Se examinan las tendencias de rehabilitación basada en la comunidad (CBR) y el modelo de rehabilitación psicosocial denominado Clubhouse (CH) como instrumentos de políticas de reforma de la Salud Mental (MH). El trabajo se basa en documentación del proyecto transnacional “Empoderamiento de adultos con enfermedad mental para aprendizaje e inclusión social en 2010-2012” además de otras fuentes. La colección de datos y subsecuentes análisis se prepararon en el contexto de cerca de 30 recomendaciones internacionales de políticas de salud mental desde los años 90 hasta el 2012. Los documentos fueron analizados y comparados con diferentes enfoques orientados a la recuperación, tales como el modelo CH, y con conceptos clave de la ciencia de Rehabilitación, vinculados con tendencias recientes de la rehabilitación psicosocial. Algunas de las más importantes recomendaciones intergubernamentales de políticas de salud mental son las Guías conjuntas de Trabajo de la Organización Mundial de la Salud (OMS) y UNESCO y varias asociaciones internacionales tales como la Asociación Mundial de Rehabilitación Psiquiátrica (WAPR) y el Marco Piramidal de la OMS para la óptima combinación de servicios de Salud Mental, complementados con el Plan Integral de Acción en Salud Mental 2013-2020 aprobado por la OMS este año. Todas estas fuentes incluyen el espectro total de trastornos mentales. Factores de combinación son los derechos humanos, basados en una comprensión más holística de las discapacidades en lugar de un enfoque meramente médico. Todas estas recomendaciones están orientadas a su utilización a nivel global.

The article focuses on the trends of community-based rehabilitation (CBR) and the psychosocial Clubhouse rehabilitation model (CH) as tools for mental health (MH) policy reforms. It is based on documentation of the transnational project "Empowering Adults with Mental Illness for Learning and Social Inclusion in the years 2010-4 Hänninen E, et al.

This keynote paper examines the historical developments in Finland in developing community mental health services. In particular, it describes the development and growth of the ‘clubhouse model’ in the support and management of individuals with mental health and how Finland leads the way in such an approach. The paper describes the relative success of this ‘integrated’ model of care and considers what the future for community mental health in Finland will be.

ContentThe virtual study trip to community mental health in Finland includes several examples about how the local mental health services are organised and which methods are used in the coordination and integration processes of services for people with mental illness (e.g., public services, private services, voluntary organisations and other NGOs of and for people with mental illness, psychosocial rehabilitation and the empowering clubhouse rehabilitation network in Finland).Time divisionIntroduction and general overview to the workshop theme by Esko Hänninen (10’), service providing NGO’s presentation (15’), service users’ experiences about the Finnish community mental health services (2×10’), other participants of the workshop are telling about situations in their countries and discussion (45’).Educational resultsLearning to understand the welfare mix approach and how to manage the mix while organising coordinated and integrated multi-stakeholders’ community mental health services.

IntroductionWorld Health Assembly adopted in May 2013 the Comprehensive MH Action Plan 2013–2020. At the end of 2012 WHO published QualityRights Tool Kit for mental health field; at same time a European Expert Group published European Guidelines on the Transition from Institutional to Community Care. In 2010 WHO, ILO and UNESCO published the joint community-based CBR-guidelines which cover psychosocial rehabilitation. In 2007 WHO launched recommendation for Pyramid Framework to support MH policy change. These recommendations are built upon the UN Convention on Rights of People with Disabilities (UN 2006), it includes people with mental disorders, too.ObjectivesTo present the findings of a MH policy analysis of the above-mentioned and about 25 earlier MH policy recommendations approved by Inter- Governmental Organisations since 1990. Common denominators are shared with participants, and compared with the reality in Europe. Main message is a search for community-based, more comprehensive, human rights based rehabilitation services, coordinated across organisational boundaries. Some examples are described.AimsPresentation of the Bavarian experiences about CBR-based Clubhouse model, originally Fountain House model since 1948, disseminated since 1980s in Europe. In 2013 there are about 90 Clubhouses serving their members in 22 European countries.Presentation of research findings which prove the Clubhouse model is an evidence-based rehabilitation practice.MethodsContent analysis of about 30 international MH policy recommendations since 1990s and comparative analysis of some community-based rehabilitation approaches.ResultsSummarising main research findings in different countries in Europe and worldwide.ConclusionsClubhouse model is fitting in with the MH policy recommendations and should be used more widely in Europe.