Mental health policy and practice across Europe: an overview

More documents

Recommendations

Info

438 Mental health policy and practice employment opportunities abroad. Finally, management strategies need to enhance leadership, motivation, recruitment and the deployment of often scarce personnel. Conclusions Mental disorders contribute significantly to the global burden of disease, and are associated with economic and social costs to individuals, families and countries. Reducing this burden is possible given an important evolving information base to guide policy, service development and clinical practice. However, there remains a sizeable gap between what we know in terms of what works and what is actually available in countries. In developed countries, deinstitutionalization has not been accompanied by sufficient provision of community-based residential and occupational facilities. The detection and treatment of mental disorders in primary care settings remains poor and there remain tensions between the competing demands for general versus specialist services. In developing countries, the gross under-provision of resources, personnel and services needs urgent attention. The gap needs to be closed by continued advocacy efforts to raise mental health on the agenda of governments, by continued dissemination of information on effective policies, service development and clinical practice, and the dissemination of international human right standards. The larger macro-social and economic factors impacting on mental health need to be pursued in this overall effort. Poverty, education and economic development are some of the millennium development goals that, if appropriately addressed, can contribute to reducing the gap. International and multilateral organizations and non-governmental organizations (NGOs) have unique roles to play. These roles necessarily differ according to the specific mandates of organizations and it is not the place of this chapter to elaborate on these. In the end, it will be the political commitment of governments to address mental health problems, the strength of consumer and family movements in countries to ensure that mental health does not disappear from the agenda, the support provided by international and multilateral organizations, NGOs and the international community at large that will ensure continued progress in the area of mental health. References Berto, P., D’Ilario, D., Ruffo, P., Di Virgilio, R. and Rizzo, F. (2000) Depression: cost-ofillness studies in the international literature, a review, The Journal of Mental Health Policy and Economics, 3(1): 3–10. Birnbaum, H., Greenberg, P., Barton, M., Kessler, R., Rowland, C. and Williamson, T. (1999) Workplace burden of depression: a case study in social functioning using employer claims data, Drug Benefits Trends, 11: 6BH–12BH. Chisholm, D., Sekar, K., Kumar, K., Saeed, K., James, S., Mubbashar, M. and Murthy, R.S. (2000) Integration of mental health care into primary care: demonstration costoutcome study in India and Pakistan, British Journal of Psychiatry, 176: 581–8.
The WHO perspective 439 Desjarlais, R., Eisenberg, L., Good, B. and Kleinman, A. (1995) World Mental Health: Problems And Priorities In Low-Income Countries. New York: Oxford University Press. Gabriel, P. and Liimatainen, M.R. (2000) Mental Health in the Workplace. Geneva: International Labour Office. Green, A. (1999) An Introduction to Health Planning in Developing Countries, 2nd edn. Oxford: Oxford University Press. Greenberg, P.E., Stiglin, L.E., Finkelstein, S.N. and Berndt, E.R. (1993) The economic burden of depression in 1990, Journal of Clinical Psychiatry, 54(11): 1–14. Kind, P. and Sorensen, J. (1993) The costs of depression, International Clinical Psychopharmacology, 7: 191–5. Murray, C.J.L. and Lopez, A.D. (eds) (1996a) The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability From Diseases, Injuries and Risk Factors in 1990 and Projected to 2020. Cambridge, MA: Harvard School of Public Health on behalf of the World Health Organization and the World Bank (Global Burden of Disease and Injury Series, vol. I). Murray, C.J.L. and Lopez, A.D. (1996b) Global Health Statistics. Cambridge, MA: Harvard