observatory on Health Syst
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The European Observatory on Health
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Open University Press McGraw-Hill E
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European Observatory on Health Syst
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viii Contents five six The evidence
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List of tables 2.1 Beds in state ps
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List of figures 4.1 The production
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List of boxes 3.1 A personal testim
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List of contributors Francesco Amad
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xviii List of contributors Viviane
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Series editors’ introduction Euro
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Foreword Mental health may be the m
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Foreword by the Minister of Health
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Acknowledgements This volume is par
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chapter one Mental health policy an
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An overview 3 agencies (see Chapter
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An overview 5 Funding In broad term
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An overview 7 Social inclusion and
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An overview 9 actions such as inter
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An overview 11 of symptom alleviati
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An overview 13 Kessler, R.C., Demle
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chapter two The historical developm
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Historical development of mental he
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A lack of historical continuity His
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Tackling social exclusion 35 • in
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Tackling social exclusion 37 networ
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Tackling social exclusion 39 regula
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Tackling social exclusion 41 where
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Tackling social exclusion 43 and Sw
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Tackling social exclusion 45 addres
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Tackling social exclusion 47 than o
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Tackling social exclusion 49 in thi
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Tackling social exclusion 51 not ho
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Tackling social exclusion 53 Box 3.
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Tackling social exclusion 55 Conclu
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Tackling social exclusion 57 Disabi
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Tackling social exclusion 59 Read,
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Financing and funding 61 problems h
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Financing and funding 63 provides a
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Financing and funding 65 recognizin
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Financing and funding 67 care docto
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Financing and funding 69 Trends in
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Financing and funding 71 employment
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Financing and funding 73 kind, cove
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Financing and funding 75 emphasis o
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Financing and funding 77 provided i
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Financing and funding 79 for differ
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Financing and funding 81 budgets in
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Financing and funding 83 Europe or
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Financing and funding 85 the famili
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Financing and funding 87 of further
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Financing and funding 89 mental hea
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Financing and funding 91 community
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Financing and funding 93 Available
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Financing and funding 95 Basu, A. (
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Financing and funding 97 of interve
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Financing and funding 99 World Heal
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The evidence base 101 result of pub
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The evidence base 103 campaigns, it
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The evidence base 105 using health
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Table 5.1 A matrix of evidence Rese
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Identifying needs using epidemiolog
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The evidence base 111 facilitate gl
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The evidence base 113 Learning from
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The evidence base 115 sources of ev
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The evidence base 117 Europe, and i
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The evidence base 119 to Policy pro
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The evidence base 121 Finally, it i
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The evidence base 123 Lavis, J., Ro
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The evidence base 125 World Health
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The treatment of mental disorders 1
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Psychopharmaceuticals in Europe 147
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Table 7.6 Europe by drug type and c
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Table 7.8 Europe by drug type and c
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Table 7.10 Europe by drug type and
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Table 7.12 Europe by drug type and
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Table 7.14 Europe comparative presc
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Table 7.20 Decline in psychiatric i
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Promotion and prevention 189 Mental
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Promotion and prevention 191 Box 8.
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Promotion and prevention 193 risk o
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Promotion and prevention 195 and th
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Page 243 and 244: chapter nine Common mental health p
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Page 273 and 274: Reforms in community care 245 Secon
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Page 279 and 280: Addiction and alcohol 251 (Brown et
Page 281 and 282: Addiction and alcohol 253 Figure 11
Page 283 and 284: Addiction and alcohol 255 Table 11.
Page 285 and 286: Addiction and alcohol 257 Some stud
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Page 291 and 292: Addiction and alcohol 263 Hours and
Page 293 and 294: Addiction and alcohol 265 College s
Page 301 and 302: Addiction and alcohol 273 Alcohol t
Page 303 and 304: Addiction and alcohol 275 developme
Page 305 and 306: Addiction and alcohol 277 Greenfiel
Page 307 and 308: Addiction and alcohol 279 World Hea
Page 309 and 310: Housing and employment 281 European
Page 311 and 312: Housing and employment 283 to a lif
Page 313 and 314: Housing and employment 285 relative
Page 315 and 316: Housing and employment 287 comprise
Page 317 and 318: Housing and employment 289 treatmen
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Housing and employment 299 Return t
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Effectiveness of pre-vocational and
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Housing and employment 303 where re
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Housing and employment 305 mental h
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Housing and employment 307 S.M. (20
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A human rights perspective 309 Nor
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Monitoring compliance with the inte
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A human rights perspective 313 Ment
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A human rights perspective 315 Equa
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A human rights perspective 317 Last
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A human rights perspective 319 Comb
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A human rights perspective 321 segr
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A human rights perspective 323 The
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A human rights perspective 325 •
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A human rights perspective 327 ensu
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A human rights perspective 329 •
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A human rights perspective 331 Arti
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A human rights perspective 333 Refe
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A human rights perspective 335 Will
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The user and survivor movement 337
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Care of asylum seekers and refugees
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generic local team or psychiatric h
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Carers and families 375 In this cha
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Carers and families 377 impact they
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Carers and families 379 2002). In a
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Carers and families 381 conducted i
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Carers and families 383 Interventio
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Carers and families 385 Child careg
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Carers and families 387 subject to
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Carers and families 389 Conclusion
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Carers and families 391 Cohen, C.A.
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Carers and families 393 in long-ter
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Carers and families 395 care in rel
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chapter seventeen Mental health pol
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Policy in former eastern bloc count
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Table 17.1 General information and
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Box 18.1 Recommendations in The Wor
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The WHO perspective 429 isolation,
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The WHO perspective 431 high when c
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The WHO perspective 433 Key issues
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The WHO perspective 435 Box 18.2 Qu
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The WHO perspective 437 services is
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The WHO perspective 439 Desjarlais,
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Index abuse of psychiatry, eastern
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Index 443 community care ECHR, 321
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Index 445 European countries commun
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Index 447 initiatives, discriminati
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Index 449 applying principles, 317-
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Index 451 policy, 228-9 practice, 2
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