Conclusions of "Balancing Mental Health Promotion and Mental Health Care: A Joint World Health Organization / European Commission Meeting"

Brussels, 22-24 April 1999

"There is No Health Without Mental Health"

Mental health promotion and mental health care are complementary parts of the spectrum of necessary interventions to achieve good mental health outcomes for the population. Both approaches are essential elements of a comprehensive mental health strategy and a balance should be realized between them, stressing an intersectoral and a multi-disciplinary approach.
This balance will be based on historical, cultural, structural [including availability of health and social services] and ethical factors and conditions, and made at the appropriate level in each context. Actions should be based on the best available knowledge or evidence, and continuously evaluated.

The following nine key principles are central to mental health promotion and to mental health care: personal autonomy, sustainability, effectiveness, accessibility, comprehensiveness, equity, accountability, coordination, and efficiency.

Common goals and strategies to advance mental health promotion and care include:

Enhancing the visibility and improving recognition of the value of mental health, including at the political level
Increasing the interchange of knowledge and experience on mental health and the transmission of mental health information
Developing innovative and comprehensive, explicit mental health policies in consultation with all stakeholders, including users and carers, and respecting NGO and citizen contributions
Defining priorities regarding settings, target groups, and target conditions for activities and interventions in mental health promotion, primary, secondary and tertiary prevention and prevention of mortality (e.g. families, schools, workplaces, prisons, neighbourhoods, social services, primary and specialist care)
Development of primary care and specialized mental health services focusing on quality of care and the development of new non-stigmatizing and self-help approaches
Tackling inequity in health by giving special attention to the mental health promotion and care needs of marginalized, deprived and socially excluded groups, taking account of the serious social changes and upheavals currently occurring in many countries of the European region of the WHO, in particular in the newly emerging democracies.
Developing evidence-based guidelines for mental health promotion, primary and secondary care, including rehabilitation and community-based interventions
Developing a human resource strategy and emphasizing continuing professional development (life long learning and training)
Highlighting research and development, establishing mental health information and monitoring systems, including systems to assess the prevalence, cost and needs of mental health and outcomes of intervention
Development of mental health legislation based on human rights, emphasising freedom of choice, and the importance of appropriate confidentiality

The participants expressed the wish that European Commission and World Health Organization focus upon these priority issues in the framework of their respective programmes, and as a basis to explore avenues for joint actions. It is also expected that all European countries will pay adequate attention to the priority issues identified by the meeting. The priorities will be discussed further in the European Conference on Promotion of Mental Health and Social Inclusion, which will be organised by the Finnish Presidency of the European Union, to take place in Tampere, Finland in October 1999, and taken into account in context of the WHO initiative "Nations for Mental Health".