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European Economic and Social Committee




European Year on Mental Health –
Better work, better quality of life


                Yves Brand,
    Policy Officer Mental Health Europe
Mental Health Europe (MHE)



Is an European non-governmental organisation committed to:

 •   The promotion of positive mental health and well-being;

 •   The prevention of mental distress;

 •   The improvement of care;

 •   Advocate for social inclusion;

 •   Protect the human rights of people with mental health problems, their
     families and carers.
MHE’s areas of work




•   Mental Health Promotion;

•   Prevention of Mental Health Problems;

•   Mental Health and Social Policy;

•   Mental Health, Human Rights and Disability.
Mental Health Matters



• Stigma is still very present;

• Persons with severe mental health problems are among the
  most excluded of all groups;

• Mental health is a vast area;

• Good mental health and well-being is a precondition for
  economic growth and development within the EU.
Mental Health and Poverty


• Social disadvantage and deprivation can trigger mental illness;

• Vicious circle: poverty increases the chances of mental health
  problems, while people with mental health problems are more likely to
  suffer from poverty;

• In Britain, research has shown that deprivation increase the risk of
  mental health problems;

• Research in Denmark indicates that the rate of suicide attempts in the
  group of people with a low income is higher than in the other groups;

• Evidence shows that depression occurs 1.5 to 2 times more often
  among low-income groups.
The De-Institutionalisation Process


Psychiatric hospitals as institutions – long-term stay on short-
                             stay beds

 •   19% of patients in “public specialized psychiatric hospitals” in France
     were hospitalized for 1 to 5 years, and 23% were hospitalized for over
     5 years;

 •   In Malta, 43% of patients stayed for 5 years or longer in psychiatric
     hospitals;

 •   In Bulgaria, approximately 30% of the patients lived in psychiatric
     hospitals for more than 3 years;

 •   Belgium had over 13.000 long-stay psychiatric beds in psychiatric
     hospitals.
The De-Institutionalisation Process



              Residential vs. community care

• In 19 European countries, support in institutional or long-term
  hospital settings still prevails over support in the community;

• In Croatia, around 4.000 people live in social care institutions
  while only 75 people use community-based organised
  housing;

• In Moldova, only 17 places are available in sheltered housing
  against 1.925 beds in long-stay psychiatric hospitals and
  1.688 places in social care institutions.
The De-Institutionalisation Process

         De-Institutionalisation strategies in Europe

• Only 16 European countries report current mental health strategies
  identifying De-Institutionalisation as an objective;

• Belgium started a major reform of mental health care in 2011. It aims to
  reduce the number of psychiatric beds by 10%;

• In Finland, the national plan for mental health and substance abuse
  foresees a 30% reduction of psychiatric hospital beds by 2015;

• Moldova has a national programme on mental health for 2012-2016
  aiming to reduce the number of places in psychiatric hospitals.
Implementation of the UN CRPD


                        Guardianship

• 25 European countries have guardianship regimes that
  implement plenary substitute decision-making;

• Forced admission into institutions or hospitals often happens
  along with the incapacitation of the person;

• Seven European countries are currently introducing or planning
  to introduce new, more evolved guardianship legislation.
Implementation of the UN CRPD


                     Involuntary treatment

• Involuntary admission and treatment is common in institutions
  and none of the EU countries prohibits it;

• Forced treatment is not only limited to hospitals and institutions;

• In France, a new law on involuntary treatment entered into force
  in 2011, which allows psychiatric care to be imposed outside of
  the hospital without consent .
European Year on Mental Health?


