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Profiling mental health systems in the European Union Member States and activities in prevention and promotion of mental health Chiara Samele, Senior Fellow.

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Presentation on theme: "Profiling mental health systems in the European Union Member States and activities in prevention and promotion of mental health Chiara Samele, Senior Fellow."— Presentation transcript:

1 Profiling mental health systems in the European Union Member States and activities in prevention and promotion of mental health Chiara Samele, Senior Fellow Foundation Anniversary Celebration Institute of Mental Health 7 November 2012

2 Acknowledgments Funders: Executive Agency for Health and Consumers (EAHC, EC) – Jurgen Scheftlein and Roisin Rooney Researchers: Stuart Frew and Norman Urquía Steering group: Gerry Carton, Professors Nick Manning, Peter Bartlett, Justine Schneider, Eddie Kane Project Manager: Lesia Joubert Country collaborators: a network of 25 Mental Health experts EU Governmental Experts in Mental Health and Well-being: from Member States and other countries Advisory group: Dr Teresa Di Fiandra (Ministry of Health, Italy), Dr Matt Muijen (WHO Europe), Dr Bernd Puschner, (Ulm University, Germany), Professor Mirella Ruggeri (University of Verona) and Professor Norman Sartorius (former director WHO Division of Mental Health) Dr Lynne Friedli (Mental Health Promotion Specialist)

3 Context of the project Concerning levels of mental illness, unmet need for services, economic and social costs Prevention of mental illness and mental health promotion – an important focal point Growing evidence-based, rise of recovery- oriented and person-centred approaches Concerns about the impact of the economic crisis on mental health

4 EU mental health policy overview 12-point action plan – promotion of mental well-being – tackle stigma & discrimination – effective care in the community… WHO European Region, the EU and the Council of Europe approved a ‘Mental Health Declaration’ and Action Plan for Europe (WHO, 2005) Followed by the EC’s Green Paper ‘Improving the MH of the Population’ (2005) and the ‘European Pact for MH and Well- Being’ – 5 priority areas (2008 )

5 Recent developments EU Council Conclusions in June 2011 reaffirmed its support for the Green Paper (2005) and the EU Pact (2008) Council invited Member States and the Commission to set up a ‘Joint Action on MH and W-B’ under EU Public Health Programme Forthcoming WHO European MH Strategy – to bring together promotion, prevention and treatment

6 Main objectives Describe mental health systems, how currently organised (prevention and promotion) Describe mental health status of the population Describe the types of prevention of mental illness and promotion of mental health programmes implemented – policies and future directions Set out proposals to strengthen prevention and promotion initiatives Identify potential economic and social benefits of actions and investments in prevention and promotion

7 Methods 1. Searched for academic and grey literature since Using a structured template we collected information/ data on 29 countries 3. Surveyed MH prevention and promotion experts across participating countries 4. Searched EU and WHO databases for EU statistics

8 Data collected 1.Background information 2.Legislation and policy 3.Mental health services (access, usage, variations…) 4.Financing of MH services 5.Workforce 6.Prevalence and incidence 7.Protective and risk factors 8.Monitoring systems – available indicators 1.Prevention and promotion activities (schools, workplace and older people) 2.Delivery of prevention and promotion 3.Financial responsibility for prevention and promotion 4.Investments into mental health 5.Initiatives to strengthen mental health systems for prevention and promotion

9 Analyses Produced a set of 29 country profiles (validated by Governmental experts): Performed an overall descriptive analysis of country profiles with the supplementary data (Excel and SPSS) An analysis of the qualitative responses received from mental health promotion and prevention experts (Nvivo)

10 Some initial findings on … Mental health systems Prevention and promotion activities Mental health systems Prevention and promotion activities

11 Legislation and policies and prevention and promotion priorities Source: Country profiles

12 Types of psychiatric inpatient services Country Institutional care Psychiatric Hospitals Psychiatric services in general hospitals Day centers/ hospitals Austriayes Belgiumyes Bulgariayes Croatiayes Cyprusyes Czech Repyes Denmark?yes Estonia?yes Finlandyes Franceyes Germanyyes Greeceyes Hungaryyes Irelandyes Italyyes Latviayes Lithuaniayes Luxembourgyes Maltayes Netherlandsyes Norway??yes Polandyes Portugalyes Romaniayes Slovakia?yes Sloveniayes Spainyes Sweden ?yes UKyes Total no:

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14 Source: WHO European Hospital Morbidity Database 2012 ?

15 Types of community-based mental health services Source: Country profiles and WHO Atlas 2011

16 Variations and gaps in services ThemeCountry Lack of a range and distribution of community based services Bulgaria, Czech Republic, Croatia, Estonia, Malta, Latvia… Decentralised systems of healthcare creating problems with coordination and integration of services Austria, Denmark, Estonia, Finland, France, Germany, Italy, Netherlands, Spain

17 Source: Country profiles; WHO MH Atlas 2011 (figures for )

18 Combined prevention & promotion programs Prevention programs Promotion programsTotal Schools Workplace Older people General Total Number of prevention and promotion programs by setting/target group

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22 Responsibility for delivering prevention and promotion initiatives It’s everyone’s business and cannot be seen as the sole responsibility of specialist mental health agencies

23 Source: Eurostat 2012

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25 EU focus – impact of economic crisis on mental health - suicide Country with increases >10% % increase in number of suicides ( ) Sweden10.1% Lithuania11.0% The Netherlands12.7% Latvia13.9% Ireland15.1% Norway18.1% Slovakia19.0% Greece20.3% Poland22.6% Malta34.6% Cyprus63% Responses by MS: -Action plans -Increase MH spending -Easier access to MH services -Improving guidelines and training -Campaigns and helplines Source: Informal European Commission survey 2012

26 Joint Action on Mental Health and Well-being Due to commence in 2013 Lead by: Prof Jose-Miguel Caldas de Almeida, Nova University of Lisbon Key objective: To formulate policy recommendations - based on previous EU work - and to build a sustainable commitment to implement these Address issues relating to:  Strengthening partnerships between health and other sectors for promotion for employees and children and adolescents  Promote the evidence-based action on depression and suicide  Manage the transition from institutional to community mental health care  Promote social inclusion and tackle discrimination  Promote the integration of mental health in all policies The EuroPoPP-MH project will form a platform for the forthcoming Joint Action

27 Thank you


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