Patterns of service for the long‐term mentally ill in Europe

Abstract

Mental health services are organized and financed in very different ways across Europe; nevertheless there are a number of common trends and issues. In this paper we deal with some of those issues which influence the quality of services to those with long-term and severe mental health problems and disabilities. The most obvious trend has been the rundown of psychiatric beds particularly in the large mental hospitals and this in its turn has given rise to the problem of providing alternative services. Throughout Europe people are striving, with mixed success, to establish new services that are community orientated, provide reasonable levels of clinical care with some continuity and coordination, and ensure that the individuals served have appropriate accommodation and day-time activities. While there are some excellent services, there are even more services throughout Europe struggling to solve common problems. We have tried to draw some lessons from their efforts.

Expert Arguments for Trends of Psychiatric Bed Numbers: A Systematic Review of Qualitative Data

“…It has been argued that need of psychiatric beds may vary between regions (131), and even changes between seasons (132). The provision of psychiatric beds has to respond to local requirements and conditions (127). The arguments presented here may help to tailor policies after evaluation of fit and contextdependent applicability.…”

“…Mental health service planners need orientation on how to further develop the psychiatric inpatient sector (7)(8)(9)(10). Despite the diversity of services and nomenclatures used across regions (10,(16)(17)(18), there was agreement on several themes, such as the need to develop integrated mental health systems that assure coherence and continuity of care, along with the need to aim for specific populations and contexts (127). In all, arguments expressing concern about further bed reductions prevailed as there is a high demand on inpatient services, especially on short-stay and acute beds, evidenced in high occupancy and increasing admission rates (10,99).…”

Migration and mental health care in Europe: Report of a preliminary mapping exercise

“…The French equivalent simply refers to services that are not in hospital. Most often the term refers to the reduction of hospital beds or the establishment of hostels (Rowland et al 1992). Secondly, there is very little comparative data on mental health or social care services at a European level.…”

“…Secondly, there is very little comparative data on mental health or social care services at a European level. Even comparisons of so-called`hard data' such as numbers of beds available or admission rates have been dif® cult to achieve owing to the different de® nitions of terms such as`patient' and`bed' (Rowland et al 1992). Furthermore, the shift to community care has led to the emergence of an increasingly differentiated range of services that add to the complexity of gathering comparative data (Goodwin 1997: 4).…”

Severe mental illness, statutory supervision and mental health nursing in the United Kingdom: meeting the challenge

“…The World Health Organization ( Rowland et al 1992 ) proclaimed that mentally ill people should enjoy the same fundamental rights as the rest of society, yet supervised discharge appears to contradict this. Atkinson (1996) points out that the mentally ill citizen under such legislation is not being treated as other citizens.…”