    The European Year on Mental Health would be beneficial:

• Because it affects every European citizen;

• To raise awareness on mental health issues;

• To support research and projects;

• To improve cooperation with other sectors;

•    Because it is a precondition for economic growth;

• To ensure concrete actions and outcomes of the CRPD.
For further information




                 Yves Brand
Mental Health Europe – Santé Mentale Europe
   Boulevard Clovis 7, B-1000, Brussels
            Tel. +32 2 280 04 68
            Fax +32 2 280 16 04
       E-mail: yves.brand@mhe-sme.org
              www.mhe-sme.org

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European Year on Mental Health – Better work, better quality of life

  • 1. European Economic and Social Committee European Year on Mental Health – Better work, better quality of life Yves Brand, Policy Officer Mental Health Europe
  • 2. Mental Health Europe (MHE) Is an European non-governmental organisation committed to: • The promotion of positive mental health and well-being; • The prevention of mental distress; • The improvement of care; • Advocate for social inclusion; • Protect the human rights of people with mental health problems, their families and carers.
  • 3. MHE’s areas of work • Mental Health Promotion; • Prevention of Mental Health Problems; • Mental Health and Social Policy; • Mental Health, Human Rights and Disability.
  • 4. Mental Health Matters • Stigma is still very present; • Persons with severe mental health problems are among the most excluded of all groups; • Mental health is a vast area; • Good mental health and well-being is a precondition for economic growth and development within the EU.
  • 5. Mental Health and Poverty • Social disadvantage and deprivation can trigger mental illness; • Vicious circle: poverty increases the chances of mental health problems, while people with mental health problems are more likely to suffer from poverty; • In Britain, research has shown that deprivation increase the risk of mental health problems; • Research in Denmark indicates that the rate of suicide attempts in the group of people with a low income is higher than in the other groups; • Evidence shows that depression occurs 1.5 to 2 times more often among low-income groups.
  • 6. The De-Institutionalisation Process Psychiatric hospitals as institutions – long-term stay on short- stay beds • 19% of patients in “public specialized psychiatric hospitals” in France were hospitalized for 1 to 5 years, and 23% were hospitalized for over 5 years; • In Malta, 43% of patients stayed for 5 years or longer in psychiatric hospitals; • In Bulgaria, approximately 30% of the patients lived in psychiatric hospitals for more than 3 years; • Belgium had over 13.000 long-stay psychiatric beds in psychiatric hospitals.
  • 7. The De-Institutionalisation Process Residential vs. community care • In 19 European countries, support in institutional or long-term hospital settings still prevails over support in the community; • In Croatia, around 4.000 people live in social care institutions while only 75 people use community-based organised housing; • In Moldova, only 17 places are available in sheltered housing against 1.925 beds in long-stay psychiatric hospitals and 1.688 places in social care institutions.
  • 8. The De-Institutionalisation Process De-Institutionalisation strategies in Europe • Only 16 European countries report current mental health strategies identifying De-Institutionalisation as an objective; • Belgium started a major reform of mental health care in 2011. It aims to reduce the number of psychiatric beds by 10%; • In Finland, the national plan for mental health and substance abuse foresees a 30% reduction of psychiatric hospital beds by 2015; • Moldova has a national programme on mental health for 2012-2016 aiming to reduce the number of places in psychiatric hospitals.
  • 9. Implementation of the UN CRPD Guardianship • 25 European countries have guardianship regimes that implement plenary substitute decision-making; • Forced admission into institutions or hospitals often happens along with the incapacitation of the person; • Seven European countries are currently introducing or planning to introduce new, more evolved guardianship legislation.
  • 10. Implementation of the UN CRPD Involuntary treatment • Involuntary admission and treatment is common in institutions and none of the EU countries prohibits it; • Forced treatment is not only limited to hospitals and institutions; • In France, a new law on involuntary treatment entered into force in 2011, which allows psychiatric care to be imposed outside of the hospital without consent .
  • 11. European Year on Mental Health? The European Year on Mental Health would be beneficial: • Because it affects every European citizen; • To raise awareness on mental health issues; • To support research and projects; • To improve cooperation with other sectors; • Because it is a precondition for economic growth; • To ensure concrete actions and outcomes of the CRPD.
  • 12. For further information Yves Brand Mental Health Europe – Santé Mentale Europe Boulevard Clovis 7, B-1000, Brussels Tel. +32 2 280 04 68 Fax +32 2 280 16 04 E-mail: yves.brand@mhe-sme.org www.mhe-sme.org