School of Public Health on behalf of the World Health Organization and the World Bank (Global Burden of Disease and Injury Series, vol. II). Murray, C.J.L. and Lopez, A.D. (2000) Progress and directions in refining the global burden of disease approach: a response to Williams, Health Economics, 9: 69–82. Patel, V. (2001) Poverty, inequality, and mental health in developing countries, in D. Leon and G. Walt (eds) Poverty, Inequality and Health: An International Perspective. Oxford: Oxford University Press. Thornicroft, G. and Tansella, M. (1999) The Mental Health Matrix: A Manual to Improve Services. Cambridge: Cambridge University Press. Üstün, T.B. (1999) The global burden of mental disorders, American Journal of Public Health, 89(9): 1315–18. World Bank (1993) World Development Report 1993: Investing in Health. New York: Oxford University Press for the World Bank. World Health Organization (2001a) Atlas: Mental Health Resources in the World 2001. Geneva: World Health Organization. World Health Organization (2001b) Atlas: Country Profiles on Mental Health Resources 2001. Geneva: World Health Organization. World Health Organization (2001c) Mental and Neurological Disorders (fact sheet No. 265, December). Geneva: World Health Organization. World Health Organization (2001d) The World Health Report 2001. Mental Health: New Understanding, New Hope. Geneva: World Health Organization. World Health Organization (2001e) Gender Disparities in Mental Health – Ministerial Round Tables 2001. Geneva: World Health Organization. World Health Organization (2002a) Resolution EB109.R8 – Strengthening Mental Health. One Hundred and Ninth session of the Executive Board. Geneva: World Health Organization. World Health Organization (2002b) Resolution WHA 55.10 – Mental Health: Responding to the Call for Action. Fifty-fifth World Health Assembly. Geneva: World Health Organization. World Health Organization (2002c) World Report on Violence and Health. Geneva: World Health Organization. World Health Organization (2002d) World Health Report 2002. Reducing Risks, Promoting Healthy Life. Geneva: World Health Organization. World Health Organization (2003a) Investing in Mental Health. Geneva: World Health Organization. World Health Organization (2003b) WHO Mental Health Policy and Service Guidance Package: Mental Health Financing. Geneva: World Health Organization.
Page 1 and 2:
European Observatory on Health Syst
Page 3 and 4:
The European Observatory on Health
Page 5 and 6:
Open University Press McGraw-Hill E
Page 7 and 8:
European Observatory on Health Syst
Page 9 and 10:
viii Contents five six The evidence
Page 11 and 12:
List of tables 2.1 Beds in state ps
Page 13 and 14:
List of figures 4.1 The production
Page 15 and 16:
List of boxes 3.1 A personal testim
Page 17 and 18:
List of contributors Francesco Amad
Page 19 and 20:
xviii List of contributors Viviane
Page 21 and 22:
Series editors’ introduction Euro
Page 23 and 24:
Foreword Mental health may be the m
Page 25 and 26:
Foreword by the Minister of Health
Page 27 and 28:
Acknowledgements This volume is par
Page 29 and 30:
chapter one Mental health policy an
Page 31 and 32:
An overview 3 agencies (see Chapter
Page 33 and 34:
An overview 5 Funding In broad term
Page 35 and 36:
An overview 7 Social inclusion and
Page 37 and 38:
An overview 9 actions such as inter
Page 39 and 40:
An overview 11 of symptom alleviati
Page 41 and 42:
An overview 13 Kessler, R.C., Demle
Page 43 and 44:
chapter two The historical developm
Page 45 and 46:
Historical development of mental he
Page 47 and 48:
Page 49 and 50:
Page 51 and 52:
Page 53 and 54:
Page 55 and 56:
A lack of historical continuity His
Page 57 and 58:
Page 59 and 60:
Page 61 and 62:
Page 63 and 64:
Tackling social exclusion 35 • in
Page 65 and 66:
Tackling social exclusion 37 networ
Page 67 and 68:
Tackling social exclusion 39 regula
Page 69 and 70:
Tackling social exclusion 41 where
Page 71 and 72:
Tackling social exclusion 43 and Sw
Page 73 and 74:
Tackling social exclusion 45 addres
Page 75 and 76:
Tackling social exclusion 47 than o
Page 77 and 78:
Tackling social exclusion 49 in thi
Page 79 and 80:
Tackling social exclusion 51 not ho
Page 81 and 82:
Tackling social exclusion 53 Box 3.
