A joint initiative of the Open Society Foundations and Mental Health Europe, this recently-launched paper is the first European report of the state of deinstitutionalization and community-based care in the mental health field.
Across Europe, considerable efforts have been made to shift the balance of care from psychiatric hospitals to a varied provision of services in the community for people with severe mental health problems.
Deinstitutionalisation and the provision of high quality community-based services is one of the major challenges for mental health reforms. Despite far-reaching changes in some countries, institutions are still the dominant form of service provision in many countries in Europe. Nearly 1.2 million people live in residential settings for people with disabilities and facilities for people with mental health problems, many of them in large institutions or longstay hospitals.
In 2008 the United Nations Convention on the Rights of Persons with Disabilities (UN CRPD) made the unjustified segregation of persons with disabilities, including people with mental health problems, in congregate settings, a violation of human rights. By ratifying the Convention, states make a commitment to take effective and appropriate measures to facilitate the full inclusion and participation of people with disabilities in the community.
The report is divided into three parts. The first part provides an overview of the policy context of deinstitutionalisation and mental health reform in Europe as well as a brief review of the process of deinstitutionalisation and community-based care. The second part describes some of the recent trends in the transition to community-based care in Europe. This part draws on both recent research as well as information from Mental Health Europe member organisations and external experts (where member organisations were not available or could not provide the relevant information). Part three puts forward some conclusions and recommendations for European and national stakeholders. Individual country reports can be found in the Annex.