People with mental health problems differ from case to case according to the nature of their problems. What is specific about people with severe mental disorders is that they are more heavily exposed to social exclusion than others. According to the OECD, people with severe mental health conditions are six to seven times more likely to be unemployed than people with no mental health condition.
Against this serious backdrop, the EU Joint Action on Mental Health and Wellbeing, an action framework initiated by the European Commission (DG SANCO), incorporates a working package on the transition towards socially inclusive and community-based care for people with severe mental disorders. The participating members of this working group gathered on 26-27 February in Madrid and discussed the progress of a draft report on the nine participating countries (Portugal, Italy, Hungary, Spain, Ireland, Estonia, Bulgaria, Austria, United Kingdom) with regards to the transition towards community-based care. The draft report covers a wide range of relevant aspects such as the policy frameworks, the different care settings, and the extent to which community-based care has emerged across different national settings.
It has become apparent through data collection that each country has a nationally specific mental health system and that the individual transition processes reflect the strengths and weaknesses of each system. ESN supports the working group via its members in two countries, the Dublin City Council/HSE Mental Health Services in Ireland and the Department of Social Welfare of the Tartu City Government from Estonia, to actively engage with this working package.
The data seeks to develop a more nuanced perspective on the development stages of mental health systems across Europe. For that purpose, the working group has chosen three different time periods taking into account the availability of data: before 1998, from 1998 to 2008, and from 2008 to 2012.
When examining the participating countries, similarities and differences in the development of mental health systems become apparent. Whilst in Estonia and Ireland, a reduction of beds in psychiatric hospitals has been achieved before and after 1998, the transfer of patients to community-based services and general hospitals has been of significant importance in Ireland, but only of some importance in Estonia.
In all countries, the transfer of patients and the overall systemic transition are influenced by the degree to which community-based facilities provide alternative services. In this analysis, local mental health centres are taken as an example of community-based facilities. As a matter of example, in 2012 Ireland had 2.24 of these centres per 100,000 inhabitants, while Estonia had 5.15.
The European Social Network (ESN) continues to facilitate its members’ involvement with this Joint Action. It actively supports the collection of data in order to gain a comparative overview across Europe and to develop policy recommendations for a commonly endorsed framework of action in the field of mental health.