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Mental health services are required to involve family, carers, and service users in the delivery and development of mental health services but how this can be done in routine practice is challenging. One potential solution is to prescribe practice standards or clear expectation relating to family involvement. This paper describes practice standards introduced to an adult mental health service and a study that aimed to evaluate the impact of the standards on practice. Hospital and community files were audited before and after the introduction of standards for evidence of participation and surveys of carers and consumers relating to the quality of participation were undertaken. Increases in documented carer participation were found, particularly in relation to treatment or care planning. The expressed needs relating to participation varied in hospital and community settings. The majority of carers and service users were satisfied with their level of participation. The introduction of practice standards is an acceptable, inexpensive, and feasible way of improving the quality of family and carer participation, but gains may be modest. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to trace evolution of mental health system in Poland. Method: Available Polish literature and fundamental policy documents including mental health legislation are reviewed and major milestones in this evolution identified and then discussed against the background of political and social developments. Results: The mental health system evolved since the beginning of the 1970s from large hospitals towards community-based care. It was found that the changes were rather slow due to financial shortages and lack of clear demand from users. Recent transitions offer opportunities to increase impact of users and their families. On the other hand, however, introduction of health insurance system reduces prospects for well co-ordinated mental health policy and may lead to inequalities in access to services. Conclusion: It can be concluded that evolution of mental health services has been influenced by prevailing ideologies as much as by technical and professional considerations. [ABSTRACT FROM AUTHOR]

Objective: To describe mental health care needs and challenges across the WHO European region of 51 nations. Method: Based on morbidity and mortality data from HFA Statistical Database and Health21, the policy framework of WHO Europe, major trends in mental health care needs, psychiatric reform and mental health promotion are discussed. Results: There is a mortality crisis related to mental ill health in Eastern European populations of transition. Destigmatization is required to improve early intervention and humanization of services, and national mental health audits are needed to create the basis for national mental health planning, implementation and monitoring. There are both problems and advances in service restructuring, and comprehensive mental health promotion programmes, preventive and monitoring strategies are required. Conclusion: Partnerships between national and international organizations, especially WHO and the European Union, have to be strengthened to make progress on the way to integrated community mental health services. [ABSTRACT FROM AUTHOR]