Mental health policy and practice across Europe: an overview

388 Mental health policy and practice
including France, the focus of the family association is not on providing services,
but instead on working with families to provide information, training and
support.
In June 1990, EUFAMI was established at a congress in De Haan, Belgium,
when family representatives from 16 European countries expressed a strong
desire to collaborate to guarantee the rights and welfare of mentally ill people
and their relatives throughout Europe. The levels of commitment were high. As
one participant noted ‘we even learned that a Romanian couple, a doctor and
his wife, had sold their car in order to pay for the journey to De Haan’. The
priorities for EUFAMI and its member associations are to fight stigma, to support
families and to campaign for good practice. By the end of 2005, 41 family
associations in 26 European countries, as well as neighbouring Morocco, were
members of EUFAMI. 1
The success of family associations has been the subject of review (Brand
2001). The principal achievement has been to obtain the active recognition by
professionals that family members are partners in the care process. This process
has been led by the World Psychiatric Association, which has actively sought to
involve family members in developing policy statements. Human rights have
been high on the policy agenda both at the Council of Europe, as well as in the
European Commission and the World Health Organization (WHO). EUFAMI,
in particular, was active in pressing for a ‘seat at the table’ for relatives. This
has started to show results with family members being involved in high-level
discussions and consultation with these organizations. One notable example
has been the recent WHO Action Plan and Declaration on mental health (World
Health Organization 2005a, 2005b), endorsed by all 52 countries of the European
region in Helsinki in January 2005, where non-governmental organizations
(NGOs) representing both service users and families, including EUFAMI, had
been able to play an important role in preparatory discussions and consultations
leading up to the event. As well as welcoming the final Declaration and
Action Plan, which recognized the importance of supporting the needs of family
carers, EUFAMI also noted that a number of countries for the first time had
included family members and service users within their official delegations
(EUFAMI 2005). Recently, EUFAMI has played an active role in stakeholder
consultations on the European Commission’s Green Paper outlining a strategy
for mental health (Commission of the European Communities 2005).
As well as gaining recognition and having a greater say in the development of
policy, both Europe-wide organizations such as EUFAMI and national organizations
can help to share best practice – for instance, in respect of legislation
and codes of practice. Good practice in one country might be used as an
example for those elsewhere as part of their lobbying and campaigning activities.
The availability of services and treatments across Europe can also be used
to help make the case for improved services within any one country. During
2003, for example, family associations in Hungary and Poland were actively
involved, with support from EUFAMI, in lobbying their governments on the
case for access to newer but more expensive antipsychotic medications. Family
associations also can play an important role in supporting research that looks
not only at the care needs of people with mental health problems, but also at the
needs of other family members such as siblings.