Patterns of service for the long-term mentally ill in Europe

Mental health services are organized and financed in very different ways across Europe; nevertheless there are a number of common trends and issues. In this paper we deal with some of those issues which influence the quality of services to those with long-term and severe mental health problems and disabilities. The most obvious trend has been the rundown of psychiatric beds particularly in the large mental hospitals and this in its turn has given rise to the problem of providing alternative services. Throughout Europe people are striving, with mixed success, to establish new services that are community orientated, provide reasonable levels of clinical care with some continuity and coordination, and ensure that the individuals served have appropriate accommodation and day-time activities. While there are some excellent services, there are even more services throughout Europe struggling to solve common problems. We have tried to draw some lessons from their efforts.