Page 83 and 84:
Tackling social exclusion 55 Conclu
Page 85 and 86:
Tackling social exclusion 57 Disabi
Page 87 and 88:
Tackling social exclusion 59 Read,
Page 89 and 90:
Financing and funding 61 problems h
Page 91 and 92:
Financing and funding 63 provides a
Page 93 and 94:
Financing and funding 65 recognizin
Page 95 and 96:
Financing and funding 67 care docto
Page 97 and 98:
Financing and funding 69 Trends in
Page 99 and 100:
Financing and funding 71 employment
Page 101 and 102:
Financing and funding 73 kind, cove
Page 103 and 104:
Financing and funding 75 emphasis o
Page 105 and 106:
Financing and funding 77 provided i
Page 107 and 108:
Financing and funding 79 for differ
Page 109 and 110:
Financing and funding 81 budgets in
Page 111 and 112:
Financing and funding 83 Europe or
Page 113 and 114:
Financing and funding 85 the famili
Page 115 and 116:
Financing and funding 87 of further
Page 117 and 118:
Financing and funding 89 mental hea
Page 119 and 120:
Financing and funding 91 community
Page 121 and 122:
Financing and funding 93 Available
Page 123 and 124:
Financing and funding 95 Basu, A. (
Page 125 and 126:
Financing and funding 97 of interve
Page 127 and 128:
Financing and funding 99 World Heal
Page 129 and 130:
The evidence base 101 result of pub
Page 131 and 132:
The evidence base 103 campaigns, it
Page 133 and 134:
The evidence base 105 using health
Page 135 and 136:
Table 5.1 A matrix of evidence Rese
Page 137 and 138:
Identifying needs using epidemiolog
Page 139 and 140:
The evidence base 111 facilitate gl
Page 141 and 142:
The evidence base 113 Learning from
Page 143 and 144:
The evidence base 115 sources of ev
Page 145 and 146:
The evidence base 117 Europe, and i
Page 147 and 148:
The evidence base 119 to Policy pro
Page 149 and 150:
The evidence base 121 Finally, it i
Page 151 and 152:
The evidence base 123 Lavis, J., Ro
Page 153 and 154:
The evidence base 125 World Health
Page 155 and 156:
The treatment of mental disorders 1
Page 157 and 158:
Page 159 and 160:
Page 161 and 162:
Page 163 and 164:
Page 165 and 166:
Page 167 and 168:
Page 169 and 170:
Page 171 and 172:
Page 173 and 174:
Page 175 and 176:
Psychopharmaceuticals in Europe 147
Page 177 and 178:
Page 179 and 180:
Page 181 and 182:
Page 183 and 184:
Table 7.6 Europe by drug type and c
Page 185 and 186:
Table 7.8 Europe by drug type and c
Page 187 and 188:
Table 7.10 Europe by drug type and
Page 189 and 190:
Table 7.12 Europe by drug type and
Page 191 and 192:
Table 7.14 Europe comparative presc
Page 193 and 194:
Page 195 and 196:
Table 7.20 Decline in psychiatric i
Page 197 and 198:
Page 199 and 200:
Page 201 and 202:
Page 203 and 204:
Page 205 and 206:
Page 207 and 208:
Page 209 and 210:
Page 211 and 212:
Page 213 and 214:
Page 215 and 216:
Page 217 and 218:
Promotion and prevention 189 Mental
Page 219 and 220:
Promotion and prevention 191 Box 8.
Page 221 and 222:
Promotion and prevention 193 risk o
Page 223 and 224:
Promotion and prevention 195 and th
Page 225 and 226:
Promotion and prevention 197 (Üstu
Page 227 and 228:
Promotion and prevention 199 and un
Page 229 and 230:
Promotion and prevention 201 The li
Page 231 and 232:
Promotion and prevention 203 income
Page 233 and 234:
Promotion and prevention 205 implem
Page 235 and 236:
Promotion and prevention 207 When d
Page 237 and 238:
Promotion and prevention 209 health
Page 239 and 240:
Promotion and prevention 211 Murphy
Page 241 and 242:
Promotion and prevention 213 Vuori,
Page 243 and 244:
chapter nine Common mental health p
Page 245 and 246:
Mental health disorders in primary
Page 247 and 248:
Mental health problems in primary c
Page 249 and 250:
Page 251 and 252:
Page 253 and 254:
Page 255 and 256:
Page 257 and 258:
Page 259 and 260:
Page 261 and 262:
Page 263 and 264:
chapter ten Reforms in community ca
Page 265 and 266:
Table 10.1 Mental health care in th
Page 267 and 268:
Reforms in community care 239 syste
Page 269 and 270:
Reforms in community care 241 integ
Page 271 and 272:
Reforms in community care 243 In 19
Page 273 and 274:
Reforms in community care 245 Secon
Page 275 and 276:
Reforms in community care 247 must
Page 277 and 278:
Reforms in community care 249 Goldb
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
Page 287 and 288:
Addiction and alcohol 259 availabil
Page 289 and 290:
Addiction and alcohol 261 Table 11.
