WHO/Europe meeting on mental health: community care and de-institutionalization
WHO, in partnership with the Regional Health Development Center on Mental Health, held a meeting on community care and de-institutionalization of mental health, hosted by Bosnia and Herzegovina in Sarajevo on 19–20 November 2015. Participants were representatives of Bosnia and Herzegovina, Bulgaria, Israel, Montenegro, the Republic of Moldova, Romania and Serbia.
The programme included presentations and discussions on the developments of mental health care in the participating countries, in particular with respect to community mental health centres, methods of quality assurance, new service models for early intervention and improvement of routine care, and the challenges of providing mental health care for refugees.
Several main conclusions were reached.
- Progress has been made in improving the conditions in hospitals and establishing community mental health centres. Overall, the number of psychiatric hospital beds is similar to that in western European countries.
- Relative spending on mental health care varies across countries, but tends be much lower than in western Europe. While a relatively larger proportion of the available funding is invested in in-patient care, overall funding levels for mental health care need to be increased.
- Mutual learning and support of countries in the WHO European Region should help to promote further progress.
- Care may benefit from service models that replace routine care of questionable effectiveness with more evidence-based and effective interventions. Examples are the model of early intervention developed in Verona, Veneto (Italy) and the DIALOG+ intervention.
- The refugee crisis is a substantial and consistently changing challenge to health care in countries in south-eastern Europe. In particular for transient refugee populations, the focus is on the provision of basic health care, which needs to be made available quickly and often in small places near borders.
