mental health in europe: a long road ahead
TRANSCRIPT
SPECIAL ISSUE - EDITORIAL
Giovanni de Girolamo Æ Giovanni Neri
Mental health in Europe: a long road ahead
Published online: 20 February 2007
Mental health care in Europe underwent profoundchanges in the last 30 years. Almost everywhere in thewestern European countries hospital-based care hasbeen downsized and a concurrent increase in variousforms of community care has taken place. Despite thisgeneral trend, many cross-country differences arevisible: they concern the extent of the reduction insize and importance of mental hospitals, the settingup of community-based services and the parallelchange in staff training, as professional resources areultimately the crucial factor for granting a differentmodel of treatment and care.
In this perspective a major problem in the oftenhot discussions among professionals, and also inthe very delivery of mental health care, is due tothe scarce awareness of a key point spelled out byThornicroft (2000): community care ‘is a servicedelivery vehicle. It can allow treatment to be offeredto a patient, but is not the treatment itself. Thisdistinction is important, as the actual ingredients oftreatment have been insufficiently emphasized’(Thornicroft 2000). A full understanding of thiscentral point can avoid many of the practical mis-takes and of the speculative expectations in therecent past.
This special issue of the European Archives of Psy-chiatry and Neurological Science includes four contri-butions aimed at providing a clear and largelycomparable picture of the current state of mental healthcare in four main European countries: France, Ger-many, Italy and the U.K.
As we noted above, these contributions show that,while the tendency for the homogenization of dif-ferent systems of care in Europe, as well as of mostaspects of societal sectors and values, is in place, along road remains to be made in order to achieve areal homogeneity between mental health services indifferent countries composing the European mosaic.
Most of these differences and many of the serviceshortcomings have to do with the gap between theacquisition of knowledge and its application: the re-sults of most research studies are not opportunelytransformed into improved patient care and morecost/effective organization of services. Indeed, newknowledge—if applied—is frequently implementedinadequately, inappropriately, and inconsistently.
It is our hope that the contributions included inthis issue of the EAPNS will help clinicians,researchers and policy planners cope with these dif-ficult challenges of the future.
Reference
1. Thornicroft G (2000) Testing and retesting assertive communitytreatment. Psychiatr Serv 51, 703
G. de Girolamo (&)Department of Mental HealthAUSL di BolognaViale Pepoli, 540123 Bologna, ItalyTel.: +39-051/6584204Fax: +39-051/6492322E-Mail: [email protected]
G. NeriDepartment of Mental HealthAUSL di ModenaVia Emilia Ovest 34841100 Modena, ItalyTel.: +39-059/8896686Fax: +39-059/8896683E-Mail: [email protected]
Eur Arch Psychiatry Clin Neurosci (2007) 257:63 DOI 10.1007/s00406-006-0692-0E
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