Page 291 and 292:
Addiction and alcohol 263 Hours and
Page 293 and 294:
Addiction and alcohol 265 College s
Page 295 and 296:
Page 297 and 298:
Page 299 and 300:
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
Page 319 and 320:
Housing and employment 291 rented h
Page 321 and 322:
Housing and employment 293 occupati
Page 323 and 324:
Housing and employment 295 market;
Page 325 and 326:
Housing and employment 297 Table 12
Page 327 and 328:
Housing and employment 299 Return t
Page 329 and 330:
Effectiveness of pre-vocational and
Page 331 and 332:
Housing and employment 303 where re
Page 333 and 334:
Housing and employment 305 mental h
Page 335 and 336:
Housing and employment 307 S.M. (20
Page 337 and 338:
A human rights perspective 309 Nor
Page 339 and 340:
Monitoring compliance with the inte
Page 341 and 342:
A human rights perspective 313 Ment
Page 343 and 344:
A human rights perspective 315 Equa
Page 345 and 346:
A human rights perspective 317 Last
Page 347 and 348:
A human rights perspective 319 Comb
Page 349 and 350:
A human rights perspective 321 segr
Page 351 and 352:
A human rights perspective 323 The
Page 353 and 354:
A human rights perspective 325 •
Page 355 and 356:
A human rights perspective 327 ensu
Page 357 and 358:
A human rights perspective 329 •
Page 359 and 360:
A human rights perspective 331 Arti
Page 361 and 362:
A human rights perspective 333 Refe
Page 363 and 364:
A human rights perspective 335 Will
Page 365 and 366:
The user and survivor movement 337
Page 367 and 368:
Page 369 and 370:
Page 371 and 372:
Page 373 and 374:
Page 375 and 376:
Page 377 and 378:
Page 379 and 380:
Page 381 and 382:
Page 383 and 384:
Page 385 and 386:
Care of asylum seekers and refugees
Page 387 and 388:
Page 389 and 390:
Page 391 and 392:
Page 393 and 394:
Page 395 and 396:
Page 397 and 398:
generic local team or psychiatric h
Page 399 and 400:
Page 401 and 402:
Page 403 and 404:
Carers and families 375 In this cha
Page 405 and 406:
Carers and families 377 impact they
Page 407 and 408:
Carers and families 379 2002). In a
Page 409 and 410:
Carers and families 381 conducted i
Page 411 and 412:
Carers and families 383 Interventio
Page 413 and 414:
Carers and families 385 Child careg
Page 415 and 416: Carers and families 387 subject to
Page 417 and 418: Carers and families 389 Conclusion
Page 419 and 420: Carers and families 391 Cohen, C.A.
Page 421 and 422: Carers and families 393 in long-ter
Page 423 and 424: Carers and families 395 care in rel
Page 425 and 426: chapter seventeen Mental health pol
Page 427 and 428: Policy in former eastern bloc count
Page 449 and 450: Table 17.1 General information and
Page 455 and 456: Box 18.1 Recommendations in The Wor
Page 457 and 458: The WHO perspective 429 isolation,
Page 459 and 460: The WHO perspective 431 high when c
Page 461 and 462: The WHO perspective 433 Key issues
Page 463 and 464: The WHO perspective 435 Box 18.2 Qu
Page 465: The WHO perspective 437 services is
Page 469 and 470: Index abuse of psychiatry, eastern
Page 471 and 472: Index 443 community care ECHR, 321
Page 473 and 474: Index 445 European countries commun
Page 475 and 476: Index 447 initiatives, discriminati
Page 477 and 478: Index 449 applying principles, 317-
Page 479 and 480: Index 451 policy, 228-9 practice, 2
Page 481 and 482: Related books from Open University
Page 483: PURCHASING TO IMPROVE HEALTH SYSTEM
show all

Mental health policy and practice across Europe: an overview

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?