Mental health policy and practice across Europe: an overview

342 Mental health policy and practice
present, all of them (ex-) users and survivors, representing 26 European countries.
In 1998 the network was legally incorporated, becoming a federation of
associations of users and survivors. However, changes in rules governing NGO
funding by the EU meant that between 1999 and 2004 no conferences were
held. Under these rules ENUSP could only attract funding in partnership with
other organizations and not simply to fund its own conferences. However, the
organization continued to hold web-based board meetings and finally was able
to hold its fifth congress in Denmark in July 2004.
The protection of human rights remains a fundamental concern of the user
movement and ENUSP places human rights at the centre of its approach to
mental health. The organization is committed to improving the status of people
who are involuntarily detained and treated – i.e. coerced by the psychiatric
system. The network campaigns for advanced directives or ‘psychiatric wills’.
These set out how an individual wishes to be treated in the event that they are
unable to make clear their choices at the time of a future emergency, and have
been shown in at least one randomized study to reduce the need for compulsory
treatment and admission (Henderson et al. 2004). The ENUSP campaign has
had some successes; for instance, users in Germany have succeeded in preventing
new legislation that would have permitted compulsory treatment in the
community.
Chapter 13 has set out some of the existing legal safeguards and international
conventions applying to service users. The user movement, including ENUSP,
devotes much energy to seeking to further tighten human rights legislation with
respect to psychiatric service users. This includes not only the European Convention
on Human Rights but also global treaties. However, some in the user
movement regard the European Convention as a piece of hypocrisy when it
comes to mental health. The Convention was drafted in the early 1950s and
excludes ‘persons of unsound mind’ from many of its provisions.
One other principle activity for ENUSP and many of its constituent organizations
is the development of anti-stigma and public education campaigns
(see Chapter 3). This can be very difficult in countries where the majority of
people using mental health services may be hidden away from view in large
institutions.
It is important for all NGOs to have good lines of communication to a range of
stakeholders. ENUSP has recognized the importance of effective communication
with the media, having built up expertise in this area, and also with other
stakeholder groups. This can be illustrated by the substantial presence of ENUSP
and many of its member organizations at the 2002 Leipzig conference of the
World Federation of Mental Health, a body representing psychiatrists from
around the world.
ENUSP is affiliated to, or lobbies, many organizations at both the European
and global levels. These include the European Commission, the NGO Mental
Health Europe, the World Health Organization (WHO) Regional Office for
Europe, the World Network of Users and Survivors of Psychiatry (WNUSP),
the United Nations (UN) (Ad Hoc Committee Convention on Persons with
Disabilities) and the WHO worldwide. However, ENUSP is constrained by
limited resources in what it can do. It receives no funding from the abovementioned
international organizations, other than for special projects run in